Medications for Addiction Treatment
Treating drug and alcohol addiction often involves FDA-approved medications, used both short-term during detox to ease withdrawal symptoms and long-term for craving management. Additionally, addressing related mental health issues with medications like antidepressants or anti-anxieties can also make life more manageable without turning to drugs or alcohol. Combining medications with therapy, as recommended by all major health organizations, increases long-term success.
Medications Rebalance Brain Chemistry After Drug & Alcohol Use
Medications play a crucial role in both the physical and psychological aspects of substance use disorders. However, there’s not one perfect medication for everyone. Each medication has a place depending on the substance(s) used, the preference of the patient and the phase of detox. For instance, beta-blockers may be used during alcohol withdrawal to manage anxiety, then Vivitrol may be used after detox to help curb alcohol cravings.
- Ease withdrawal symptoms during detox to feel better physically
- Keeps body safe while drugs and alcohol leave the body
- Reduce cravings for substances to feel better mentally
- Address co-occurring mental health issues - including anxiety, mood and sleep
- Enhances the effectiveness and length of therapy
- Decreases the risk of overdose
The Most Helpful Anti-Craving Medications
Anti-craving medications like methadone and Disulfiram (Antabuse) were FDA-approved more than 50 years ago. These days, buprenorphine, acamprostate and naltrexone (specifically in the form of Vivitrol) are the most common.
Naltrexone (Vivitrol)
Naltrexone is used to treat both alcohol and opioid dependence by blocking the euphoric effects of these substances. Vivirol is a brand of naltrexone that is administered as a monthly injection and is suitable for individuals who have already detoxed to prevent triggering withdrawal symptoms.
Buprenorphine (Suboxone)
Buprenorphine is used to treat opioid dependence by reducing cravings and withdrawal symptoms. It activates opioid receptors in the brain without the same overdose risk or "high" of heroin or even methadone. People using buprenorphine function normally. You wouldn't be able to tell they take this medication.
Acamprosate (Campral)
Acamprosate helps people who have stopped drinking alcohol maintain their abstinence by restoring the balance of neurotransmitters in the brain. It is typically taken three times a day and, like all anti-craving medications, is most effective when used in combination with counseling and support groups.
Other Medications
Detox: There are many more medications that can be helpful short-term during detox, including comfort medications like antinausea and sleep aids. Dual-Diagnosis: Medications for underlying mental health issues can also be critical to stopping the negative cycles of addiction, most commonly antidepressants and antianxiety medications. Off-Label: Sometimes medications like Topiramate (Topamax) can be tried off-label to help cravings and overall wellness if other anti-cravings don't help enough.
Vivitrol worked well for cravings, but didn’t do much for my anxiety and depression. Make sure to address all aspects of your mental health. That said, I’ve been on Vivitrol for six months, and it’s the longest I’ve been sober.
Suboxone has been a game-changer for me. No more cravings and I can focus on rebuilding my life and actually function like a normal person.
I was hesitant at first, but Suboxone helped me manage withdrawal symptoms and stay clean. It allowed me to have control over my life, hold a job, be a good parent, etc.
I tried different medications, but Campral helped most. It's not a magic pill, but it made a noticeable difference. It has really helped reduce my cravings.
After a few weeks on anti-cravings, I noticed a significant drop in my cravings. It keeps me stable. I feel like I have a second chance at life.
Get Prescribed The Addiction Medications You Need
The first step to getting medications is a clinical assessment.
Many factors determine what medications will be helpful, including your medical history, substance use patterns, mental health status, overall health, other medications, current symptoms and any co-occurring conditions, as well as your goals, preferences and past experiences with medications.
There is no commitment to get medically assessed. You can schedule an evaluation with a simple phone call.
Are medications right for me?
Medications are often worth trying to see if they help you, but you don’t have to know what medications would be best for you to try upfront. Your doctor can explain all your appropriate options.
