While therapy is usually the foundation of addiction treatment, there are also several helpful medications. Addiction medicines fall into the larger category of medication-assisted treatment. While some downsides can stem from addiction medications, the upsides often outweigh those.
Medication-assisted treatment is beneficial for the treatment of opioid use disorder. Medicines are an essential tool to combat the devastation of the opioid epidemic in the United States.
Learning more about these medicines can help people explore what could work best for themselves or their loved ones.
Science and research have come a long way in evidence-based treatments for substance abuse. Medicine can be part of those treatments.
An Overview of Medication-Assisted Treatment
Medication-assisted treatment (MAT) is a way to help treat substance use disorders. MAT can prevent overdose and help people maintain long-term recovery as well.
MAT is the use of medicines in combination with counseling and behavioral therapy. The goal is a holistic approach to treating addiction to drugs or alcohol. The Food and Drug Administration (FDA) approves the medicines part of MAT. MAT programs need to be very individualized to be effective.
Primarily MAT is for the treatment of opioid addiction. Opioids include prescription pain medicines and illicit drugs like heroin. When someone takes a prescription addiction medication, it can work differently.
These medicines can block the pleasurable effects associated with opioids, normalize brain chemistry, prevent cravings, and help with physical symptoms of withdrawal.
MAT can help improve the survival of patients and retention in effective treatment programs. Other benefits include:
- Reductions in illegal drug use and criminal activity
- Reduces the risk of overdose
- Increases in the ability to maintain employment
- Improvements in birth outcomes among pregnant women with substance use disorders
Medications for Alcohol Use Disorder
Less than 1% of people who get help for alcohol dependence receive a prescription medication. This suggests the use of these helpful medicines is highly underused.
Some of the medicines that may be helpful for alcohol addiction are:
- Disulfiram (Antabuse): This medication was the first to receive approval for alcohol abuse and dependence. When someone takes the medicine and drinks alcohol, they have a severe, adverse reaction. For example, most people who take it throw up if they drink.
- Naltrexone: There are several forms of this medicine. Brand names include Depade and Revia. There’s also a monthly extended-release injection form of the treatment available as Vivitrol. When someone takes naltrexone, it blocks the high they experience from drinking or taking opioids. Research shows naltrexone can reduce alcohol consumption.
- Acamprosate (Campral): Campral is a brand name of the generic acamprosate. Acamprosate is the most recent medicine the FDA approved to treat alcoholism and alcohol dependence. Campral helps normalize changes in the brain that occur because of alcohol. When someone takes Campral, it can help alleviate some of the physical and emotional discomforts they experience when they stop drinking that could raise their risk of relapse otherwise.
Medications for Opioid Use Disorder
According to the National Institute on Drug Abuse, several prescription drugs are helpful for the treatment of an opioid use disorder. Patients should combine medications with behavioral counseling. This combination can help increase not only treatment retention but social functioning.
The National Institute on Drug Abuse reports that MAT is not widely used for heroin and opioid addiction despite its effectiveness and availability. Less than ½ of private substance use disorder treatment programs offer MAT. Only around 1/3 with opioid dependence receive medication at these centers that offer it.
Methadone is one of the most extended available MAT options for opioid addiction and dependence.
The medication is also to treat chronic pain in some cases.
- Methadone treatment can be safe and effective when used as prescribed.
- When you take methadone, it changes how your brain and nervous system react to pain.
- Methadone helps alleviate symptoms of opioid withdrawal.
- The MAT can also help block the effects of opioids such as heroin, oxycodone, and hydrocodone.
When someone is using methadone and behavioral treatments, they should also participate in social support programs.
- To receive methadone for opioid addiction, you have to obtain the medicine under the supervision of a qualified medical professional.
- You usually have to go to a clinic to receive it.
- After a period complying with your doctor’s requirements, you may be able to take your doses at home between your visits.
- You can only get methadone through a SAMHSA-certified opioid treatment program.
Methadone does have potential side effects and can be a drug of abuse, so it’s essential to take it exactly as your health care provider instructs you to. Opioid overdoses are also possible with methadone treatment for substance use disorders.
Buprenorphine is available by prescription in doctor’s offices, making it more accessible than methadone. Buprenorphine is a medication-assisted therapy that works as an opioid partial agonist-antagonist.
- The medicine binds to the same receptors as opioid drugs in the brain.
- The difference is that since it’s only a partial opioid agonist, it doesn’t stimulate the brain as powerfully as other opioids.
- The long-acting medicine keeps opioid receptors active but at a low level, reducing or preventing severe withdrawal symptoms and cravings.
Treatment with buprenorphine also blocks the effects of other opioids, so you wouldn’t feel euphoric or high if you were to relapse. The lack of pleasurable or euphoric effects makes buprenorphine a better alternative to methadone for some people.
Naltrexone is for the treatment of both opioid and alcohol use disorders. Naltrexone blocks the effects of opioid receptors, reducing cravings and urges to use the drugs. Naltrexone can help with physical dependence when paired with behavioral interventions.
Suboxone is a brand-name MAT that combines buprenorphine and naloxone.
Suboxone can reduce the severity of opioid withdrawal symptoms and reduce dependence over the long term.
People often have questions like how long does Suboxone stay in your system and whether or not there are any Suboxone side effects to be aware of.
- First, suboxone has a very long half-life, meaning it takes your body a long time to eliminate it. It can take eight days or more for suboxone to not be detectable in your system anymore by blood tests or urine tests.
- You can take Suboxone as a sublingual film or a sublingual tablet, meaning they dissolve under the tongue.
- Since it’s a partial opioid agonist, Suboxone side effects can be similar to other opioids. For example, possible adverse effects could include dizziness, blurred vision, drowsiness, loss of appetite, or respiratory depression. Even these theoretically common side effects are rare when you use your dose of Suboxone properly.
- Suboxone has an abuse-deterrent element. This medication for opioid use disorder, when used as an oral film or tablet, affects you differently if you try to abuse it. Buprenorphine can create some of the same effects as other opioids. However, this isn’t an issue if you use Suboxone properly, rather than trying to crush it and snort it or inject it. If you try to abuse the Suboxone, the otherwise inactive naloxone becomes effective.
- Crushing the Suboxone causes you to experience immediate withdrawal symptoms because of the naloxone’s activity.
Are Addiction Medications Right For You?
Not everyone is a good candidate for addiction medications as part of a treatment plan. For example, if you have a mild or short-term addiction, you may not need medicine as part of your treatment of substance use. Instead, therapy-based treatment may be best for you.
If you have a severe, long-lasting addiction, medicines can help you achieve recovery. Medicines for addiction aren’t an overnight cure, however. They also aren’t something you can use on their own without other forms of treatment if you want a sustainable long-term recovery.