With the worldwide escalation of substance abuse, governments as well as the medical and psychiatric profession have taken a serious look at addiction treatment. Addiction treatment has many different approaches and each approach is designed to address certain aspects of drug addiction and its consequences for the individual, the family and for society.
Some of these approaches are meant to work alongside existing treatment programs and others are actual treatments on their own. The list of evidence-based treatment approaches continues growing as research develops, however the following is a basic look at what is currently available concerning medically based treatments. Behavioural therapies are also essential in evidence-based approaches to addiction treatment, particularly used in combination with medically based treatments. Both medical treatment and behavioural therapy have proved effective in addiction treatment.
Medically Based Addiction Treatments
Opioid Addiction
Opioid addiction describes people addicted to illicit drugs such as heroin. Methadone is one of the medications used for opioid addiction treatment. Methadone maintenance treatment is generally done in a specialised setting such as a rehabilitation centre. The specialised program gives enough dosages of methadone to prevent opioid withdrawal to block the effects of the opioid use and to reduce opioid craving. Together with behavioural treatment, which includes individual and group counselling and other medical, psychological and social services, methadone maintenance treatment should aid the patient towards reduced use of the drugs and help towards long term recovery.
Buprenorphine is a medication which is used for treatment which decreases or eradicates withdrawal symptoms connected with opioid dependence but does not have the same effects of euphoria and sedation caused by heroin or other opioids. These medications need to be prescribed by medical professionals and the individual needs to be monitored by trained staff.
Patients who are treated properly with methadone or buprenorphine can function as normal. They are able to work to avoid crime and violence and to reduce their exposure to HIV by no longer injecting drugs and involving themselves in drug-related sexual behaviour. They can also take an active part in counselling and therapies which are helpful in recovery.
Naltrexone is a medication which has few side effects. It is often used in outpatient treatment after detoxification in a treatment centre. Patients must be opioid-free for several days before taking naltrexone to prevent withdrawal symptoms. The medication blocks all the effects of opioids when administered correctly. The reason for the treatment is that the patient will lose the craving for the opioid when the usual desired effects are no longer associated with it. Naltrexone is not addictive and has no side effects, however, it is often difficult to get the patient to follow through with treatment. Support, supervision and therapy alongside treatment is essential to encourage continued treatment. It is best used for those who are motivated recently detoxified and desperately want a drug-free future.
Tobacco Addiction
A few types of Nicotine Replacement Therapies (NRT) exist, which include a transdermal nicotine patch, a nicotine spray, nicotine gum and nicotine lozenges. The theory is that stable low levels of nicotine will prevent the withdrawal symptoms which cause the continued use of tobacco. Bupropion, which was originally used as an antidepressant, has mild stimulant effects and was found among depressed patients to control their tobacco cravings. They also found that while on the medication, when they quit smoking they did not gain weight as is so often the case. Varenicline is a recent medication used to stop smoking. It mildly stimulates the nicotine receptor and blocks the ability of nicotine to activate dopamine, so that the smoker does not feel the effects of smoking. It therefore reduces the craving for smoking.
Each of these medications is recommended together with behavioural interventions, including group and individual therapies or telephone helplines. This teaches the quitter to avoid high-risk situations for smoking relapse and helps them to plan for strategies to deal with such situations when they occur. Coping mechanisms which are taught include cigarette refusal skills, assertiveness and time management skills.
Alcohol Addiction
Naltrexone blocks the opioid receptors that are involved in the “feel good” effects of drinking and the urge for alcohol. It decreases the risk of relapse to heavy drinking for a few months but is not that effective in long-term abstinence. Acamprosate is a medication which is said to decrease the symptoms of a long and drawn-out period of withdrawal. Acamprosate is better for patients with severe alcohol addiction as it has proved to help drinkers maintain abstinence for a longer period of a few months.
Disulfiram causes an extremely unpleasant reaction which includes flushing, nausea and palpitations each time the patient consumes alcohol. The problem with disulfiram is that patients rarely stay with the program unless they are completely determined. Some people use it as an emergency tactic in high-risk situations, such as mandatory social occasions where alcohol is unavoidable and the temptation is too much for them. It can also be used under supervision while in a treatment centre or by a close family member.
Topiramate is a medication which is not yet entirely understood and it is still under research but has been shown in two trials to greatly improve multiple drinking outcomes. It is not an approved medication at this stage but may be something to watch out for in future medical treatment. Many behavioural treatments have been successful in the treatment of alcohol addiction, however, it appears that what is key is that the alcoholic seeks help. It does not seem to be important what particular treatment he receives rather it is the fact of going for help that motivates success.
These medical treatments all have evidence proving their effectiveness in treating addiction and as mentioned before, work best in conjunction with behavioural therapy. Addiction treatment can be confusing and in the middle of the stress which already exists due to the situation, it is difficult to know which route to take. It is not necessary to struggle alone as there are experienced people willing to help.
Contact wedorecover.com for guidance and advice to help you make an informed decision.
Founded in 2008, WeDoRecover has evolved from an advisory service for addiction treatment into a comprehensive provider of care, following its 2019 merger with Changes Addiction Rehab in Johannesburg. Specialising in connecting patients to top-tier addiction treatment centers in the UK, South Africa and supporting individuals in recovery world wide.