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Detox - Addiction Treatment Medications

Destin Recovery Addiction Treatment Center

Treating Drug and Alcohol Addiction Today

Detox MedicationsAlso known as Medication-Assisted Treatment (MAT), pharmacotherapy is form of addiction treatment that integrates prescription medicines along with traditional treatment modalities such as individual or group counseling.

The American Society of Addiction Medicine (ASAM) recognizes addiction as a brain-based disease and supports access to all evidence-based treatments, including pharmacologic interventions. In a public policy statement, ASAM asserts that pharmacologic intervention should be considered a primary strategy in the treatment of addiction.

Here are some of the detox medications currently approved, used or under investigation for alcohol or drug dependence.

Detox Medications for Drug and Alcohol

Here are some of the detox medications currently approved, used or under investigation for alcohol or drug dependence.

Disulfiram

Disulfiram, marketed as Antabuse, is a familiar drug used to treat alcoholism. The drug, which has been available in the United States since 1951, alters the way alcohol is metabolized by the body. It is a form of aversion therapy, meaning that users who drink even a small amount of alcohol will experience unpleasant symptoms such as palpitations, nausea, vomiting and headaches. Studies indicate disulfiram is most effective when it is used in combination with counseling or other therapeutic interventions. Antabuse is not used often today. Even the significant negative symptoms that can occur do not lead to more than a brief period of sobriety. This is consistent with the fact that alcohol is a symptom of the disease of addiction, and treating a symptom alone does not help the underlying need to change a feeling or get numb that more accurately describes alcoholism or addiction.

Acamprosate Calcium (Campral)

Acamprosate calcium is FDA-approved for the maintenance of abstinence from alcohol in patients with alcohol dependence who are abstinent at treatment initiation. Acamprosate reduces the physical and emotional discomfort (e.g. sweating, anxiety, sleep disturbances) many people feel in the weeks and months after they’ve stopped drinking which makes it easier for them not to drink after the immediate withdrawal period. Large US studies have suggested that placebo is as effective as campral for craving, but placebo effect can be powerful.

Naltrexone Extended Release (Vivitrol)

Naltrexone earned FDA approval as a treatment for alcohol dependence in 1995. This medication makes drinking less pleasurable by decreasing feelings of intoxication. This is mediated through blocking of opiate receptors which are responsible for the positive feelings sought with alcohol that can lead to abuse and dependence. Clinical trials suggest that even if used, alcohol may not be as pleasurable.   Initially available only in pill form, the medication was prescribed for use every one to three days. Daily dosing was not effective very long though. If one wanted to drink, they simply skipped the daily dose of Naltrexone. For this reason an extended release form was created that has been more effective.

Vivitrol is the extended release form of naltrexone. It was approved for use as a treatment for opioid dependence in 2010 in addition to the use for alcohol. The medicine is given via intramuscular injection once every month. Because Vivitrol blocks the way opiates work in the brain, it removes the pleasure associated with using opiates, thus decreasing the incentive for users of heroin and other opiates. Studies indicate that use of Vivitrol improves treatment retention and may prevent relapse. It may also decrease symptoms of post-acute withdrawal, the symptoms that can occur for several weeks after stopping opiates. Like other pharmacologic drugs, it is most effective when used with counseling and other treatment.

Users must undergo detox before beginning naltrexone; otherwise, the withdrawal symptoms are extremely unpleasant. Use of any form of drugs or alcohol is less pleasurable when naltrexone is in the body.

Methadone

Methadone is a synthetic narcotic used to treat people who are addicted to heroin and other opioid drugs. It is dispensed primarily in pill, liquid and powder form and lasts 24 to 36 hours. It is usually provided in clinics so the dosage can be carefully controlled and adjusted as needed.

Methadone is considered a form of maintenance because it doesn’t “cure” addiction, but acts as a substitute that prevents addicts from experiencing serious withdrawal symptoms. Although use of methadone to treat addiction remains controversial, studies indicate that it works to reduce some risk of medical complications and overdose by drugs purchased on the street, and decrease transmission of HIV or hepatitis caused by sharing of needles. If methadone is used, it is best used as a bridge in a continuum of long term recovery efforts. Long term methadone does not allow restoration of the physical and emotional changes that opiates produce.

Destin Recovery is not a methadone clinic. Destin recovery treats people unable to get off methadone.

Buprenophine

The FDA approved buprenorphine for use in treatment of opioid addiction in 2002. Buprenophine is sometimes combined with naloxone, a drug that is particularly helpful for addicts who use opiates intravenously. The combination form is marketed as Suboxone or Zubsolve. A newer form for buccal administration (Bunavail) or a long acting form deposited under the skin are in development.

Buprenorphine has properties that make it attractive for treatment of opiate addiction. It is a “partial opiate” meaning it only partially turns activates opiate receptors. This allows someone to wean gradually without withdrawal symptoms. It has a ceiling effect which makes it more difficult to have an overdose. Overall thinking and functioning are less effected allowing a restoration of normal life routines compared to full opiates. It is being used as long term maintenance by some, but this too prevents a full restoration of brain chemistry necessary to allow a person to maximize their potential in this life.

Although not FDA approved for this, Buprenorphine can also provide pain relief in chronic pain situations without as much of the inevitable tolerance created by full opiate pain relievers. Incidentally, no opiates are FDA approved for chronic pain relief as they have never been shown to be effective for chronic pain despite widespread use for this. Full opiates have been shown to make chronic pain worse (hyperalgesia).

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