Medication-Assisted Treatment for Substance Use Disorders
Recovering from addiction is one of the most challenging things a person will do in their lifetime. Luckily, there is a range of effective treatments available to help recovering individual’s overcome their dependency. Psychotherapy is the mainstay of addiction rehab. It helps recovering individuals examine the unhealthy behaviors that fuel their addiction. In addition to therapy and counseling, certain medications can help patients during their treatment. This is known as Medication-Assisted Treatment (MAT). MAT increases the effectiveness of other addiction treatments and decreases the chances of relapse.
The Medication-Assisted Treatment program at Boca Recovery Center utilizes FDA-approved drugs to treat people with alcohol and opioid addictions. Medication-Assisted Treatment is offered in conjunction with psychotherapy to help clients get through detox and actively participate in their recovery from substance use disorders.
It may sound counterintuitive to treat alcohol or drug addiction with another drug. Some people believe it is simply substituting one drug for another. However, the medications used during addiction rehab help to break the vicious cycle of physical dependence on illicit substances. MAT drugs ease difficult withdrawal symptoms and help manage other medical and mental health issues. Medication Assisted Treatment is useful in stabilizing individuals during early recovery. MAT plays a very important role in helping recovering individuals stay clean. Talk to us at the Boca Recovery Center on (855) 637-1331 today to learn more about our medication-assisted drug rehabilitation programs.
In this article, we present an overview of Medication-Assisted Treatment for drug and alcohol addiction. We discover some of the medications that are used during drug rehab and how they work. We also examine the potential side effects of these medications. Are you or a loved one struggling with drug abuse? Read on and find out if you are a candidate for Medication-Assisted Treatment as part of your rehabilitation process.
What is Medication-Assisted Treatment (MAT)?
Medication-assisted treatment (MAT) involves the prescription of certain treatment drugs that support recovery. The treatment medications serve many functions, including:
- Diminishing cravings
- Easing withdrawal symptoms
- Countering the intoxicating effect of illicit substances
- Decreasing the chances of relapse by inducing uncomfortable symptoms if the person uses
Medication-Assisted Treatment (MAT) is the use of FDA-approved medications, in combination with psychotherapy and counseling, to provide a holistic approach to the treatment of substance use disorders.
Several medications are available to treat two major substance use disorders – opioids and alcohol. Also, medications are available to help people with nicotine (tobacco) addiction. In the following paragraphs, we provide a summary of the most commonly prescribed drugs used to treat opioid, alcohol, and nicotine addiction. Notably, there are no approved medications to treat marijuana addiction or addiction to stimulants like methamphetamine or cocaine. However, several drugs are in clinical trials. You can read about some promising new drugs toward the end of this article.
Medications for Opioid Abuse
Medications to treat opioid addiction have been around for decades, but accessibility to these drugs has been limited. In the wake of the current opioid crisis in America, MAT for opioid abuse has become more easily available over the last decade.
According to the National Institute on Drug Abuse (NIDA), 128 people die every day from an opioid overdose in the United States.
At Boca Recovery Center, we offer medication-assisted treatment for opioid dependence in combination with counseling and behavioral therapies. This gives recovering individuals the best chance of sustained recovery. We use FDA-approved drugs for the treatment of opioid addiction.
Buprenorphine is a medication that is prescribed to individuals who are addicted to opioids and are seeking recovery. It can be used for all types of opioid addiction, whether it is a dependence on prescription painkillers like Vicodin and OxyContin or addiction to street drugs like heroin.
How does buprenorphine help individuals with Opioid Use Disorders? Opioid drugs attach to certain receptors in the brain to produce their effects. Buprenorphine attaches to these same opioid receptors in the human brain.
This prevents exogenous opioids (drugs of abuse) from attaching to the receptors and exerting their effect. Interestingly, buprenorphine has a ceiling effect, i.e., it is difficult to overdose on. This means once you reach a particular dose, the effects level off and don’t escalate with higher doses.
