Pharmacotherapy for Opiate Rehabilitation

Are you tired of drugs and alcohol controlling your life? With 128 people a day dying from an opioid overdose, are you ready for opiate addiction rehabilitation? Did you know there are new treatments for heroin addiction? Specifically, what is pharmacotherapy, and can it help in recovery?

What is Pharmacotherapy?

Pharmacotherapy or medication-assisted treatment (MAT) is the use of medication to treat a disorder or disease. In addiction treatment such as opiate addiction rehabilitation, anti-addiction medication ease withdrawal symptoms, cravings, and reduce the recurrence of use. But, the main goal of pharmacotherapy is helping you maintain Recovery for Life. 

More than 1 in 7 Americans 12 and older suffer from substance use disorder (SUD). However, only about 10 percent receive professional treatment. With new treatments for heroin addiction and anti-addiction medication, the hope is more people seek treatment.

What Makes Pharmacotherapy Successful?

Addiction or SUD is a chronic disease. Like medications for chronic diseases, some addictions require anti-addiction medication. Over 2 million Americans in 2016 suffered from opioid use disorder (OUD) because of prescription opioids. 

At the same time, over 260,000 struggles with OUD because of heroin. However, a common OUD treatment is pharmacotherapy.  When combining anti-addiction medication such as methadone and naltrexone with behavioral and holistic therapies, the benefits include:

  • Increases retention in treatment
  • Lowers illicit opiate use 
  • Decreases criminal behaviors due to SUD
  • Improves members survival rate
  • Improves the outcome of pregnancies in women struggling with SUD
  • Increases members ability to gain employment

Abstinence-Based Treatment vs. Pharmacotherapy in Treatment

If you enter an abstinence-based treatment program, you will not receive medication to help with recovery. You will go “cold-turkey,” meaning you will not receive anti-addiction medication to ease withdrawal. 

Abstinence in addiction treatment refers to the complete cessation of substance misuse entirely. The approach in abstinence-based programs is a person suffering from addiction is always at risk of recurrence of use. 

In addition, SAMHSA (Substance Abuse and Mental Health Services Administration) says abstinence is the safest approach to treating SUD. These programs also remove unwanted temptations from your life. Lastly, abstinence-based programs are still the most common treatment programs. 

However, the CDC and the National Institute on Drug Abuse (NIDA) recommend using pharmacotherapy. These agencies believe a strict regime of medications offers a reduction in opiate misuse issues. Above all, anti-addiction medication provides a stable path to recovery.

For example, anti-addiction medication is often only used in detox or in emergency overdose cases. These interventions can save a life and also help ease withdrawal symptoms. Above all, pharmacotherapy in detox increases your stay in treatment.

Why Are More Opiate Addiction Rehabilitation Centers Using Anti-Addiction Medication?

The best opiate addiction rehabilitation centers use evidence-based treatment approaches. For instance, evidence shows proper use of pharmacotherapy, along with other therapies, works better than detox and therapies without anti-addiction medication.

3 Things Evidence-Based Programs Believe About Pharmacotherapy

First, there are anti-addiction medication proven safe, effective, non-addictive, and little risk of misuse. Furthermore, anti-addiction medication does support total abstinence. 

Second, if an anti-addiction medication has a risk of misuse, the risk can be avoided. For example:

  • Prescribed for short-term use
  • Strictly monitored
  • Part of a comprehensive treatment plan

Lastly, when the risk of pharmacotherapy outweighs the risks of SUD, then it’s acceptable. The dangers of SUD include overdose, death, and crime.

How is Anti-Addiction Medication Used in Opiate Addiction Rehabilitation? 

Anti-addiction medication used in addiction treatment can help in recovery by:

  • Withdrawal – Some anti-addiction medication ease your withdrawal symptoms during detox. In fact, SAMHSA estimates medication is used in almost 80 percent of detoxes. Although detox is not a form of treatment, it is a critical first step in your recovery. 
  • Preventing recurrence of use – When you use anti-addiction medication, it helps reduce cravings. In addition, these medications help restore normal brain function. As a result, you can maintain Recovery for Life. 
  • Treating co-occurring disorders – Many individuals struggling with misuse also suffer from comorbid mental illnesses such as anxiety, depression, and PTSD. As a result, these mental illnesses can worsen and be worsened by substance misuse. Therefore, treating both disorders simultaneously increases Recovery for Life.

