Medication Assisted Treatment or Therapy is the use of medications, in combination with counseling and behavioral therapies, to provide a whole-patient approach to the treatment of substance use disorders, usually related to opioid and heroin addiction.
In a recent Huffington Post article featuring President Barack Obama discussing the current heroin and opioid addiction problem, the President said of medication assisted treatment, “Only a small minority of Americans who might benefit from the best treatment are getting it.”
Pharmacotherapy is a new advancement in addiction treatment science that is offering promising results in treating drug and alcohol addiction.
While the practice of pharmacotherapy is not new, the understanding of brain chemistry and how behavior is affected by chemical stimuli continues to advance.
Many scientists and treatment specialists are optimistic that pharmacotherapy can be an effective treatment option, especially when used in a larger, more comprehensive treatment programs.
The practice of Pharmacotherapy is defined as the treatment of disease through the administration of highly advanced prescription drugs. Pharmacotherapy can be used to treat a wide variety of physical and mental health illnesses including schizophrenia, panic disorders, Alzheimer’s disease, as well as many different infectious diseases.
However, in recent years scientists have discovered that pharmacotherapy can be very effective at treating drug and alcohol addiction, while helping patients to reduce cravings during early recovery periods. This form of pharmacotherapy is often known as Medication Assisted Treatment (MAT) and refers to any treatment for a substance abuse disorder that includes pharmacological intervention as part of a larger comprehensive substance abuse treatment plan.
Treatment specialists have a number of different drugs available to them that can be very effective at reducing cravings and treating various substance abuse disorders. These can include Naltrexone, Acamprosate, and Campral, which are all powerful and effective drugs for treating alcohol dependence and withdrawal. Naltrexone for instance, is an antagonist that blocks receptors believed to interact with alcohol and pleasure centers in the brain.
Acamprosate, on the other hand, interacts with chemicals in the brain that are associated with a sense of anxiety or panic, especially about the absence of alcohol in the body and alcohol withdrawal.
Pharmacotherapy is also very effective at treating opiate disorders and helping to prevent relapse after opiate detox. Medications used for treating opioid dependence include Methadone, Buprenorphine, also known as Suboxone, Subutex, and Naltrexone.
Methadone and Suboxone both work to help alleviate painful symptoms of opiate withdrawal and work as an opiate substitute in the brain. While methadone has been around for a much longer duration, many treatment experts view Suboxone as a safer and less addictive alternative.
Pharmacotherapy is used in drug treatment settings in a number of different ways. It may be used to help relieve cravings and withdrawal symptoms of alcohol or opiate related addictions, or may be used to help prevent relapse over the long-term.
Certain pharmacotherapy medications can be helpful in reducing cravings while the patient undergoes a more comprehensive treatment program, while some are used after the treatment program is over to ensure the patient doesn’t relapse down the road.
Doctors using pharmacotherapy methods rely heavily on producing tightly controlled drug treatments, ensuring that dosages are safe and consistent. However, it is important to remember that these powerful and effective drug treatment medications are best used in conjunction with a comprehensive behavioral and cognitive treatment program.
Before attempting any of these pharmacotherapy treatment options it is important to talk to your doctor about any current and past medical issues you may have, as well as any medication you’re currently taking. This is because many of these medications can cause interactions with other prescription drugs which may cause adverse health effects.
For instance, anyone who suffers from kidney problems should not take the drug Acamprostate, while Naltrexone can be hazardous to anyone with prior liver damage. Because each individual can react differently to these medications, it is important to contact your doctor or treatment specialist immediately if you are having any adverse health conditions.
Alcohol Use Disorder, commonly referred to as alcoholism, can be difficult to treat because it affects a number of different areas of the brain and produces strong cravings. While many people manage to stay sober for life, others relapse due to the intense cravings.
Because alcohol is legal and socially accepted, it is challenging to steer clear of the numerous triggers that often prompt a relapse. Cognitive therapies can aid as coping mechanisms, but some people need additional help through the use of medication to accompany treatment.
Medication is effective along with proven therapies such as CBT, MET, Family and Psycho / Social Support like self help groups.
Antabuse is the trade name for Disulfiram, which is a drug that causes a negative reaction to drinking alcohol.
For those taking Antabuse, drinking even small amounts of alcohol can cause them to experience unpleasant feelings or become physically sick. Many of the symptoms mimic a strong hangover, such as nausea, vomiting, blurred vision, or headaches. It is often used when other medications or treatment forms are unsuccessful.
Antabuse is usually only effective if the patient wants to take it as a deterrent or aversive medication to stay away from alcohol.
Acamprosate goes by the trade name Campral, and is an effective medication treatment for alcohol addiction when used in conjunction with other cognitive therapies and recovery counseling.
It should not be used by people with kidney problems, and because it can cause adverse effects, it should only be used under the direction of a doctor with experience prescribing it.
Naltrexone Oral (Revia)
The oral version of Naltrexone (trade name Revia) is a prescription tablet taken by mouth and is best used together with recovery treatment.
It works by curbing the pleasurable feeling of drinking alcohol instead of reducing cravings. Naltrexone should only be used after completing detox and not by persons with liver problems.
Naltrexone Injection (Vivitrol)
Naltrexone is also available as a once a month Vivitrol injection that is much easier to manage than the daily oral tablet for alcohol dependence. It is non-addictive, non-narcotic medication that works well when used at the same time as alcohol treatment or counseling.
