There are multiple factors involved in a successful recovery plan for substance use disorder. Due to the chemical changes that are caused by the misuse of substances, certain medications are very useful in helping patients achieve chemical balance and recovery.
Medication-assisted treatment can be a key piece to a collaborative care model that is personalized to each patient and, therefore, has the highest chance for a successful recovery. Many medications are used for the treatment of different addictions. The choice of specific addiction medications will be highly dependent on the individual patient, the rehab facility protocol and the medical professional overseeing your treatment. Understanding why medication for addiction may be helpful and the options available as medications for drug addiction will be beneficial to achieving sobriety.
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How Medications Help with Addiction Treatment
The use of addiction medications in the treatment of substance use disorders can play an important role in preventing relapse and facilitating longer periods of abstinence. Due to the misuse of drugs, certain chemical changes take place in the brain which increases the risk of setbacks occurring in recovery. The main mechanisms behind how addiction medications work for treatment include:
- Management and alleviation of withdrawal symptoms during detox
- Suppression of cravings to use drugs
- Prevention of compulsive drug use (i.e., a setback)
- Eliminating a substance’s ability to produce a high
- Triggering adverse side effects when the addictive drug is used to disincentivize further use
Types of Addiction Medications
The first step involved in the selection of appropriate addiction medications is identifying the type of substance(s) that are causing the addiction. Each drug affects the brain in different ways. Addictive impulses, likewise, are controlled in different ways. There are several types of medications that can be used for specific drug dependencies or use disorders.
Alcohol Addiction Medications
Many unpleasant effects come with alcohol withdrawal. The safest way to stop drinking if you have an alcohol dependency is through medical detoxification. During the detox process, doctors closely monitor their patient’s health and may prescribe medications to help with withdrawal symptoms.
Other medicines can help stop or decrease heavy drinking habits. These reduce the pleasant feelings that come from consuming alcohol, so the reward response from drinking is disrupted. This effect can help reduce cravings for alcohol.
Acamprosate helps relieve symptoms of long-lasting alcohol withdrawal. Over time, alcohol changes the function of certain neurotransmitters and their receptors in your brain. These receptors are disrupted when someone with an alcohol dependency suddenly stops drinking. Acamprosate works by stabilizing these neurotransmitters and helps balance them during withdrawal. It is especially helpful in more severe cases of alcohol withdrawal.
Disulfiram is used to decrease alcohol addictions by associating negative feelings with drinking alcohol. If you take disulfiram and alcohol at the same time, it will make you feel sick with some non-serious but very unpleasant effects. These include:
- Nausea and vomiting
- Accelerated heartbeat
- Chest pain
- Shortness of breath
- Blurry vision
- Excessive sweating
Gabapentin is an anticonvulsant medication used to treat seizures. Its effects on neurotransmitters in the brain make it useful for treating other neurological conditions as well as alcohol withdrawal.
Naltrexone blocks the pleasant feelings that come from consuming alcohol. When your brain stops associating alcohol consumption with feelings of reward and happiness, you are much less likely to feel cravings for it. It also helps with opioid addictions for the same reason.
Opioid Addiction Medications
There are several medicines used to manage opioid addictions that work in different ways. Some prevent you from feeling good when you take opiates or opioids while others can help taper off the opioid dose used. During opioid detox, doctors might prescribe a medication to treat withdrawal symptoms.
Methadone is a type of opioid itself, but with fewer toxic effects than opioids like heroin. It targets the same opioid receptors in the brain as other opioids, but with lesser effects, making it beneficial for treating opioid addiction. Its dose can be gradually lowered to wean someone off of an opioid dependency without the extreme withdrawal effects or cravings associated with stopping cold-turkey.
Buprenorphine is a type of opioid medication that works similarly to methadone. However, it lasts longer than methadone and is less likely to become addictive because its euphoric effects eventually fade. This effect may make it safer and more effective for treating opioid addiction.
Sublocade is a branded form of buprenorphine. It is long-lasting and administered through injection. People go to clinics to receive a sublocade injection once every month to prevent cravings, reduce withdrawal symptoms and block euphoric feelings from taking other opioids.
Narcan is a medicine that is used to revive people who overdosed on opioids. It is the nasal-spray version of the drug naloxone. Because of the opioid epidemic and the rise in opioid overdoses, many people, including emergency medical technicians (EMTs), police officers and even some civilians carry Narcan with them. Narcan works by blocking opioid receptors in the nervous system, reversing the effects of opioids.
Suboxone is a combination of buprenorphine and naloxone. Though it is sometimes used to treat opioid addiction, people can also develop a dependency on suboxone itself so it must be used with caution.
Naltrexone can help treat opioid abuse. It works by reducing or eliminating the feeling of euphoria that comes with taking opioids or opiates. This effect can stop the cravings that come with an opioid dependency.
Vivitrol is a branded form of naltrexone that is administered by injection. Like Sublocade, people receive a Vivitrol shot once per month to stave off opioid cravings.
