April 11, 2019
Medications and devices can be used to manage withdrawal symptoms, prevent relapse, and treat co-occurring conditions.
Withdrawal. Medications and devices can help suppress withdrawal symptoms during detoxification. Detoxification is not in itself “treatment,” but only the first step in the process. Patients who do not receive any further treatment after detoxification usually resume their drug use.
Relapse prevention. Patients can use medications to help re-establish normal brain function and decrease cravings. Medications are available for treatment of opioid (heroin, prescription pain relievers), and alcohol addiction. People who use more than one drug, which is very common, need treatment for all of the substances they use.
Opioids: Buprenorphine (Suboxone, Subutex, Probuphine , Sublocade) are used to treat opioid addiction. Acting on the same targets in the brain as heroin and morphine, buprenorphine suppresses withdrawal symptoms and relieves cravings. All medications help patients reduce drug seeking and related criminal behavior and help them become more open to behavioral treatments.
Alcohol: Three medications have been FDA-approved for treating alcohol addiction. The three approved medications are as follows:
- Naltrexone blocks opioid receptors that are involved in the rewarding effects of drinking and in the craving for alcohol. It reduces relapse to heavy drinking and is highly effective in some patients. Genetic differences may affect how well the drug works in certain patients.
- Acamprosate (Campral) may reduce symptoms of long-lasting withdrawal, such as insomnia, anxiety, restlessness, and dysphoria (generally feeling unwell or unhappy). It may be more effective in patients with severe addiction.
- Disulfiram (Antabuse) interferes with the breakdown of alcohol. Acetaldehyde builds up in the body, leading to unpleasant reactions that include flushing (warmth and redness in the face), nausea, and irregular heartbeat if the patient drinks alcohol. Compliance (taking the drug as prescribed) can be a problem, but it may help patients who are highly motivated to quit drinking.
Co-occuring conditions: Other medications are available to treat possible mental health conditions, such as ADHD, depression or anxiety, that may be contributing to the person’s addiction.