Medications for Addiction

Methadone

A synthetic opioid medication, methadone was first used for pain control in the United States in 1947. In 1964, methadone was introduced as a form of maintenance therapy for heroin addicts. This drug is still used to manage chronic pain, but it has also become one of the most widely prescribed medications for opioid dependence. When taken under medical supervision, methadone can be a highly effective way to cope with the effects of opiate withdrawal and to stay clean and sober after rehab.

Methadone reduces withdrawal symptoms and cravings for opiates like heroin, morphine, codeine and oxycodone by binding with the opioid receptors in the brain that affect sensations of pain and pleasure. Although methadone produces pain relief and a sense of well-being, it does not create the euphoric high of elicit drugs when it’s taken at the recommended doses.

According to the Mount Sinai Journal of Medicine, setting the parameters for methadone therapy is an individualized process. The dose that works for one patient may be insufficient for another. When prescribed for opioid dependence, methadone is administered at facilities that are authorized for this purpose, so access to the drug is limited.

As with any other opioid drug, there is a potential for addiction and dependence when you take methadone, and the side effects of methadone abuse can include overdose and death. But when it’s taken correctly, methadone can enable the recovering addict to hold down a job, pursue daily activities and build a more stable, secure life.

Naltrexone

Naltrexone, sold under the brand names ReVia, Vivitrol and Depade, was approved by the U.S. Food and Drug Administration for use in the treatment of opioid dependence in 1984. Naltrexone acts on the opioid receptors in the brain to block the effects of opiate drugs like heroin, codeine or morphine. When you take naltrexone as directed, you won’t get the same euphoric effects out of taking opioid drugs. Naltrexone acts in a similar way to block the pleasurable effects of alcohol. In 2004, the drug was approved by the FDA for use in the treatment of alcohol dependence.

Naltrexone can be taken orally as a tablet or as an extended-release monthly injection. Outside of the United States, a naltrexone implant is available. Oral naltrexone is taken in tablet form every day or once every two to three days. Depending on the guidelines of your rehab program, you may be required to take naltrexone at a clinic, or you may be allowed to take the drug at home. Taking naltrexone orally requires a lot of motivation; when the drug is not effective, it’s often because the patient didn’t comply with treatment.

Injectable naltrexone is administered once every few weeks at a doctor’s office or clinic. Because you only have to get this intramuscular shot once a month, compliance can be a lot easier. However, some users experience irritation, infection or tissue death at the injection site. Safe administration of the drug should reduce the risk of these complications.

Unlike methadone, naltrexone is not addictive, and discontinuing the drug does not produce withdrawal effects, according to the Substance Abuse and Mental Health Administration. However, naltrexone doesn’t reduce the symptoms of drug or alcohol withdrawal. Taking naltrexone may help you with your recovery goals by minimizing your cravings for alcohol or drugs. If you have a relapse while you’re on naltrexone, it may be easier for you to get back with your program after you slip.

Buprenorphine

Buprenorphine is one of the most recent pharmacological weapons in the battle against drug addiction. Originally introduced in the United States as a narcotic analgesic in 1985, the drug was approved by the FDA for the treatment of opioid dependence in 2002. This medication belongs to a class of drugs called opiate partial agonists-antagonists. Like methadone, buprenorphine helps the user maintain abstinence by replicating the effects of more powerful opiates at a lower level. When taken appropriately, buprenorphine can reduce the craving for drugs and help you avoid the withdrawal symptoms that make recovery so difficult.

When it’s misused, buprenorphine can cause dependence, addiction and overdose. To lower the risk of abuse, this drug has been combined with naloxone in a medication called Suboxone. Naloxone counteracts the effects of buprenorphine, making it more difficult to overdose on the drug. However, Suboxone has the potential to cause a fatal overdose if it’s taken incorrectly, especially if it’s injected with a tranquilizer.

Expert Opinion in Pharmacotherapy warns that while the combination of buprenorphine and naloxone can be an effective tool for treating opioid dependence, the presence of naloxone doesn’t eliminate the potential for abuse. Doctors must still monitor the administration of Suboxone carefully to ensure that the patient receives the positive effects of the drug without becoming dependent or addicted. Unlike methadone, buprenorphine can be prescribed by any certified physician, which makes access to the drug much easier.