Treating Addiction with Medication
There is a wide range of medications – both over the counter and prescription – that are commonly used in treating addiction. For every challenge in treating addiction, experts and individuals struggling with addiction have tried to incorporate medicines to overcome hurdles and move forward into recovery, as described in an article from Social Work Today.
Medications can be used in every phase of treatment and recovery to support the various issues that may arise to derail the person’s journey toward recovery. From the pains of withdrawal to the triggers and cravings that arise after treatment is over, medications can be an important part of the process.
During detox, the risk of relapse is incredibly high. This is because of the physical and mental discomforts that can occur during withdrawal, including:
- Headache and body aches
- Nausea and vomiting
- Runny nose and red eyes
- Insomnia and other sleep issues
- Breathing and heart rate problems
In some cases, over-the-counter medicines are enough to manage the issues. For example, Pepto-Bismol can manage some of the digestive issues that arise, while analgesics like acetaminophen and ibuprofen can help with headache and body aches.
However, for some of the more severe symptoms or to moderate severe cravings for the drug, many professionals rely on prescription medications to help the individual deal with symptoms and avoid some of the risks of the detox process. There are also prescription medications that can make detox easier by replacing the substance of abuse to enable a smooth taper off the drug, often avoiding some severe health risks that might occur otherwise.
The Substance Abuse and Mental Health Services Administration (SAMHSA) discusses the ways in which some medications are prescribed to enable the individual to focus on treatment and continue to avoid relapse, aiding in the overall treatment process. For example, some types of prescription drugs help to minimize cravings by activating the same receptors in the brain that the drug of abuse did, but with a lower degree of addiction risk. Other medications may completely interrupt the drug’s action in the brain, resulting in extreme discomfort in the event of an attempted relapse to drug use. Both of these types of medications can decrease the potential for relapse.
A Treatment Improvement Protocol from SAMHSA also notes that, in addition to these medicines, it may be necessary during treatment to prescribe medication for co-occurring conditions that contributed to the substance abuse to begin with. For example, if the individual was trying to manage symptoms of depression or anxiety by using drugs or alcohol, treating the depression or anxiety with appropriate medications can decrease the desire to use the substance to self-treat the condition or moderate its effects.
Over-the-counter medications may also ease occasional headaches or other physical symptoms that might trigger a desire to relapse. Use of nonaddictive, over-the-counter medicines may also relieve co-occurring physical conditions, like chronic pain, without resorting to narcotic medications. Supplements may be used to help restore the individual’s nutritional health, which can prevent serious health issues from developing.
Once treatment is over, medications can sometimes be used to help those who are at high risk of relapse by continuing to minimize cravings and support abstinence from the drug of abuse. Many people are aware of the use of methadone for this purpose in heroin addiction treatment, as described by the Journal of Addictive Diseases. Easing cravings, helping to moderate activity in damaged brain pathways, and providing positive or negative reinforcement of abstinence are the main focus points of these medications. These are referred to as maintenance medications.
Aftercare may also involve continuing medical treatment of co-occurring conditions. This aftercare should always be monitored by a medical professional to make sure that it does not lead toward renewed addiction.
The Genetic Science Learning Center describes some of the prescription medications that are used for addiction treatment.
- Methadone and buprenorphine: tapering for opioids, withdrawal management, maintenance medications, as described by WebMD
- Naltrexone: emergency treatment for opioid overdose, relapse prevention for opioids and alcohol
- Clonidine: withdrawal symptom treatment for opioids
- Diazepam: tapering for alcohol or benzodiazepines, withdrawal management, anxiety treatment
- Acamprosate and disulfiram: alcohol craving reduction and relapse prevention
- Bupropion or varenicline: nicotine withdrawal management
- Nicotine replacement therapy: tapering for nicotine
- Antidepressants and anti-anxiety medications: treatment for co-occurring conditions
These medications require supervision from a medical or addiction treatment professional.
To help in managing withdrawal symptoms, the following over-the-counter medications and supplements may be used:
- Pepto-Bismol: for digestive discomfort and nausea
- Acetaminophen or ibuprofen: for headache and body aches
- Melatonin: for insomnia or sleep issues
- Nutritional supplements: for nutritional problems resulting from drug abuse
A doctor or treatment professional can provide information on the supplements that may be needed after abuse of a particular substance. For example, alcoholism is known to result in thiamine deficiency, which can result in brain disease, as described by the National institute on Alcohol Abuse and Alcoholism.
Concerns about Addiction Treatment Medications
The issues around using medicine to treat addiction may be quite obvious to those who struggle with the condition as well as those who treat it. Caution is needed because a major risk of treating addiction with medication is extending the addiction or replacing one addiction with another.
One example of this, as explained by a study in Evidence-Based Medicine, has to do with nicotine replacement therapy. The study demonstrates that people who quit nicotine “cold turkey” are more likely to maintain abstinence than those who try to taper off using nicotine replacement methods.
Another example is in using benzodiazepines like diazepam to help with alcohol tapering. This can be a life-saving technique, helping to prevent severe withdrawal symptoms like delirium tremens (DTs), as described in the Journal of Clinical and Diagnostic Research. However, benzodiazepines are also highly addictive, risking substituting one addiction for another. For this reason, use of these medications in addiction treatment should always be supervised.
Multifaceted Addiction Treatment
While medical support can be useful in treating addiction, it is not a magic bullet. This is true both because of the risks involved in using medication for treatment and because relapse can still occur while using these medications. Nonadherence to prescription instructions, improper dosing, overuse, and other behaviors can lead to relapse, as well as to renewed or replaced addiction.
Because of this, it is important to engage in a well-rounded, research-based treatment program. Through this type of program, the individual complements medical support with:
- Cognitive Behavioral Therapy in addition to other therapies
- Skill-based learning for trigger and relapse avoidance
- Education about drug abuse and its effects
- Peer group support
- Treatment plan management
- Motivational therapies
Working through a program like this helps the individual to stop using the substance of abuse and learn practical ways to continue in recovery. Through this kind of treatment, people who struggle with drug or alcohol abuse or addiction can achieve recovery and become confident in their abilities to stay that way.