Addiction affects the mind, body and spirit. It alters the brain's chemistry and function, causes various physical health issues, and profoundly affects one’s sense of purpose, values, and connection to others. That’s why an effective drug addiction treatment center integrates interventions that address each of these dimensions. Medications, along with behavioral therapy and counseling, provide a whole-patient approach to drug addiction treatment.
The blend of therapy and medication can be a beneficial treatment for drug addicts and even help sustain recovery for some. Medication treatment for drug addiction is an evidence-based approach that is strongly recommended by the NIH, CDC, APA and other agencies dedicated to public health care.
Medications are integral to the treatment of substance use disorders. They offer effective solutions for managing withdrawal symptoms, reducing cravings, and preventing relapse and opioid overdose deaths. Let's break down how medications specifically address each of these challenges:
When someone decides to quit substances, their body often reacts negatively. They may experience withdrawal symptoms like nausea, anxiety, tremors, etc., that make the entire process incredibly challenging. In some cases, the symptoms are so intense that they may make a person abandon their efforts to quit and return to substances. Medications can alleviate these withdrawal symptoms and make the detox process safer and more manageable.
Cravings are intense urges or desires to use drugs or alcohol again, even after deciding to quit. They arise unexpectedly, triggered by factors like stress, social situations, or even certain smells or memories associated with drug or alcohol use. Medications help dial down the intensity of these cravings, giving one a better chance of sticking to their decision to stay sober. Some medications are designed to block the effects of drugs or alcohol on the brain's reward system, so they’re less appealing. Others may modulate neurotransmitter levels in the brain, helping to restore balance and reduce the frequency and intensity of cravings.
Relapse is a normal part of recovery. About 40 to 60% of people relapse within 30 days of leaving an intense addiction treatment. However, medication can help lower this risk by stabilizing brain chemistry and reducing the rewarding effects of drugs or alcohol. Besides, medications have been shown to ease withdrawal symptoms and dial down the intensity of cravings, both of which are triggers for relapse.
Medications can also serve as a crucial tool in preventing overdose deaths. People with SUD are at a heightened risk of accidental overdose, especially during periods of relapse or when attempting to quit on their own. Medications like Naloxone have been credited with preventing over 26,500 opioid overdose deaths. This underscores the life-saving potential of naloxone in emergency overdose situations.
Medications are a common part of substance abuse treatment. They help fight against drug and alcohol addiction. Some, like Naltrexone, block the brain’s opioid receptors, which in turn prevent the “high” or reduce the feelings of intense cravings. Others like naloxone and methadone inhibit the brain’s opioid receptors from activating. With that said, let’s explore some examples of medications used in addiction treatment:
People with AUD drink regularly and in large quantities. Over time, they develop a physical dependency and cannot function well without alcohol. At this point, any attempts to quit can result in a range of withdrawal symptoms, some of which can be life-threatening. So doctors may prescribe medications to help change how the body reacts to the alcohol or manage the long-term effects. The FDA has approved three medications for AUD:
Disulfiram is one of the three FDA-approved drugs for alcohol addiction treatment. It’s a second-line option after naltrexone and acamprosate in patients with sufficient clinical supervision. Disulfiram inhibits the activity of aldehyde dehydrogenase, an enzyme responsible for metabolizing alcohol into acetic acid. As a result, a person experiences nausea, vomiting, flushing, palpitations, and headache when they consume alcohol.
Unlike disulfiram, acamprosate does not directly interfere with the metabolism of alcohol. Instead, it modulates neurotransmitter activity in the brain, particularly those involved in the brain's reward system. Acamprosate helps to reduce cravings and alleviate withdrawal symptoms. This makes it easier for people to maintain sobriety during the early stages of recovery.
Naltrexone is an FDA-approved opioid antagonist used to treat opioid and alcohol use disorders. It blocks the effects of these substances in the brain, specifically targeting opioid receptors. When someone consumes alcohol or opioids, it triggers the release of endorphins. However, naltrexone steps in to disrupt this process. This, in turn, prevents alcohol from exerting its usual rewarding effects, making drinking less appealing.
