Treating Addiction with Medication

Effective addiction treatment often includes the use of medications. Addiction medications are designed specifically to help those battling addiction get through withdrawal and avoid drug cravings.

Medication for Detox and Withdrawal

Effective addiction treatment starts with detox and medication. They are the first step in healing the process. Generally, the initial drugs used in addiction treatment combat withdrawal symptoms.

Medications are most commonly used in inpatient treatment facilities. In these facilities, 80% of detoxifications are aided by medications.

Outpatient clinics can use medication-assisted detoxification with a well-trained doctor. There are also specific medications that can be taken at home.

In some cases, special medical devices may be used to manage withdrawal symptoms. In November 2017, the FDA approved an electronic stimulation device called the NNS-2 Bridge.

This device is used to help reduce symptoms of opioid withdrawal. It is placed behind the ear and sends electrical signals that simulate certain brain waves associated with withdrawal symptoms. This is not available at every facility as it is quite a new treatment.

Medication for Relapse Prevention

Addiction medications also help prevent relapse and may treat coexisting conditions that make relapse more likely. There are medications that help improve brain function in recovering addicts. This, in turn, decreases drug cravings.

There are currently medications that reduce cravings for drugs such as:

  • Heroin
  • Prescription pain relievers
  • Tobacco and nicotine
  • Alcohol

New drugs are being developed to help treat patients who are addicted to stimulants like cocaine and methamphetamines. There are also medications being developed to reduce cravings in those addicted to marijuana.

It is possible to take more than one medication for cravings and relapse prevention, particularly if you are addicted to more than one drug.

Medications for Opioid Addiction

There are several drugs used to treat opioid addiction, including:

  • Suboxone
  • Methadone
  • Buprenorphine
  • Naltrexone

Both methadone and buprenorphine bind to opioid receptors, suppressing withdrawal symptoms and relieving cravings.

Naltrexone operates completely differently and is an opioid receptor antagonist drug. It can only be given to people who have withdrawn completely from opioids. It does not specifically prevent cravings, but it does prevent any high from an opioid drug. Therefore, it reduces a person’s urges to go out and use opioids illegally or take prescription opioid drugs.

Medications for Tobacco Addiction

The main treatment for tobacco addiction is nicotine replacement therapy. These treatments are available over-the-counter.

Nicotine replacement therapy can be administered through:

  • Patches
  • Spray
  • Lozenges
  • Gum

There are two FDA-approved prescription drugs for nicotine addiction. These medications are bupropion (Zyban®) and varenicline (Chantix®). Each drug acts differently on the brain, but both are helpful in preventing relapse.

For patients trying to quit using tobacco, it is important to supplement nicotine replacement therapy with behavioral therapies. Group therapy and individual therapy are extremely useful in combating tobacco addiction. Telephone quitlines are also helpful forms of behavioral therapy.

Medications for Alcohol Addiction

There are three FDA-approved medications for treating alcohol addiction. A fourth drug, called topiramate, is undergoing large-scale trials and may soon be FDA-approved for alcohol addiction.

Naltrexone

One FDA-approved medication is naltrexone. It blocks the opioid receptors in the brain that activate when those struggling with addiction drink alcohol. This drug makes alcohol less rewarding to your brain, therefore reducing cravings.

Acamprosate

Acamprosate is commonly used for alcohol withdrawal. This medication is best used for people who have a mild addiction to alcohol. It is used on a long-term basis.

Acamprosate controls unpleasant withdrawal symptoms, including:

  • Insomnia
  • Dysphoria
  • Restlessness
  • Anxiety

Disulfiram/Antabuse

Antabuse is a common brand of the disulfiram. This unique drug interferes with alcohol breakdown. It causes the chemical acetaldehyde to build up in the body after drinking alcohol.

This leads to severely unpleasant side effects, such as flushing, irregular heartbeat, nausea and vomiting. It is best used for patients who are very motivated to quit alcohol.

The biggest downside with this drug is that many people recovering from alcohol addiction will stop taking it in order to start drinking again.

Medications for Coexisting Mental Health Conditions

There are many drugs for coexisting mental health conditions in addiction. The choice of these medications depends on the patient’s symptoms and underlying mental health disorder.

Examples of medications used to treat coexisting mental health conditions include:

  • Antidepressants
  • Anti-anxiety medications
  • Non-addictive sleep medications
  • Antipsychotics
  • Mood stabilizers
Author:Kent Hoffman
Kent Hoffman

Dr. Kent Hoffman has been practicing medicine for nearly 30 years. He is board-certified to practice addiction medicine and family medicine. Dr. Hoffman gets to know his patients on a first-name basis to provide compassionate and professional health care.

Last modified: 01/14/2019