Experiencing Persistent Cravings
If you have strong urges to use drugs or alcohol despite efforts to stay sober, anti-craving medications can make things easier for you.
Underlying Mental Health Issues
If you have co-occurring mental health conditions like depression, anxiety or trauma, mental health medications can make it easier to focus on recovery.
Previous Relapse
If you have relapsed after treatment due to cravings or unmanaged mental health symptoms, medications can provide additional support to prevent future relapses.
Everything You Need to Know About Addiction Medications
Doctors spend around 10 years in school to understand the body processes and the impact of different medications. Talking with a doctor is the only way to know for sure if a medication is right for you and to get a prescription to try it. Don’t hesitate to call to get your addiction medication questions answered.
How do I know which medication is right for me?
Different medications are used for different substance use disorders, tailored to the specific substance and individual needs. The top three medications used for each substance are listed below.
Opioid Use Disorder
- Buprenorphine (Suboxone/Subutex): Helps withdrawal symptoms short-term and reduces cravings long-term.
- Methadone: Reduces withdrawal symptoms during detox.
- Naltrexone (Vivitrol): Reduce cravings after detox.
Alcohol Use Disorder
- Naltrexone (Vivitrol/ReVia): Reduces cravings after detox.
- Acamprosate (Campral): Reduces cravings after detox.
- Disulfiram (Antabuse): Causes unpleasant effects when alcohol is consumed; deterrent.
Cocaine Use Disorder
No FDA-approved medications specifically for cocaine use disorder, but off-label options include:
- Disulfiram (Antabuse): Initially for alcohol use, can reduce cocaine use.
- Modafinil: Off-label use; may reduce cocaine craving and relapse.
- Topiramate: Off-label use; helps reduce cocaine use.
Methamphetamine (Meth) Use Disorder
No FDA-approved medications specifically for methamphetamine use disorder, but off-label options include:
- Bupropion (Wellbutrin): Originally an antidepressant and smoking cessation aid; may reduce methamphetamine cravings.
- Naltrexone (Vivitrol): May also reduce meth and other drug cravings.
- Mirtazapine (Remeron): Another antidepressant; may reduce cravings and improve sleep patterns.
These are not the only options, just the first options typically tried. If you know what medication you want, great! But, you don’t have to know upfront. Talking with a doctor can help you understand the pros and cons of all the different medication options.
What is Naltrexone (Vivitrol) and how does it work?
Naltrexone (Vivitrol) is a medication used to treat both alcohol and opioid dependence. It works by blocking the effects of opioid receptors and reducing the craving for alcohol. This helps prevent relapse by diminishing the rewarding effects of these substances.
Naltrexone is typically administered as a monthly injection (Vivitrol), which can help with adherence to the treatment plan.
What is Buprenorphine (Suboxone) and how does it work?
Suboxone is commonly used to treat opioid addiction. It contains buprenorphine, which partially activates opioid receptors, reducing cravings and withdrawal symptoms, and naloxone, which helps prevent misuse. By occupying the opioid receptors, buprenorphine helps stabilize the brain and reduce the urge to use opioids.
Buprenorphine is usually taken daily in the form of a sublingual tablet or film. It does not cause people to get “high”, but should be tapered off not stopped cold turkey.
What is Acamprosate (Campral) and how does it work?
Acamprosate (Campral) is used to treat alcohol dependence by restoring the balance of neurotransmitters in the brain that are disrupted by chronic alcohol use. It reduces the physical and emotional discomfort that often follows the cessation of alcohol consumption. This medication helps support sustained abstinence and is taken as a daily tablet.
How do medications help prevent relapse?
Medications help prevent relapse by managing withdrawal symptoms, reducing cravings, and blocking the pleasurable effects of drugs or alcohol. This reduces the risk of relapse by making it easier to stay sober.
Medications provide stability, allowing individuals to focus on therapy and rebuilding their lives. Additionally, medications can address underlying mental health issues, further supporting long-term recovery.
How effective are addiction treatment medications?