Overdose deaths involving opioids have drastically increased over the last ten years to 80,411 in 2021. Besides overdose deaths, the opioid epidemic has increased the cases of babies born with OUD because their mothers abused opioids during pregnancy. It has also led to the spread of infectious diseases like hepatitis C and HIV. Effective medications like methadone, naltrexone and buprenorphine are essential components of treating opioid use disorder (OUD) and reducing the associated harms.
Methadone is a long-acting opioid agonist that helps to relieve withdrawal symptoms and reduce cravings in people with opioid use disorder. It binds to the same receptors in the brain as opioids but in a less potent manner, thereby reducing the euphoric effects of opioid use and minimizing withdrawal symptoms.
Buprenorphine is a partial opioid agonist that also binds to opioid receptors in the brain but with a lower level of activation compared to full agonists like heroin or oxycodone. This helps to alleviate cravings and withdrawal symptoms without producing the same intense euphoria, making it a safer alternative for long-term maintenance therapy.
Naloxone is a life-saving medication that swiftly reverses overdose from opioids like fentanyl, heroin and prescription opioids. It’s small to carry and easy to use. When administered on time, Naloxone blocks the opioid receptors in the brain and restores normal breathing and consciousness. It's often used in emergencies to save lives and is part of harm reduction strategies.
Drug addiction treatment centers also offer the following treatments for drug addicts:
Varenicline serves as a partial nicotine receptor agonist. It reduces nicotine cravings and withdrawal symptoms by targeting nicotine receptors in the brain. It's commonly used as a smoking cessation aid to help people gradually quit smoking alongside counseling and education.
NRT provides nicotine through gum, patches, lozenges, or inhalers – but without the other harmful chemicals in tobacco. This medication helps relieve some withdrawal symptoms and cravings while gradually weaning individuals off nicotine. It's a key component of smoking cessation programs, supporting people in breaking the physical addiction to nicotine.
Modafinil is a wakefulness-promoting agent that helps combat excessive daytime sleepiness associated with conditions like obstructive sleep apnea, narcolepsy, and shift work sleep disorder. It enhances cognitive function and alertness, making it beneficial for those recovering from substance abuse who may experience sleep disturbances or cognitive deficits.
Baclofen is mainly used as a muscle relaxant but has shown promise in reducing alcohol cravings and promoting abstinence in alcohol use disorder treatment. It modulates neurotransmitter activity in the brain, potentially reducing the reinforcing effects of alcohol and decreasing the desire to drink.
If you're struggling with addiction, medication can help you quit while you take it. These medications are safe and effective when used as directed, but they are only one tool of drug addiction treatment. Medications are often used alongside evidence-based modalities like counseling and behavioral therapy to help treat all aspects of addiction.
Addiction is a complex disease that often involves physical, psychological, and social factors. Medications address the physiological aspects by targeting brain receptors involved in addiction, but counseling and behavioral therapies address the underlying emotional and behavioral patterns that contribute to substance abuse.
About 50% of people struggling with addiction also have co-occurring mental health issues like depression, anxiety, or PTSD. Counseling and therapy provide a platform to address these underlying mental health issues in tandem with addiction treatment. Medications alone may not fully address the complexities of co-occurring conditions, underscoring the importance of a holistic treatment approach.
Counseling and therapy offer opportunities for one to build supportive relationships, both with their therapists and with peers in group therapy or support groups like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). These support networks provide encouragement, accountability, and a sense of belonging, which are vital for long-term recovery.
While medications can be immensely helpful in the initial stages of recovery, the ultimate goal is sustained sobriety and overall well-being. Counseling and behavioral therapy provide the tools and strategies necessary for one to maintain their recovery over the long term, even after medications are no longer needed.
Medications are crucial in addiction treatment. However, they are most effective when integrated into a comprehensive treatment plan that includes counseling, therapy, and support networks. The holistic approach addresses the multifaceted nature of addiction and increases the likelihood of successful, long-term recovery.