Buprenorphine is the only addiction treatment medication that can be prescribed in an office-based setting. It is often administered in combination with another medication called naloxone. Naloxone induces uncomfortable withdrawal symptoms if the recovering individual attempts to misuse opioids via injection. The combination of buprenorphine and naloxone is available as Suboxone.
Like all medications, buprenorphine can cause some side effects. These include fever, muscle aches, irritability, nausea, vomiting, constipation, and sleep disturbance.
The FDA has approved a buprenorphine implant for opioid dependence. It is called Probuphine. The implant consists of four rods that are inserted in the arm. These rods slowly release buprenorphine into the person’s bloodstream and provide ongoing treatment for 6 months. The continuous low dose of buprenorphine alleviates cravings and withdrawal symptoms but does not create a euphoric high. The implant is a convenient way to obtain medication-assisted treatment. It is easier than ingesting daily pills or using dissolvable films. The maximum recommended treatment with Probuphine implant is two six-month treatments.
Naltrexone is a medication assisted treatment used in people with an opioid or alcohol addiction. It comes in both a pill version and an injectable form (Vivitrol). Injectable naltrexone can be given by monthly dosing through intramuscular injection, so it is convenient compared to daily pill use.
Like buprenorphine, naltrexone also works by blocking opioid receptors in the brain. When a person is treated with naltrexone, the medication “blocks” the opioid receptors in the brain. As a result, alcohol or opioid drugs cannot attach to the receptors. This prevents opioids and alcohol from causing a high (euphoria).
One disadvantage of MAT with naltrexone is that it decreases opioid tolerance. A relapse can be dangerous if a recovering individual returns to using. Opioid use while on treatment with naltrexone can result in an overdose and respiratory depression (fatal slowing of breathing). However, unlike some other MAT medications, naltrexone does not have the potential for abuse. It is important to take naltrexone exactly as advised by a physician. When taken in excess, naltrexone can cause liver damage.
The potential side effects of naltrexone treatment include headache, muscle ache, nervousness, vomiting, diarrhea, and difficulty sleeping.
Naloxone is an opioid antagonist, meaning it has the opposite action to opioids. It is used as a medication-assisted treatment for opioid addiction because it blocks the action of opioids. Naloxone can prevent a life-threatening opioid overdose. For this reason, naloxone is used in emergencies when people have overdosed on opioids.
Naloxone comes in the form of an automatic injection. Opioid users and their family members should learn how this device works so they can use it in the event of an overdose. Naloxone injection devices are sometimes distributed to heroin abusers as a safety measure. Voice control in the device advises the user step-by-step on its correct use. Opioid users should keep the naloxone device on them at all times.
If someone you love is abusing opioids, you should be aware of the signs of opioid overdose. These include shallow breathing, constricted pupils, severe drowsiness, and unresponsiveness. The presence of any of these signs requires immediate medical attention.
Methadone is used in medication-assisted treatment for opioid addiction. It is a full opioid agonist, meaning it produces the same effects as opioids. The difference is that it has a longer-lasting but milder action compared to street drugs like heroin. Methadone is used to reduce cravings and decrease withdrawal symptoms in individuals recovering from opioid addiction. One dose of methadone can prevent withdrawal symptoms for up to one and a half days.
However, methadone has a potential for abuse. For this reason, it is administered only through special methadone clinics where it is given on a set schedule. We do not prescribe methadone at Boca Recovery Center.
Methadone can cause side effects like headache, sweating, dry mouth, vomiting, stomachache, loss of appetite, sleep disturbance, mood change, and reduced libido. More serious side effects of methadone include facial swelling, rash, itching, seizures, hallucinations, breathing difficulty, and severe drowsiness. If you or a loved one is on methadone treatment and experiencing these symptoms, you should get medical help immediately.
Medications for Alcohol Abuse
Medication Assisted Treatment for alcoholism helps prevent relapse and promote abstinence in individuals who have alcohol dependence. Below are the commonly used medications used for alcohol abuse MAT.
