Although some critics of MAT or medication-assisted treatment say that it makes no sense to use drugs to treat drug addiction, MAT actually helps the addicted brain to heal and the addicted person to enjoy life and live up to their responsibilities once again. This article will discuss the following topic: what medications are used to treat substance abuse?
Treatment of substance abuse is a long-term endeavor. It includes two main stages: detox and rehab followed by aftercare. Once the brain has become dependent on a substance, the withdrawal process will usually be unpleasant, supremely difficult, protracted and painful. Some substances, such as alcohol, barbiturates, benzodiazepines and most any kind of hypnotic drug, such as the banned glutethimide (Doriden), Placidyl (ethchlorvinyl) and the infamous Quaalude (methaqualone). These powerful, dangerous hypnotics fell out of favor and were largely replaced by benzodiazepines well prior to the 1990s.
Drugs for Detox
Drugs used for detox are often also used for rehab and maintenance. Suboxone is a good example. A combination drug containing the narcotic buprenorphine and the opioid reversal drug naloxone (hence its name), Suboxone works to relieve opioid withdrawal symptoms and is known for keeping opioid cravings at bay. It’s these cravings that commonly result in relapses.
Apart from the treatment of substance abuse, Suboxone is sometimes prescribed for pain relief alone.
Suboxone works in the brain like all opioids do. It binds to and activates the brain’s mu opioid receptor. The brain has three main opioid receptors, the mu, the delta and the kappa. These receptors are linked to pain relief, sedation, euphoria and its opposite dysphoria.
Although an opioid itself, buprenorphine has some important advantages over illicit narcotics like heroin and bootleg fentanyl and even legal but commonly abused drugs like oxycodone and hydrocodone:
- It’s long-acting. One individualized dose daily is sufficient
- It’s taken orally
- It’s prescribed on a monthly basis with no daily visit to a clinic required
- Dose can be easily adjusted
- Effective for most people
Suboxone can be taken short-term in gradually lower doses over time to ease the person’s detox symptoms. It can be combined with other non-narcotic medications if necessary. After the detox period is over, the person will ideally be drug-free.
Suboxone is also suitable for long-term use with no limits on its treatment time period. It’s prescribed by a specially licensed Suboxone doctor and filled at s standard public pharmacy. Suboxone has the distinct advantage of home use. No onehas to know. This is important for certain jobs. Opioid addiction still carries a heavy stigma in our society.
Suboxone is the gold standard for opioid detox and maintenance, but if it fails, methadone is available. A synthetic opioid, methadone is sometimes also prescribed for pain relief (not associated with opioid withdrawal). Methadone is a superior pain reliever and will stop opioid cravings for almost everyone.
Alcohol Detox and Maintenance
This is extremely dangerous to try at home. Alcohol and benzodiazepine withdrawal symptoms can kill and should never be treated at home without medical supervision from an addiction treatment specialist.
Alcohol detox is always managed with drugs, especially benzodiazepines like diazepam or Valium. This long-acting benzodiazepine allows the brain to safely withdraw from alcohol with very little risk of dangerous grand mal seizures and little to no discomfort.
Acamprosate for Alcoholics
The chemically unrelated drug acamprosate may be used by former alcoholics to reduce the intense cravings for alcohol that so often result in relapse. Although benzodiazepines are not typically used long-term for alcohol withdrawal (or anything else except for certain targeted medical conditions like seizures), acamprosate can be taken long-term to manage alcohol cravings. It’s effective and generally considered safe.
Naltrexone for Alcohol and Opioids
Naltrexone is an opioid overdose rescue drug with other important applications for recovering opioid addicts and alcoholics. It blocks certain brain receptors and prevents any “high” from either alcohol or opioids. Opioids and alcohol work on different brain receptors, but naltrexone appears to help addicts in both drug classes to manage their cravings.
Naltrexone is also thought to greatly reduce alcohol and opioid drug cravings by occupying the mu brain receptor. Naltrexone can only occupy and bind to this receptor; it cannot activate it. The result is a quiet mu receptor that doesn’t keep sending out opioid craving complaints.
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