A New Prescription for Addiction: A Comprehensive Treatment Plan
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Not all substance withdrawal syndromes can be treated with detox medications, however; for example, there are no medications specifically approved for managing stimulant dependence and withdrawal. In some cases, medical professionals may administer supportive medications, such as antidepressants. There are several medications available for the management of opioid and alcohol withdrawal.
What is drug addiction treatment? | National Institute on Drug Abuse (NIDA)
These include: 5 Methadone : This full opioid agonist is capable of displacing heroin and prescription painkillers at the opioid receptors in the brain. Methadone is relatively long-acting, which facilitates a controlled, daily dosing schedule. Since it is an opioid, it does have potential for abuse. Buprenorphine : This partial opioid agonist also displaces opioids of abuse at the opioid receptor sites and alleviates opioid withdrawal and cravings.
As a partial agonist, buprenorphine has a ceiling to its effects —including its potential for achieving a subjective, rewarding high—which helps to minimize its abuse potential. Compared to methadone, it may produce a lesser-pronounced euphoria. Buprenorphine is frequently formulated in combination with naloxone to further deter abuse. Clonidine : This non-opioid drug is often used in combination with other opioid detox medications to manage the autonomic arousal symptoms of opioid withdrawal, such as high blood pressure and rapid pulse.
Benzodiazepines : Benzodiazepines, including Valium and chlordiazepoxide, are the preferred class of medications to manage acute alcohol withdrawal. Because benzodiazepine use can lead to dependence, the doctor will create a gradual tapering schedule for you in which you slowly reduce your dose over time. Phenobarbital : Barbiturates were once commonly used to treat alcohol withdrawal, but they have high abuse potential and can quickly lead to tolerance.
Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition)
Overdose is also a concern with these drugs. Phenobarbital is still in use but only in very supervised environments, such as in a hospital. Anticonvulsants : These have proven to be effective in managing mild to moderate alcohol withdrawal symptoms. Antipsychotics : These drugs help to control delusions, hallucinations, and agitation during alcohol withdrawal. The combination of behavioral therapy and medication is known as medication-assisted treatment MAT. The term is typically used in reference to opioid addiction treatment, but it may also refer to treatment for alcohol abuse as well.
Methadone can be used in the long-term as a maintenance medication to promote abstinence. Some people may take it for a few months, while others may take it for years and even a lifetime. This medication can only be dispensed via a certified opioid treatment programs OTP , commonly called a methadone clinic. The naloxone has no effect when Suboxone is taken as directed orally , but if the drug is dissolved in solution and injected, the opioid antagonizing properties will induce opioid withdrawal.
Similar to methadone, this medication can be used for as long as the patient is comfortable. Unlike methadone, Suboxone can be prescribed by physicians in an office-based environment by a Suboxone-licensed doctor. It should be given after a period of abstinence or detox. This medication deters drinking, because a person will experience unpleasant effects if they drink while taking this medication.
These effects may include flushing, sweating, headache, racing pulse, nausea, and vomiting. It may reduce the desire to drink in people who are recovering from alcoholism. Initiation of acamprosate should be delayed until 5 days after the last drink. During inpatient addiction treatment, you can expect a highly structured environment with around-the-clock monitoring and supervision. Your treatment team may consist of several, variously qualified practitioners. Evidence-based therapies, as discussed above, will make up the core of treatment; however, some holistic treatment programs may integrate traditional treatment approaches, such as psychotherapy, with complementary and alternative therapies CAM.
These CAM therapies may include: 13 Yoga. Meditation and mindfulness. Recreational therapy. Music therapy. Guided imagery. Other treatment components that may be included are:.
Just as each program offers varying services and therapies, they also differ in amenities. For instance, luxury treatment programs provide patients with an upscale setting and luxurious services, such as massage therapy, spa treatment, gourmet meals, golf, equine therapy, etc. People in luxury treatment typically have their own private rooms, while many other standard inpatient programs may require that patients share a room.
The number one rule is always a zero-tolerance policy for drugs and alcohol. You must remain abstinent while attending addiction treatment. As stated before, some may require that you have a roommate. Others may forbid cell phones and other electronics, such as iPads or laptops. Occasionally, a rehab may allow pets to stay with you during your treatment, but this is very rare.
There is no one set timeline for the duration of addiction treatment. It will largely depend on your unique needs and situation as well as your recovery progress. Many inpatient programs offer a range of 30 to 90 day treatment, although it can be extended on an as-needed basis.
Additional Treatment Information
According to the National Institute on Drug Abuse NIDA , residential or outpatient programs that are shorter than 90 days may have limited effectiveness, and longer bouts of treatment are generally associated with better treatment outcomes. Partial hospitalization programs, or day treatment, may require many hours of treatment per day, most days of the week, while intensive outpatient programs require a few hours per session for a couple days per week. Relatively lower-intensity outpatient programs may require meeting once or twice a week for hours each session.
This includes both primary treatment and aftercare, or follow-up support. Although not everyone relapses, it is still considered to be a normal part of the recovery process and indicates that they require another course of treatment, possibly with a different approach.
Many people who seek treatment for addiction struggle with polydrug abuse, meaning that they may be dependent on more than one substance. This means that they are likely to experience multiple withdrawal syndromes when they abruptly quit using. Some common substance combinations include: 5,17 Alcohol and cocaine. Alcohol, cocaine, and heroin. Heroin and cocaine. Alcohol and marijuana. Benzodiazepines and alcohol. Benzodiazepines and opioids.
Ecstasy and alcohol. These changes in the brain can lead to the harmful behaviors seen in people who use drugs. Drug addiction is also a relapsing disease. Relapse is the return to drug use after an attempt to stop. The path to drug addiction begins with the voluntary act of taking drugs. But over time, a person's ability to choose not to do so becomes compromised. Seeking and taking the drug becomes compulsive.
This is mostly due to the effects of long-term drug exposure on brain function. Addiction affects parts of the brain involved in reward and motivation, learning and memory, and control over behavior. Most patients need long-term or repeated care to stop using completely and recover their lives. Based on scientific research since the mids, the following key principles should form the basis of any effective treatment program:.
A range of care with a tailored treatment program and follow-up options can be crucial to success. Treatment should include both medical and mental health services as needed. Follow-up care may include community- or family-based recovery support systems. Medications and devices can be used to manage withdrawal symptoms, prevent relapse, and treat co-occurring conditions.
Medications and devices can help suppress withdrawal symptoms during detoxification. Detoxification is not in itself "treatment," but only the first step in the process. Patients who do not receive any further treatment after detoxification usually resume their drug use. One study of treatment facilities found that medications were used in almost 80 percent of detoxifications SAMHSA, This device is placed behind the ear and sends electrical pulses to stimulate certain brain nerves.
Can drug addiction be treated?
Also, in May , the FDA approved lofexidine, a non-opioid medicine designed to reduce opioid withdrawal symptoms. Relapse prevention. Patients can use medications to help re-establish normal brain function and decrease cravings.
Medications are available for treatment of opioid heroin, prescription pain relievers , tobacco nicotine , and alcohol addiction. Scientists are developing other medications to treat stimulant cocaine, methamphetamine and cannabis marijuana addiction. People who use more than one drug, which is very common, need treatment for all of the substances they use.
Most of the programs involve individual or group drug counseling, or both. These programs typically offer forms of behavioral therapy such as:.