If you’re struggling with alcohol or substance use, there are medical treatments for addiction available to help you recover.
Gone are the days of viewing addiction as a choice or moral failing. Instead, we now understand addiction as a complex, chronic brain disease. While stigma persists, more and more people are accepting the truth about addiction. That leads to a common question: are there medical treatments for addiction?
The answer? YES!
We break down the current medical treatments for addiction:
Fact: counseling and therapy are medical treatments!
There are evidence-based treatments, such as cognitive-behavioral therapy and motivational interviewing, that can help you get motivated to change your addictive behavior, understand the root causes of that behavior, and learn how to manage cravings and other challenges throughout the recovery process.
At Workit Health, we offer behavioral healthcare like online therapy, personalized for you, all from the comfort and privacy of your home.
Medications for Opioid Use
Combining medication with behavioral healthcare can greatly improve your chances for a successful recovery.
The oldest medication for opioid addiction, methadone is itself an opioid but with a longer half-life (the time it takes for half of the medication to be used up) than heroin (24 hours for methadone compared to 2-6 minutes for heroin).
Treatment with methadone works by lessening the painful symptoms of withdrawal by acting as a longer-lasting replacement for the opioid the body has become used to. This helps patients wean off of heroin or pain pills more comfortably and successfully. Methadone as blocks the psychoactive effects of other opioids. Since methadone is an opioid, treatment with it can only legally be done at a SAMHSA-certified treatment center.
Along with Vivitrol, Suboxone is now the preferred treatment for opioid use disorder. Like methadone, Suboxone reduces withdrawal symptoms and blocks the effects of other opioids. However, buprenorphine (the active ingredient in Suboxone) only partially stimulates the brain’s opioid receptors whereas methadone, heroin and pain pills fully stimulate them.
The partial nature of Suboxone results in two major benefits: there is a much lower risk for 1) overdose and 2) addiction. Therefore, you can take Suboxone at home, as opposed to methadone, which needs to be taken at the treatment program. However, you can only get a prescription from a provider with a special waiver from the government.
Workit Health offers Suboxone treatment in several states. In most of those states we are able to provide treatment 100% online, but Ohio does require one in-person appointment to begin treatment. Not in one of the states covered by Workit Clinic? Find a Suboxone provider near you.
Unlike methadone and Suboxone, naltrexone is not an opioid, so there are fewer cumbersome regulations to navigate. Naltrexone is an opioid antagonist that shuts down the brain’s opioid receptors, reducing cravings and preventing you from getting high if you take an opioid.
This drug comes in two forms, a daily pill (brand names include ReVia) and a monthly injection (brand name Vivitrol). While naltrexone is not an opioid and therefore is non-addictive, there are a few things you should know. Namely that you must detox from all opioids 7-10 days before starting naltrexone, or else you risk being dropped into withdrawal. Also, naltrexone can reduce your tolerance for opioids, which increases your risk for overdose if you start using again. Suboxone and naltrexone are about equally effective.
Suboxone and naltrexone for opioid addiction compared.
Medication for Alcohol Use
Benzodiazepines are the medication of choice for treating alcohol withdrawal in the US. While every case of alcohol withdrawal is unique, the most severe cases present with a set of symptoms called delirium tremens (DTs). The symptoms of DTs are hallucinations, fever, seizures, intense anxiety, and mood changes.
The most common benzos used to treat severe alcohol withdrawal at DTs are Librium, Valium, and Ativan. While benzos can be life-saving, they also carry their own potential for addiction and are classified as controlled substances. Workit clinicians do not prescribe them due to their risk of misuse.
During alcohol withdrawal, the body is depleted of a key vitamin called thiamine (aka vitamin B1). This can lead to a deadly brain condition called Wernicke-Korsakoff syndrome. Regardless of whether you are detoxing at home or in a facility, you must take thiamine supplements to prevent WKS.
Yup, naltrexone (aka Vivitrol or ReVia) treats alcohol use disorder as well as opioid use disorder. Turns out that opioid receptors play a key role in both alcohol cravings and the euphoric feeling one gets when drinking. Naltrexone shuts down those pesky receptors and reduces cravings and those positive feelings when drinking.
It is considered the first-line treatment for alcohol use disorder post-detox. However, it cannot be taken if someone is using opioids.
While the exact mechanism of acamprosate is still being studied, it is thought to work on the brain’s glutamate and NMDA receptors. Like naltrexone, acamprosate reduces the cravings and pleasure associated with alcohol. Because of its different mechanism of action, acamprosate can be taken with opioids.
The oldest medication for alcohol use, Antabuse inhibits a key enzyme in your body’s metabolic pathway for alcohol. When a person drinks even a little alcohol while taking Antabuse they can experience flushing, headaches, and nausea. Basically, the drug creates a very unpleasant experience when one drinks alcohol.
Antabuse does not reduce cravings. Instead, it causes a person to begin to associate those negative experiences with alcohol. It has largely been replaced by newer drugs and is only used as a last-ditch treatment.
Medication for Tobacco Use
Smoking is so dangerous not for the nicotine itself, but the myriad cancer-causing chemicals produced by burning tobacco. Therefore, replacing smoking with a much safer source of nicotine is the most common treatment to help people quit smoking. Furthermore, the gums, patches, and other nicotine replacements come in different doses to gradually wean people off of nicotine completely.
Bupropion is an antidepressant that also works on the brain’s nicotine receptors, shutting them down. Zyban has been shown to be effective on its own or in combination with nicotine replacement. However, you should note that bupropion increases your risk for seizures and cannot be taken with certain medications such as DXM (for coughs).
Unlike Zyban, Chantix stimulates nicotine receptors and blocks the nicotine from tobacco from binding. While Chantix is effective for many people, it also has a much greater risk for depression and suicide than either Zyban or nicotine replacement.
Medication for Other Substance Use
Unfortunately, at this time there are only medication-assisted treatment options for opioid, alcohol, and tobacco use. Your best bet for other types of addiction is behavioral healthcare. Exciting advances are being made in the search for treatments for methamphetamine and cocaine addiction, so there is hope!