As the United States is amidst an opioid epidemic, with close to 4.5 million people abusing non-prescription painkillers, drug addiction rates are on the rise. With more people becoming addicted to drugs, the number of overdose fatalities rises as well, with a mind-blowing 20,000 overdose cases from prescription opioids in 2015.
To best prevent overdose and accidental death, it is important for someone that struggles with an addiction to seek professional help immediately.
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Though they are extremely dangerous, opioids are not the only addictive substance in which the United States struggles. Alcohol, commonly viewed to be a “safe” substance, is one of the most commonly abused substances. The natural addictiveness of alcohol causes it to be consistently abused, contributing to the approximately 30,000 deaths per year from alcohol abuse alone.
Despite these troubling numbers, someone struggling with addiction should not lose hope. By engaging in professional addiction treatment, the individual can get their life back on track.
Detoxification is the first and usually the most difficult step in addiction treatment.
There are many uncomfortable withdrawal symptoms associated with detox, contributing to the fact that many people that detox on their own end up relapsing.
When someone is engaged in treatment by professionals, they are given the proper resources they need, including medications to aid in the treatment as a whole, including the detox phase. This ultimately greatly increases their chances of reaching and holding a position of sobriety.
Many times, someone who attempts to self-detox at home does so improperly, resulting in severe withdrawal symptoms and even death. Most of the time, this is a result of self-detoxing and going cold turkey.
Cold Turkey Detox
Attempting detox on your own is dangerous, mainly due to the fact that most people will assume that it is safe and easy to go cold turkey. “Cold turkey” refers to the immediate cessation of a drug and all drug intake, in an attempt to remove all the toxins, residue, or any substance buildup as a result of chronic drug abuse.
Going cold turkey results in some of the most dangerous withdrawal symptoms, low success rates, and will most likely take longer than medical detox due to the high rates of relapse.
Detox should always be handled with caution, and it is important that no shortcuts be made during the detox phase.
When engaging in cold turkey detox, you do not give your body the time it needs to readjust from being under the constant effects of a drug to complete sobriety. This rapid change in chemical functionality of the brain brings upon major withdrawal symptoms and Delirium tremens. Side effects can range from hallucinations and seizures to extreme heart rates.
Alcohol and benzodiazepine detox are the most difficult to treat and in the case of alcohol, a frighteningly 10 percent of alcoholics in detox experience Delirium tremens. Delirium tremens is the most dangerous withdrawal symptoms, characterized by confusion, hallucinations, hyper and hypotension, and many other side effects that can pose a threat to a detoxing addiction’s health and wellbeing.
How Do Medications Help with Treatment
Substance abuse treatment can be made much easier by implementing Medication-Assisted Treatment (MAT).
The following list is just a few ways that medication can help a patient endure the hardships associated with treatment:
- Withdrawal symptoms are the most obvious reason for the use of medication. Withdrawal symptoms can vary greatly depending on the length of time used and severity of someone’s addiction. However, they are usually extremely unpleasant and uncomfortable. MAT can treat withdrawal symptoms by reducing the mental and physical side effects of detoxing and treatment.
- Many cases of drug addiction involve a user being dual-diagnosed, simply meaning that they may have one or more disorders (both mentally or physically) that may interfere with their current treatment. Disorders such as depression and anxiety are common in patients, and antidepressants can be very useful in helping to treat cases of dual diagnosis.
- Some medications are used as a sort of substitutes for the previously-addicted substance. They reprogram the brain to function normally while sober and ultimately reduce cravings.
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Medications Used in Treatment
- Methadone – Methadone is a short-term medication that is often used to mitigate the awful heroin withdrawal symptoms. Methadone, as well as treating withdrawal symptoms in opioid addiction treatment, can be used as a substitute for heroin to taper off of it. This characteristic of methadone is the reason it is referred to as a “full opioid agonist,” producing similar effects to opioids but much more mild.
- Buprenorphine: Similar to methadone, buprenorphine is a common drug used to curb heroin cravings and withdrawals. However, buprenorphine is only a partial agonist as opposed to methadone, a full agonist. This makes it safer to use for long-term treatment, but also has weaker effects.
- Naltrexone is different from both methadone and buprenorphine due to the fact that instead of being an agonist, it is an antagonist. Naltrexone works to block the beneficial effects of opioids, keeping the pleasurable feelings of the substance from the user. This discourages people to relapse during treatment and is very effective.
- Naloxone: Naloxone and naltrexone go hand in hand in the way that they deal with opioid addiction treatment. Another pure antagonist to opioids, naloxone is simply a stronger form of naltrexone. Naloxone is essential in canceling out the narcotic effects of opioids, and can potentially reverse an opioid overdose. Naloxone is generally used in an emergency or extremely severe situations and is sometimes used in conjunction with buprenorphine.
- Naltrexone: Similar to the ways that it helps in opioid addiction treatment, Naltrexone has the same effect on people going through alcohol addiction treatment. Naltrexone limits the pleasurable effects of intoxication and discourages users from continuing abuse.