Benzodiazepine Addiction Medications
Benzodiazepines, such as Xanax and Valium, are psychoactive medications used to treat anxiety and insomnia. They can also treat convulsions in people with cerebral palsy and are sometimes used to help people relax before medical procedures. Because of their relaxing and mood-enhancing effects, people sometimes develop an addiction to benzodiazepines.
Clonazepam (brand name Klonopin) is a type of benzodiazepine that acts as a tranquilizer. Medically, it is used to treat seizures, muscle disorders and anxiety. Because it has a slow onset and is long-lasting, some medical professionals now use low doses of clonazepam for substitution therapy for addictions to other benzodiazepines. However, it needs to be used carefully since it can also be addictive.
Stimulant Addiction Medications
There are no medications currently used specifically for stimulant addictions. A few medicines are sometimes used off-label to manage stimulant addiction and withdrawal; however, researchers are working to develop new, more effective medications for this purpose.
Bupropion is an antidepressant medication that affects neurotransmitters in the brain. It can help control the symptoms of stimulant withdrawal.
Modafinil is a mild stimulant used to treat narcolepsy and other sleep disorders. Some clinics use modafinil to treat stimulant addictions by reducing cravings for other, more dangerous stimulants. However, people often misuse modafinil itself because it helps them focus and gives them energy, so it has to be used carefully.
Other Medications Used in Addiction Treatment
Some medications have broad or general uses for addiction treatment. They may be used to treat multiple types of drug addictions or withdrawal syndromes because of their overlapping symptoms. Newer medicines are effective for managing addiction, but the way they work is not fully understood yet.
Baclofen is a muscle relaxant. It is used to treat muscle pain and spasms and epileptic seizures. It is used to help relieve symptoms of alcohol and opioid withdrawal because it acts on the same neurotransmitters in the brain. However, more clinical trials are needed to prove its efficacy before it can be widely used.
Mirtazapine (brand name Remeron) is a type of antidepressant. Its mechanism of action is not well understood yet, but it may block certain receptors in the brain. Taking mirtazapine can help alleviate some symptoms of drug and alcohol withdrawal, but more research is needed.
Topiramate is used to treat neurological conditions like epilepsy and migraines. Some clinical trials show that topiramate can also help treat alcohol addiction.
Medications Used to Treat Co-Occurring Disorders
It is common for people with substance use disorders to also have a mental illness of some sort. Co-occurring disorders range from anxiety or depression to psychosis or personality disorders, and more. When a mental health condition co-occurs with addiction, both must be treated at the same time to reduce the risk of a setback occurring in recovery. Doctors may prescribe a medication to manage symptoms of the mental disorder, such as:
- Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs)
- Anti-anxiety drugs, such as alprazolam (Xanax) or diazepam (Valium)
- Mood stabilizers, such as lithium and anticonvulsant drugs
- Antipsychotics, such as risperidone (Risperdal) and aripiprazole (Abilify)
Possible Risks and Side Effects of Addiction Treatment Medications
The side effects of addiction medications are as varied as the drugs themselves. One of the main risks of medication-assisted treatment is developing an addiction to the treatment drug itself. This risk is because the medications often act on the brain in the same way and have similar effects to the abused drugs being managed.
Benefits of Medical Detox and Medication-Assisted Treatment
The main benefit of medical detox is that the patient is under the supervision of medical professionals. Doctors, nurses, counselors and other experts monitor your condition and can intervene in the event of serious withdrawal effects. Going through this process under medical guidance, and with appropriate medications, can make withdrawal symptoms lighter and can better control cravings.
Medication-assisted treatment combines medicine with counseling and other forms of therapy, often tailored to a patient’s specific needs. This offers a whole-patient approach to detoxification and addiction recovery. A multi-front approach like this can be very successful in overcoming substance use disorders and has a high success rate for patients staying sober.
If you are struggling with an addiction and need help contact The Recovery Village. Call to speak with a representative to learn more about what addiction treatment could work best for you.
Douaihy AB, Kelly TM, Sullivan C. “Medications for Substance Use Disorders.” Social Work and Pubic Health, September 9, 2013. Accessed May 13, 2019.
National Institute on Drug Abuse. “Treatment Approaches for Drug Addiction.” January 2019. Accessed May 13, 2019.
Marammani AGI, Rovai L, Rugani F, Bacciardi S, Pacini M, Dell’Osso L, Maremmani I. “Clonazepam as Agonist Substitution Treatment for Benzodiazepine Dependence: A Case Report.” Care Reports in Psychiatry, January 30, 2013. Accessed May 13, 2019.
Kampman KM. “The Search for Medications to Treat Stimulant Dependence.” Addiction Science & Clinical Practice, June 2008. Accessed May 13, 2019.
Cooney G, Heydtmann M, Smith ID. “Baclofen and the Alcohol Withdrawal Syndrome-A Short Review.” Frontiers in Psychiatry, January 22, 2019. Accessed May 13, 2019.
Substance Abuse and Mental Health Services Association. “Medication and Counseling Treatment.” May 7, 2019. Accessed May 13, 2019.