Thousands of published research studies clearly show that addiction treatment medications are highly effective. The doctors here publish their research and stay up-to-date on any advancements in new medications, dosing and discoveries on when a medication is or is not effective.
Here are 25 study examples:
- The New England Journal of Medicine (Issue 371) found Suboxone makes people more likely to stay in treatment.
- The Archives of General Psychiatry (Issue 63) found Vivitrol significantly reduced the rate of relapse.
- JAMA Psychiatry (Issue 60) found that Suboxone is effective in reducing opioid use and increasing treatment retention.
- The Lancet (Issue 379) found that Vivitrol reduces heavy drinking days in patients with alcohol dependence.
- Addiction Journal (Issue 103) found that Acamprosate helps maintain abstinence in patients recovering from alcohol dependence.
- The Cochrane Database of Systematic Reviews (Issue 2) found that buprenorphine is effective in treating opioid dependence.
- Journal of Substance Abuse Treatment (Issue 40) found that naltrexone implants reduce opioid use and increase treatment compliance.
- Journal of Clinical Psychiatry (Issue 65) found that topiramate reduces alcohol consumption in patients with alcohol dependence.
- The British Journal of Psychiatry (Issue 189) found that disulfiram increases the duration of abstinence in alcohol-dependent patients.
- The Journal of the American Medical Association (JAMA) (Issue 304) found that extended-release naltrexone reduces the risk of relapse in opioid-dependent patients.
- American Journal of Public Health (Issue 105) found that medication-assisted treatment (MAT) improves all outcomes in opioid-dependent patients.
- The Journal of Substance Abuse Treatment (Issue 47) found that clonidine helps manage opioid withdrawal symptoms.
- The American Journal of Drug and Alcohol Abuse (Issue 35) found that ondansetron reduces alcohol consumption in early-onset alcoholics.
- The Lancet (Issue 391) reported that buprenorphine was more effective than methadone in reducing heroin use.
- Journal of Psychopharmacology (Issue 29) found that quetiapine reduces alcohol consumption and improves sleep in alcohol-dependent patients.
How long do I need to take addiction treatment medications?
The duration of medication use varies depending on individual needs and treatment progress. Generally, you should stay on medication as long as the benefits outweigh the risks.
For example, Suboxone (Buprenorphine) can be used in inpatient detox for a few days/weeks or can help with cravings long-term for 6 months to several years. Vivitrol (Naltrexone) can be stopped after the first injection or used for more than a year, depending on individual response and recovery progress. And, acamprosate (Campral) is often prescribed for at least 6 months.
Checking in with a medical professional ensures the medication and dose remain effective. If a medication doesn’t seem to be helping, there are always other options or dosing to try that may help. Never rush to jump off a medication that is helping you. There is no shame in using medications!
How long do I need to take addiction treatment medications?
The duration of medication use varies depending on individual needs and treatment progress. Generally, you should stay on medication as long as the benefits outweigh the risks.
For example, Suboxone (Buprenorphine) can be used in inpatient detox for a few days/weeks or can help with cravings long-term for 6 months to several years. Vivitrol (Naltrexone) can be stopped after the first injection or used for more than a year, depending on individual response and recovery progress. And, acamprosate (Campral) is often prescribed for at least 6 months.
Checking in with a medical professional ensures the medication and dose remain effective. If a medication doesn’t seem to be helping, there are always other options or dosing to try that may help. Never rush to jump off a medication that is helping you. There is no shame in using medications!
Are addiction treatment medications safe?
Yes, addiction treatment medications are generally safe when prescribed by a healthcare professional and taken as directed. They have undergone rigorous testing and approval processes to ensure their safety and effectiveness. General side effects can include nausea, headache and dizziness, but these are typically mild and temporary. If side effects become bothersome, contact your healthcare provider to discuss. There are plenty of options to ensure you feel great while on the medications, including lowering the dose, changing the timing of the dose, treating the side effects or trying a different medication.
Rebecka M.Google