Medication In Addiction

For many drug addicts, including alcoholics, the most effective rehabilitation programs consist of a combination of behavioral therapy and medication in addiction treatment.

A form of treatment known as “maintenance therapy” is commonly used for rehabilitation of people addicted to opium-based drugs (opium, morphine, heroin, etc.). A drug with comparable effects is prescribed which produces milder withdrawal symptoms. For years now, methadone has been used to take the place of heroin. In the methadone maintenance model of treatment, the dosage of methadone administered is gradually reduced, until the addict no longer needs heroin. Most recently, this has been done as an outpatient treatment.

Buprenorphine, a medication which has been shown to be effective in blocking cravings for opiates, has been steadily increasing in number of prescriptions since it was approved by the FDA in 2002. During this time, it has been found that buprenorphine use can result in addiction and in withdrawal syndrome when use is halted; yet, it continues to have major advantages over methadone or naltrexone, both medications in extensive use at the time buprenorphine was first marketed. In actual use, it was noted that buprenorphine is only needed once every two days compared with methadone’s daily administration; and that the risk of overdose from buprenorphine is measurably lower than that from methadone.

Two commercial preparations of buprenorphine have so far been approved for use. One, Subutex®, contains as its sole ingredient buprenorphine, and is used at the outset of treatment. The other, Suboxone®, includes buprenorphine and naloxone. Naloxone is another opioid blocker, and can easily cause strong physical withdrawal symptoms if abused. Suboxone® is prescribed for ex-addicts undergoing maintenance drug therapy.

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