Addiction, medication review – suboxone, methadone

16145350800nl Drug treatment has come a long way over the years. Advancements in medication-assisted substance abuse treatment have aided in increasing the number of patients who have successfully reached recovery. Case in point, between 2003 and 2011, approximately 1,100 to 1,200 opioid treatment programs were active in the United States, per the Substance Abuse and Mental Health Services Administration. While there wasn’t a vast expansion of programs, there was a surge in the number of admissions, with SAMHSA noting 227,000 patients receiving methadone in 2003, a number that had jumped to 306,000 by 2011.

The Opium epedemic

Opium is nothing more than the dried rubber-like substance that is harvested from the pods of opium poppy pods. The U.S. Department of the Interior classifies opium addiction as a mental and physical reliance on opiate-based drugs like heroin and opioid pain relievers, which inflicts the user with symptoms of withdrawal upon cessation, financial constraints due to overspending on their supply, a growing tolerance requiring higher dosages, and negative impacts on the user’s social, family and work life, nevertheless accompanied by persisted use.

The majority of all opium is consumed via heroin or opioid pain medications, and both have become increasingly popular over the years. Some of the most alarming statistics regarding opium abuse, per the Foundation for a Drug-Free World, are:

  • Worldwide, 9.2 million people are using heroin.
  • Opiates are responsible for 18 percent of US substance abuse treatment admissions.
  • There are 13.5 million people using opiates across the globe.
  • There were 153,000 Americans using heroin in 2007.

Cognitive concerns

Pregnant woman with money. Family budget.A common link that continually turns up in research on opiate users is the presence of mental illness, specifically personality disorders. The Center for Substance Abuse Treatment’s Treatment Improvement Protocol accounts for several studies noting a prevalence of antisocial personality disorder (APD) — 24 to 39 percent to be exact — in patients seeking treatment for opioid-based addictions. Other studies have reported even higher figures, citing 72 percent of heroin-dependent patients having APD and another 47 percent having borderline personality disorder.

The road to recovery

While some addictions can be treated with detox and a few weeks of intensive therapy, those measures alone often don’t cut it for addictions to opiates. Some of the most promising measures of treatment to date for opiate addictions are medications that help to take away the drug user’s ability to achieve a high effect from the drug. Some of the primary drugs used in opioid addiction treatment are methadone, naloxone, Subutex, Suboxone, and naltrexone.

Branded and prescribed primarily as Dolophine and Methadose, methadone works by inhibiting the user from achieving the high that opioid drugs would normally give them. The National Institutes of Health reports a 72.7 percent success rate among high-dose methadone users and 20 percent among low-dose users for this drug in a University of Johns Hopkins study. Concerns, however, are mounting over the high death toll the treatment drug has caused, accounting for more than 30 percent of lives lost to prescription pain medication overdoses, per CBS News.
Branded as Narcan and included in drug emergency treatment kits, the administration of this drug can reverse the effects of overdose, and it has been attributed to a number of lives being saved. Naloxone does not permit other drugs to activate opioid receptors in the brain, and thus, a high cannot be achieved. It is an opioid antagonist and sends patients who receive it into an immediate withdrawal state.
The active ingredient in Subutex is buprenorphine, which is a partial opioid antagonist that diminishes the withdrawal experience in opiate addicts. The drug can be habit-forming, and for that reason, Suboxone is now a more widely prescribed treatment, especially in cases where the patient will not be taking the medication under supervision every day, such as in an outpatient maintenance program. The Partnership for Drug-Free Kids reported on a University of Maryland trial and noted a 65 percent retention rate among opioid addict participants.
Suboxone, which is buprenorphine combined with naloxone, acts as an opioid antagonist used primarily in the treatment of opiate addicts. While it works similarly to Subutex, the drug has had a fair amount of proponents and critics. This medication works similarly to methadone while virtually eliminating the ability for the patient to develop a tolerance by limiting the user’s ability to receive a greater high by taking more of the drug.

The most common concern for this drug is the ability for a user to stay clean after stopping treatment, because some studies have shown decreased efficacy after long-term cessation. For instance, the Partnership for Drug-Free Kids notes a 49 percent success rate for Suboxone patients while using the treatment drug, but a serious drop to only 8.6 percent once the treatment was discontinued.

Naltrexone

Patients undergoing detox for alcohol and/or opioid dependence are often prescribed naltrexone — branded as Vivitrol and ReVia — to combat the pain felt by opiate addicts during detox and the cravings that alcohol withdrawal syndrome can inflict on heavy drinkers. For alcoholics, mechanisms of the drug aren’t clearly understood, but the medication is thought to rewire the way the brain reacts to the ingestion of drugs or alcohol.

Naltrexone is not considered to be addictive. The Pittsburgh Post-Gazette reported on one study that touted an 80 percent success rate for a 20 percent subgroup of treated participants in conjunction with an inversed 20 percent success rate for the other 80 percent of participants. The drug has proven itself effective in enough patients to warrant its continued use. At this time, there is no drug treatment regimen for pain management during detox from methamphetamines or cocaine. Treating professionals may prescribe pain management medication, or antidepressants and anti-anxiety medications, as needed, and these medications are considered safe to take during recovery.

At The Recovery Village, we have only the best medical professionals on staff who are prepared to address your addiction with highly specialized treatment plans. If needed, we can discuss the ue of opioid blocker medications as well as other medications that can augment your treatment. Call us today for more information on how we can help you plan for the successful future that awaits you.

Addiction, Medication Review – Suboxone, Methadone
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Addiction, Medication Review – Suboxone, Methadone was last modified: June 25th, 2017 by The Recovery Village