- Acamprosate: Acamprosate is a medication that is commonly used to treat post-acute withdrawal symptoms (PAWS). PAWS are withdrawal symptoms that reach beyond the detox phase are usually psychological side effects. Conditions such as anxiety and insomnia are lessened, resulting in a lower chance of a user to relapse.
- Disulfiram: Disulfiram is unique in the way that it treats alcohol addiction treatment. Once administered, disulfiram will significantly decrease future urges and cravings for alcohol that someone with alcohol use disorder might get during treatment.It works by prohibiting the body from chemically breaking down alcohol. This makes any ingestion of alcohol unpleasant for the patient, resulting in sweating, vomiting, anxiety, vertigo, and so on. The very unpleasant effects will only last roughly about an hour. Administration of disulfiram is one of the most effective ways to treat alcoholism, as the patient quickly develops a negative connotation to alcohol.
Although there is no FDA-approved medication for treating stimulant addiction, there are some medications that can be used to treat general substance abuse and withdrawal symptoms.
In cocaine (a stimulant) addiction, there are medications that have been found and proven to be successful in reducing cravings and dependency through the use of antidepressants. Mirtazapine, desipramine, bupropion, and other drugs are common throughout simulant addiction as well as co-occurring disorder cases.
What Are the Risks?
Though medications can very much benefit a patient while they engage in treatment and relapse prevention, there are a few risks associated with medication-assisted treatment.
Methadone, in particular, has been in a debatable position lately, with much of the controversy surrounding it coming from the danger of tolerance and consequently dependency. Ironically, once someone begins to abuse methadone long-term, it comes with its own set of uncomfortable withdrawal symptoms.
In cases where even partial opioid agonists are used, such as buprenorphine, there is still a risk involved. If not expertly administered and controlled, a patient can very easily develop an addiction and a dependency on buprenorphine. Though buprenorphine and methadone are effective in tapering someone off of a drug during detox, it is very difficult, and great caution should be used to avoid any negative drawbacks.
Dependency and potential addiction are not the only risks that someone runs by engaging in medication-assisted treatment.
In the case of naltrexone (which decreases the tolerance to opioids), if a patient is to relapse, they will return to the same amount of the drug that they were used to before, not what their tolerance is since they have been taking naltrexone.
While medication-assisted treatment will always have its risks, as long as the medications are handled and administered by an experienced professional, they can only benefit you in your addiction treatment. By removing all risks of detoxing cold turkey, medication-assisted treatment is among the, if not thesingle most, effective way to treat substance addiction.
Medication-Assisted Treatment FAQ
Yes. MAT is an evidence-based form of addiction treatment. Medications have shown to decrease drug cravings, and their effectiveness in therapeutic settings has been studied scientifically. The National Institute on Drug Abuse (NIDA) lists buprenorphine and naloxone as viable, evidence-based pharmacotherapies. They are an excellent option for people that have struggled to maintain sobriety in the past. And the effectiveness of MAT treatments with buprenorphine or Suboxone has been backed up by scientific research.
MAT has shown to be effective in multiple ways when treating addiction. Medications relieve withdrawal symptoms and cravings to use psychoactive substance like opioids. This has several benefits for people seeking addiction treatment.
Drugs like buprenorphine can satisfy cravings without causing significant intoxication. According to the Substance Abuse and Mental Health Services Administration, research has shown that MAT doesn’t negatively impact cognitive ability, intelligence, physical capabilities, or employability.
That means someone going through a MAT program can start to pursue a normal life that would have been difficult to maintain during active addiction. MAT also helps encourage treatment attendance and pairs well with other therapy options like cognitive behavioral therapy.
With guidance from medical professionals, MAT is safe. Taking opioid medications to treat opioid addiction can be dangerous without supervision, however.
If you take the medication before other opioids have left your system, you could cause the substances to potentiate each other, which means they work together to intensify their effects. This can cause a potentially fatal overdose.
When you start a MAT program, medical staff will confirm that you have been chemically dependent on opioids and that you’ve already started to experience withdrawal symptoms. If you feel clear symptoms, it indicates that the drug has started to become ineffective, and it’s safe to start the medication. Still, MAT that involves opioids is safest with a doctor’s supervision.
Harm reduction is an approach to addiction that focuses on limited the physical and psychological consequences that might harm a person. For instance, some countries offer needle exchange programs to limit the exposure to dirty needles among heroin addicted people. This reduces the likelihood of people contracting bloodborne diseases, but it doesn’t stop them from continuing to use heroin.
MAT’s main priority is reducing harm. It helps people stop using illicit drugs, which limits their potential for an overdose. It also helps people spend less time in a cycle of intoxication and withdrawal, which allows them to maintain jobs, have relationships, and pursue life goals.
MAT doesn’t immediately help a person achieve complete abstinence from chemical substances, but it can help them achieve sobriety. MAT programs can also get people into treatment with the goal of eventually weaning off of their medication and achieving abstinence.
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