In addition to the oral and injectable versions, a Naltrexone Implant is available as a minor outpatient procedure that lasts for 3 months and can be routinely implanted in a doctor’s office. It has been shown to be effective in reducing relapse when used in tandem with an alcohol addiction program.
Topamax is an FDA approved anti-epileptic medication for treating epilepsy, but is also used successfully as an off-label treatment for alcohol use disorder for those with a moderate to severe alcohol addiction. It works by reducing cravings and decreasing the pleasure derived from drinking alcohol.
Neurontin is the trade name for Gabapentin, another anti-epileptic medication that is FDA approved for seizures and restless leg syndrome, but used off-label for treating alcohol use disorder and alcoholism. Studies have shown that those who were given multiple doses daily had a reduction in cravings and alcohol use, while reporting better mood and sleep patterns.
SSRIs (Prozac, Zoloft)
Prozac, Zoloft, and other SSRIs have shown to be effective for treating alcohol use disorder, but only for those with late onset symptoms, usually after the age of 40 years old or older.
As shown by the examples above, there are a wide variety of medications that can be used to treat alcohol use disorders. Each one works differently and should be prescribed by an experienced doctor trained in addiction medicine that understands the pros and cons for each one.
Baclofen (Lioresal) is approved for treating muscle spasms but is sometimes used off-label for reducing alcohol cravings and withdrawal.
Heroin and opioid addiction has become an epidemic in the United States, with overdose deaths rivaling that of automobile accidents and other diseases. These drugs are so addictive that it sometimes makes standard treatment alone difficult to be successful.
Fortunately, medications are available to aid in recovery by reducing cravings or blocking the effects of the drugs on the brain.
Below are various medical options that have shown to be successful for treating heroin and opioid addiction, detox, and withdrawal.
(The following 3 Naltrexone preparations are also used for alcohol dependence)
Naltrexone – Oral
Naltrexone is an opiate antagonist that is taken orally once a day and is best when used during and after a drug treatment program. It should not be used while taking any opiate medication and should only be started at least seven days after the last use of an opiate, or 14 days after last using methadone.
Naltrexone Injection (Vivitrol)
Naltrexone is an opioid antagonist that can be used as a once a month Vivitrol injection that is non-addictive and blocks the effects of opioids. It can be started after completing detox to prevent relapse and is much more convenient than taking the oral version daily.
The Naltrexone Implant is not FDA approved for addiction treatment but is used off-label. It is the most convenient version to take because it is good for 3 months and there is no need to worry about missing a dose. It is implanted in a doctor’s office as an outpatient procedure.
Like the three Naltrexone options mentioned above, the following medications are available in oral, injection, or implant treatments as heroin or opioid addiction maintenance therapies.
Buprenorphine (Subutex, Suboxone, Zubsolv)
Buprenorphine is a synthetic partial agonist that does not produce a high and acts as an opioid blocker that can be taken orally (film or tablet) for detoxification, or used as a maintenance therapy during treatment. It is available in different formulations commonly known as Subutex, Suboxone, or Zubsolv.
Sublocade is a once a month, extended release buprenorphine injection that offers the same properties as the oral versions except it is more convenient than taking daily as it reduces the chances of missing a dose.
Probuphine is a buprenorphine implant that lasts up to 6 months and has proven to be a successful opioid maintenance treatment for those who have shown stability during or after a recovery program. The implant is a quick and easy outpatient procedure that can be done in a doctor’s office
In addition to medications, there is also a device that can be used during heroin and opioid detox instead of medication to decrease withdrawal symptoms.
The NSS-2 Bridge is one of the newest FDA approved technologies to alleviate many of the uncomfortable and painful symptoms of opioid withdrawal during detox. The device is approximately the size of a hearing aid and is fitted behind the ear and delivers electrical pulses to target the amygdala. The effects can be felt in as little as 30 minutes after activation.
As shown above, there are many medications that are successful for treating alcohol, heroin, and opioid addiction.
For other substances, there aren’t any medications that have been FDA approved for overcoming addiction, although some are used off-label to help with the symptoms or side effects for certain individuals and addictions.
Marijuana isn’t a highly addictive substance but it can cause uncomfortable side effects for long-term users who try to quit. Withdrawal symptoms can include depression, anxiety, anger, moodiness, headaches, lethargy, and trouble sleeping. These symptoms are not life threatening and usually pass after a week or two.
Neurontin (Gabapentin) is FDA approved as an anti-epileptic medication for epilepsy, nerve pain from shingles, and restless leg syndrome. It is sometimes used off-label to help with marijuana withdrawal symptoms.
NAC (N-Acetyl Cysteine) is an over-the-counter antioxidant supplement that is converted to an amino acid in the body called cysteine. It is effective for treating a wide variety of health issues and has shown to be effective for reducing marijuana cravings, and decreases the urge to use marijuana for those who are trying to quit.
There aren’t many medications used to treatment cocaine or meth addiction or withdrawal and the ones that are available are not very effective.
The most common medication is Provigil (Modafinil), which is used to treat narcolepsy and other sleep disorders, like daytime sleepiness for shift workers. It acts as a stimulant to offset the effects the user is not getting after they stop using cocaine, meth, or other amphetamines.
Inspire Malibu provides medication assisted treatment for drug and alcohol addiction at our facilities in Agoura Hills and Malibu, California and serve the surrounding areas, including Thousand Oaks, Woodland Hills, Calabasas, Westlake Village, Sherman Oaks, Studio City, Tarzana, Encino, Oxnard, Ventura, and Santa Barbara.
For More Information about Medication Assisted Treatment Call Us at 800-444-1838.