Opioid Addiction Treatment

OPIOID ADDICTION TREATMENT

Opiates are a subset of opioids that are naturally occurring and come from the opium poppy plant. Most opiates are considered to be scheduled narcotics by the United States because of their highly addictive properties. They are usually prescribed as pain relievers, cough suppressants, or are sometimes used as anesthetic for some surgical procedures for instance, mouth or nose surgery. There are three categories of opiate medications.

  • Naturally occurring: – drugs made from opium such as morphine.
  • Synthetic: – manufactured drugs which include Demerol and methadone.
  • Semi-Synthetic:- these opiates come from synthesis natural compounds (plants) and other starting materials. These include but are not limited to heroin and morphine.

Opiate addiction is not a moral or mental weakness. It’s a chronic medical condition that results from changes in the brain function in susceptible people. Once narcotic addiction has developed, escaping the cycle of detox and relapse is typically a long term process. Opioid withdrawal is difficult to endure, and is a major reason for relapse and continued prescription drug abuse. Medications are used to prevent symptoms of opioid withdrawal during detox, easing the person out of physical dependence.

  1. Methadone

Methadone is a long-acting opioid drug. It activates the same opioid receptors as other narcotics, effectively eliminating withdrawal symptoms. Providing the correct dose of methadone prevents opioid withdrawal symptoms and eases drug craving but it does not provide the euphoria. The dose can be slowly tapered off, freeing the person from physical dependence without withdrawal symptoms. Methadone is the most effective known treatment for narcotic addiction.

Methadone is a long-acting synthetic opioid antagonist medication that can prevent withdrawal symptoms and reduce craving in opioid addicted individuals. It has a long history of use in treatment of opioid dependence in adults and it is usually taken orally. Methadone maintenance treatment is available in all but three States through specialized licensed opioid treatment programs or methadone maintenance programs.

  1. Buprenorphine

This is a synthetic opioid medication that acts as a partial agonist at opioid receptors. It does not produce the euphoria and sedation caused by heroin or other opioids but is able to reduce or eliminate withdrawal symptoms associated with opioid dependence and carries a low risk of overdose.

Buprenorphine is currently available in two formulations that are taken sublingually: (1) a pure form of the drug and (2) a more commonly prescribed formulation called Suboxone, which combines buprenorphine with naloxone, an antagonist (or blocker) at opioid receptors. Naloxone has no effect when Suboxone is taken as prescribed, but if an addicted individual attempts to inject Suboxone, the naloxone will produce severe withdrawal symptoms. Thus, this formulation lessens the likelihood that the drug will be abused or diverted to others.

Buprenorphine treatment for detoxification or maintenance can be provided in office-base settings by qualified physicians who have received a waiver from the Drug Enforcement Administration (DEA), allowing them to prescribe it. The availability of office-base treatment for opioid addiction is a cost-effective approach that increases the reach of treatment and the options available to partners.

  1. Clonidine

Clonidine is a blood pressure medicine that acts on the brain. Clonidine reduces the effects of the “fight or flight” response, which is over-activated during opioid withdrawal. However, clonidine does not reduce drug craving and is less effective when used alone.

  1. Naltrexone

Naltrexone is a synthetic opioid antagonist-it blocks opioids from binding to their receptors and thereby prevents their euphoric effect and others. It has been used for many years to reverse opioid overdose and is also approved by for treating opioid addiction by the Food and Drug Administration (FDA) of the US. The theory behind this treatment is that the repeated absence of the desired effects and the perceived futility of abusing opioids will gradually diminish craving and addiction. Naltrexone itself has no subjective effects following detoxification (that is, a person does not perceive any particular drug effect), it has no potential for abuse and it is not addictive.

Naltrexone also called vivitrol is usually prescribed in outpatient medical settings for the treatment of opioid addiction. Although the treatment should begin after medical detoxification in a residential setting in order to prevent withdrawal symptoms.

Naltrexone must be taken orally. It can be daily or three times in a week. However, non-compliance is always a common problem. Many experienced clinicians have found naltrexone best suited for highly motivated, recently detoxified patients who want total abstinence because of external circumstances-for instance, professionals or parolees.

Recently, a long-acting injectable version of naltrexone, called vivitrol, was approved to treat opioid addiction. This is because it only needs to be delivered once a month, this version of the drug can facilitate compliance and offers an alternative for those who do not wish to be placed on agonist or partial agonist medications.

 

REFERENCES:

  1. http://www.webmd.com/mental-health/addiction/breaking-an-addiction-to-painkillers-treatment-overvew#1
  2. https://www.recoveryconnection.com/substance-abuse/drug-classes/opiate-addiction-treatment-withdrawal/
  3. http://drugfree.org/learn/drug-and-alcohol-news/fda-approves-new-opioid-addiction-treatment-combining-buprenorphine-and-naloxone/
  4. https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/pharmacotherapies

 

 

 

         

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