Medication is only one component of addiction treatment. But it can help to manage withdrawal symptoms, cravings and co-occurring mental health conditions. It also can help with long-term recovery outcomes, especially when it is incorporated into a comprehensive treatment program.
Medications for Alcoholism
Medications for alcohol addiction are available to reduce cravings and minimize the risk of relapse. The Food and Drug Administration (FDA) has approved the following medications to treat alcohol addiction: 1
- Disulfiram (commonly known by its brand name Antabuse) produces an unpleasant reaction, such as nausea, vomiting, dizziness or heart palpitations, when combined with alcohol. When taken daily, disulfiram helps users avoid alcohol because they will anticipate a negative reaction if they drink. Disulfiram is also effective when taken right before a risky situation where alcohol might be present, such as a social gathering.
- Acamprosate (trade name: Campral) restores chemical imbalances in the brain that are common with long-term alcohol use. When taken daily, acamprosate has been found to help drinkers remain abstinent by decreasing cravings.
- Naltrexone (marketed in various formulations under the names Depade, ReVia and Vivitrol) can be taken as a pill or as an injection. It has been found to curb cravings for alcohol by decreasing its pleasurable effects.
Medications for Opioid Addiction
These medications help manage withdrawal symptoms and prevent cravings.
Opioids include heroin and prescription drugs such as morphine, oxycodone and hydrocodone. Medications are often prescribed to manage the uncomfortable withdrawal symptoms that arise when a person stops taking opiates. They are also prescribed for the long-term treatment of cravings. The following are effective medications for opiate addiction: 1
- Methadone is a controversial treatment for opioid addiction due to its own potential for addiction. But it can be safe when its use is closely monitored by a medical professional. It can be used as a long-term treatment for heavy opiate users or as a way to gradually taper people off of opiates. As a long-term treatment, methadone reduces the risk of relapse and the negative consequences associated with opiate use. Methadone is strictly regulated and can only be administered in designated clinics.
- Buprenorphine is a partial opioid agonist and elicits its effects by acting on opioid receptors throughout the brain. It is effective at decreasing withdrawal symptoms without causing the euphoric effects that can lead to abuse. Unlike methadone, buprenorphine does not have to be administered in clinics. Physicians who have undergone specialized training in the proper administration of buprenorphine may prescribe it for the treatment of opioid dependence – even on an outpatient basis.
- Naloxone is an FDA-approved injectable medication for the treatmentof opiate overdose. It works by blocking the opiate receptors in the brain, which reverses the overdose. Some local organizations offer programs to train members of the community on how to administer naloxone.
- Suboxone is a popular drug that is used to treat opiate addiction and consists of buprenorphine and naloxone. Suboxone can be prescribed to gradually taper people from opiates, ease withdrawal symptoms or curb cravings. Suboxone is commonly administered for oral use (as a sublingual film).
Role of Medications in Substance Abuse Treatment
- Management of withdrawal symptoms. Medications such as Suboxone can decrease withdrawal symptoms, providing a more comfortable detox process. Managing withdrawal symptoms with medications can reduce the risk of relapse during detox.
- Medication-assisted treatment. Medication-assisted treatment can be used as a long-term treatment for opiate addiction. People on medication-assisted treatment are given a consistent dose of a medication, such as methadone or Suboxone, every day to ward off withdrawal symptoms and cravings and to decrease the risk of relapse. Medication-assisted treatment shows promise for helping people improve functioning in many areas of their lives and can help to prevent the transmission of diseases that might otherwise result from continued non-sterile needle-sharing.
- Relapse prevention. Cravings for drugs and alcohol can put people at significant risk of relapse. Buprenorphine (for opiate users) and acamprosate and naltrexone (for alcohol users) can alleviate strong cravings. Disulfiram can also prevent drinkers from relapsing because people who take this medication know they will feel sick if they consume alcohol.
- Co-occurring conditions. Many people with substance abuse problems also experience co-occurring mental health disorders, such as anxiety, depression, bipolar disorder and post-traumatic stress disorder (PTSD). Psychiatric medications can be used to concurrently manage these mental health issues.
Combining Medication With Other Treatments
While medications are effective in reducing the risk of relapse, they are most effective when combined with other treatment approaches.1 A comprehensive treatment approach addresses medical, psychological, social, vocational and legal issues by incorporating individual, group, and family therapy with medications. Aftercare planning is also a critical component of long-term success in addiction recovery.
Evidence-based treatment approaches have been shown to be effective during research trials and are considered the treatment of choice for addiction problems. Evidence-based approaches for addiction treatment include:1
- Cognitive behavioral therapy, which examines the relationship between a person’s thoughts, emotions and behaviors.
- Contingency management, which rewards people for abstaining from drugs and alcohol.
- Motivational interviewing, which increases a person’s motivation to recover by focusing on how addiction has affected the person’s life.
Risks of Using Prescription Medications to Treat Addiction
Prescription medications can be a beneficial treatment for addiction. But they also carry risks. Some of the dangers include: 1
- Physical dependence: The use of some prescription medications can result in physical dependence, especially when a person takes more than the prescribed dose. Methadone and Suboxone users may experience withdrawal symptoms when the drugs are abruptly discontinued.
- Side effects: Prescriptions medications can cause side effects, such as difficulty concentrating, nausea, vomiting, and insomnia. Side effects vary from person to person and will depend on the specific medication being used. The effects are often dose-dependent, but they are also affected by the person’s physical and mental health. A thorough consultation with the prescribing physician can help those in recovery know what to expect in terms of associated symptoms.
- Potential for overdose: Some addiction medications put users at of overdose, especially when someone takes higher doses than prescribed. Methadone is one drug that can be fatal at high doses, and its use should always be carefully monitored by a physician. Risk of overdose is also high when drugs are mixed with one another.
Taking the following steps can reduce some of the risks associated with prescription drugs.
- Take all medications exactly as the doctor prescribes.
- Meet with your doctor regularly to discuss any issues with medications and to determine whether adjustments need to be made.
- Monitor side effects between appointments.
- Tell your doctor about any other drugs that you are taking.
- Never share your medications with other people.
- Keep medications locked and out of reach of children.
- Properly dispose of unused medications.
It is highly recommended that you discuss any questions, concerns or issues about your medications with a medical professional.
Find a Drug or Alcohol Treatment Program
If you’re struggling with addiction and would like to undergo drug or alcohol treatment, call 1-888-319-2606Who Answers? to speak with a representative who can assist you in verifying insurance coverage and finding a program.
. National Institute on Drug Abuse. (2012). Principles of drug addiction treatment: A research-based guide. NIH Publication Number 12-4180.