Types of Anti-Addiction Medication

Depending on your treatment plan, there are several classes of anti-addiction medication. 

  • Agonists – These medications attach to the same receptors as opioids and other drugs. This action reduces cravings. 
  • Replacement medications or Opioid Replacement Therapy (ORT) – ORT is also known as opioid substitution therapy or opioid maintenance therapy. This class of anti-addiction drugs is used in opiate addiction rehabilitation. New treatments for heroin addiction include this safer anti-addiction medication.
  • Aversion Therapy – Some anti-addiction medication classes trigger uncomfortable or painful reactions when you use drugs or alcohol. 

New and old anti-addiction medication in comprehensive opiate addiction rehabilitation treats various SUDs.

New Treatments for Heroin Addiction and Opiate Addiction Rehabilitation

The FDA has approved various medications that are effective in treating SUD. The following includes new and old anti-addiction medications, particularly useful in opiate addiction rehabilitation.

Buprenorphine/Naloxone

Introduced in 2002

Brand names include Suboxone, Zubsolv.

This anti-addiction medication is the first-line treatment for opioid use disorder. However, you must meet the following recommendations:

  • Are you socially stable?
  • Can you comply with your medication schedule?
  • Are you unable to go to a methadone clinic every day?
  • Do you have a job that prohibits sedating medications?

An advantage of this anti-addiction medication is by adding Naloxone to buprenorphine, is it deters opiate misuse. But, this medication has a risk of misuse, such as crushing and snorting or injecting the medicine. Above all, you can still get high from sublingual use. As a result, you can become dependent. 

Side effects include:

  • Muscle aches and pains
  • Nausea and vomiting
  • Constipation
  • Cravings
  • Insomnia
  • Irritability
  • Fever

Buspirone

Introduced in 1975

Brand names include: Buspar, also available in generic

Buspirone is as effective as methadone at easing opiate withdrawal symptoms. It also helps boost the effects of anti-depressants. However, if you have diabetes, kidney, or liver issues or take MAO inhibitors, you shouldn’t take Buspirone.

Benefits include:

  • Not a barbiturate or benzodiazepine
  • Little to no risk of misuse
  • Not sedating
  • No euphoria
  • Doesn’t affect motor functions
  • No withdrawal symptoms

Methadone

Introduced in 1947

Brand names include: Dolophine, Methadose

Methadone is the most common treatment for opioid addiction. However, Methadone is extremely addictive. It is also often misused. Above all, the risk of overdose is high. For instance, Methadone has almost double the overdoses as any other anti-addiction medication.

Side effects of methadone include:

  • Chest pain
  • Irregular heartbeat
  • Difficulty breathing
  • Lightheadedness or fainting
  • Hallucinations or confusion
  • Allergic reactions – rash, hives, swelling in the face, lips, tongue, or throat

Naloxone

Introduced in 1971

Brand names include: Narcan, Evzio

Naloxone is an emergency anti-addiction medication that reverses opioid overdoses. In most cases, Naloxone is available without a prescription. It’s easy to use, but above all, it can immediately save a life. 

Naloxone only works for opiate overdose, not other drug overdoses.  Also, it isn’t a treatment medication, although a person often seeks treatment after an overdose. Unfortunately, some people will overdose knowing Naloxone can save them.

But, Naloxone also sends you into severe withdrawal, so emergency treatment is necessary.

Naltrexone

Introduced in 1965 but approved in 1984

Brand names include: ReVia, Vivitrol

Naltrexone is an anti-addiction medication used in new treatments for heroin addiction. This medication also treats alcohol use disorder. Naltrexone blocks the effects of alcohol and opiates either by injection or orally. As a result, you don’t feel any euphoric effects. 

