Drug Addiction Treatment Medications
Treatment for people who abuse drugs but are not yet addicted
to them most often consists of behavioral therapies, such
as psychotherapy, counseling, support groups, or family therapy.
But treatment for drug-addicted people often involves a combination
of behavioral therapies and medications. Medications, such
as methadone or LAAM (levo-alpha-acetyl-methadol), are effective
in suppressing the withdrawal symptoms and drug craving associated
with narcotic addiction, thus reducing illicit drug use and
improving the chances of the individual remaining in treatment.
The primary medically assisted withdrawal method for narcotic
addiction is to switch the patient to a comparable drug that
produces milder withdrawal symptoms, and then gradually taper
off the substitute medication. The medication used most often
is methadone, taken by mouth once a day. Patients are started
on the lowest dose that prevents the more severe signs of
withdrawal and then the dose is gradually reduced. Substitutes
can be used also for withdrawal from sedatives. Patients can
be switched to long-acting sedatives, such as diazepam or
phenobarbital, which are then gradually reduced.
Once a patient goes through withdrawal, there is still considerable
risk of relapse. Patients may return to taking drugs even
though they no longer have physical withdrawal symptoms. A
great deal of research is being done to find medications that
can block drug craving and treat other factors that cause
a return to drugs.
Patients who cannot continue abstaining from opiates are
given maintenance therapy, usually with methadone. The maintenance
dose of methadone, usually higher than that used for medically
assisted withdrawal, prevents both withdrawal symptoms and
heroin craving. It also prevents addicts from getting a high
from heroin and, as a result, they stop using it. Research
has shown that maintenance therapy reduces the spread of AIDS
in the treated population. The overall death rate is also
significantly reduced.
Within various methadone programs, those that provide higher
doses of methadone (usually a minimum of 60 mg.) have better
retention rates. Also, those that provide other services,
such as counseling, therapy, and medical care, along with
methadone generally get better results than the programs that
provide minimal services.
Another drug recently approved for use in maintenance treatment
is LAAM, which is administered three times a week rather than
daily, as is the case with methadone. The drug naltrexone
is also used to prevent relapse. Like methadone, LAAM and
naltrexone prevent addicts from getting high from heroin.
However, naltrexone does not eliminate the drug craving, so
it has not been popular among addicts. Naltrexone works best
with highly motivated patients.
There are currently no medications approved by the Food and
Drug Administration (FDA) for treating addiction to cocaine,
LSD, PCP, marijuana, methamphetamine and other stimulants,
inhalants, or anabolic steroids. There are medications, however,
for treating the adverse health effects of these drugs, such
as seizures or psychotic reactions, and for overdoses from
opiates. Currently, NIDA's top research priority is the development
of a medication useful in treating cocaine addiction.
Source: National Institute on Drug Abuse
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