Available under the brand name Antabuse, disulfiram discourages drinking by causing unpleasant effects if the person consumes alcohol. If someone is being treated with disulfiram, 10-30 minutes after they consume alcohol, they will begin to experience uncomfortable symptoms. This includes sweating, flushing, headache, anxiety, headache, chest pain, weakness, palpitations, dizziness, blurred vision, confusion, and a fast heart rate. The effects of disulfiram in combination with alcohol last for about an hour. The severity of these reactions varies with the disulfiram dose and the amount of alcohol consumed. The idea is that anticipation of these unpleasant symptoms will deter a person from drinking.
Acamprosate (brand name Campral) normalizes brain activity in recovering alcoholics. Alcohol is a central nervous system depressant, i.e., it slows down brain activity. In people who abuse alcohol, the brain becomes used to a new state of low activity. When alcohol is withdrawn from the system during addiction rehab, the brain can become hyper-excited. Acamprosate helps balance brain activity and reduce withdrawal symptoms. When withdrawal symptoms are controlled and well managed with medication assisted treatment, the chances of relapse are less. The potential side effects of acamprosate include weakness, dizziness, itching, nausea, vomiting, and headache. These adverse effects are usually mild and go away after a few weeks of acamprosate treatment. However, more serious side effects like depression and suicidal ideation have also been reported. If you or a loved one is on acamprosate treatment and experiences these symptoms, seek immediate medical care.
Naltrexone is used as a medication assisted treatment in the early stages of alcoholism recovery. It works by blocking the receptors in the brain that produce the euphoric high when a person drinks alcohol. Naltrexone is non-addictive. If a recovering alcoholic suffers a relapse, naltrexone does not allow them to experience the same effects of alcohol as before. Over time, the person’s brain stops associating alcohol with euphoric feelings. Ultimately, naltrexone helps people stay abstinent.
Medications for Nicotine Addiction
Medication assisted treatment for smokers consists of over-the-counter and prescription medications that relieve cravings and withdrawal symptoms after quitting tobacco use. Commonly used medications for nicotine addiction treatment include varenicline (Chantix) and bupropion (Zyban).
Is medication-assisted addiction treatment right for me?
The experienced team at Boca Recovery Center will evaluate you when you decide to enter rehab. During your intake evaluation, we will diagnose your substance use disorder and the severity of your addiction. We will also assess you for any co-occurring mental health issues. Based on this assessment, we will recommend the most appropriate medication-assisted treatment for you (if you are found to be a suitable candidate for MAT). MAT is usually prescribed to people who:
- have been officially diagnosed with a substance use disorder.
- are motivated to comply with instructions and take the prescription medication as directed.
- do not have any medical conditions that could be worsened by MAT drugs.
- understand their options and are educated about the potential side effects of MAT.
You are NOT a good candidate for medication assisted drug rehab if you have:
- a history of misusing medications in the past.
- an addiction to a substance that cannot be treated with MAT.
- a co-occurring addiction that may interfere with treatment.
- a severe medical condition that could be complicated by MAT drugs.
- poor motivation to get clean.
The Future of Medication-Assisted Drug Rehab
Given the effectiveness of medication assisted treatments currently in use, researchers are looking for other pharmacological treatments for a variety of illicit substances. Several medications are in clinical trials to assess their safety and efficacy before they receive FDA approval for use in the general population.
One promising avenue that is being explored is amphetamines for cocaine and meth addiction. The idea is substitution pharmacotherapy. It is very similar to the use of methadone for opioid addiction. Amphetamines are stimulants like cocaine and methamphetamine. Other drugs such as the anticonvulsant topiramate and the sleep apnea medicine modafinil are also being studied to prevent relapse in individuals who are addicted to cocaine.
The caring team at Boca Recovery Center is dedicated to helping you or your loved one achieve and maintain lasting sobriety. For effective addiction rehab, we take a whole-person approach to drug rehab. We utilize evidence-based behavioral therapies along with medication-assisted treatment to help our patients get clean. Call us today on (800) 516-4357 to find out more about our MAT programs and how they can support you in your recovery from drug or alcohol abuse.