Because Naltrexone isn’t an opiate, it has several advantages, including:

  • No risk of dependence or addiction
  • ReVia is a take-home prescription, unlike Methadone
  • Any physician can prescribe unlike Methadone
  • Vivitrol injections are given by a doctor once a month
  • Fewer cravings
  • Prevent recurrence of use
  • Increases treatment time

Disadvantages of Naltrexone include:

  • Must be opioid-free for 14 days
  • Cannot use ANY opiates even if prescribed
  • If insurance doesn’t cover Vivitrol injections, they can cost $1500 apiece

What is Pharmacotherapy for Alcohol Use and Other Substance Use Disorders

Withdrawal symptoms from alcohol and other drugs can cause life-threatening seizures. Because alcohol is the most commonly misused substance, many individuals struggle with alcohol use disorder (AUD). However, any following anti-addiction medication can help you recover from various addictions. 

  • Acamprosate (Alcohol)
  • Baclofen (Alcohol)
  • Benzodiazepine (Alcohol, Benzodiazepines)
  • Bupropion (Smoking, Cocaine)
  • Calcium Carbamide (Alcohol)
  • Carbamazepine (Alcohol)
  • Dextroamphetamine (Methamphetamine)
  • Disulfiram (Alcohol, Cocaine)
  • Gabapentine (Alcohol, general SUD)
  • Methylphenidate (Methamphetamine, Cocaine)
  • Mirtazapine (Methamphetamine)
  • Modafinil (Cocaine)
  • Nalmefene (Alcohol)
  • Phenobarbital (Alcohol and Benzo withdrawal)
  • Propranolol (Alcohol, Cocaine)
  • Rivastigmine (Methamphetamine)
  • Tiagabine (Cocaine)
  • Topiramate (Alcohol, Cocaine)
  • Varenicline (Alcohol, Smoking)

Other Treatment Approaches to Benefit Pharmacotherapy

If you enter a pharmacotherapy program, you must also receive counseling. This is a requirement of the FDA. Therapies, such as behavioral therapies can help:

  • Build healthy life skills
  • Build healthy thoughts and beliefs
  • Successfully manage mental health disorders
  • Help build skills to prevent recurrence of use
  • Reinforce good behaviors

Whether you choose inpatient treatment or one of the outpatient programs, the same therapy programs are available. If you’re in one of many new treatments for heroin addiction, the therapies and benefits may include:

Cognitive-Behavioral Therapy Benefits

  • Focuses on the present
  • Goal-oriented therapy
  • Building coping skills for cravings, stress, and triggers
  • Works in a group and individual therapy
  • Changing negative thoughts to positive ones

Contingency Management Benefits

  • Increases treatment retention rates 
  • Improves Recovery for Life
  • Can be used alone or in conjunction with other therapies

Rational Emotive Behavior Therapy Benefits

  • Taking responsibility for behaviors and feelings
  • Identify and manage irrational thoughts
  • Cope with feelings without drugs and alcohol
  • Self-acceptance

Motivational Interviewing Benefits

  • Motivation to make personal changes
  • Increases participation in treatment
  • Prevents recurrence of use
  • Setting goals

Dialectical Behavior Therapy Benefits

  • Reduces self-harm and suicide attempts
  • Learning to regulate emotions
  • Changes negative behaviors that lead to addiction
  • Motivation to make positive changes

Are you ready for Recovery for Life?

Addiction is a chronic disease requiring a lifetime of treatment to maintain recovery. So, just completing opiate addiction rehabilitation is not enough to achieve Recovery for Life. In some new treatments for heroin addiction, you may continue in pharmacotherapy. 

But, the most common aftercare programs are Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). These groups are 12-step programs that offer support, encouragement, and advice for maintaining Recovery for Life.

Before leaving an opiate addiction rehabilitation center, you and your therapist will develop a relapse prevention plan. This plan will include therapies and groups to help you maintain recovery. If you follow this plan and modify it as needed with your therapist, you can retain Recovery for Life. Are you ready?

Help is Waiting at Sana Lake Behavioral Wellness Center

Whether seeking help for yourself or a loved one, our dedicated staff is waiting to answer your questions. Quit letting drugs and alcohol ruin your life. Contact us today and find out how you, too, can find recovery. 

References:

https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/methadone

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874458/

https://www.who.int/substance_abuse/activities/psychosocial_interventions.pdf

https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=3&SID=7282616ac574225f795d5849935efc45&ty=HTML&h=L&n=pt42.1.8&r=PART#se42.1.8_112