What Is “Evidence-Based” Addiction Treatment? Part 3

What Is “Evidence-Based” Addiction Treatment? Part 3

Help for Drug Addiction

“Ultimately, pharmacogenetics can be expected to provide a basis for the personalized treatment of addiction by matching specific medications to patients based on their genetic  characteristics, enhancing treatment efficacy and reducing the risk of adverse effects.”

~ Clinical Manual of Addiction Pharmacology, edited by Drs. Henry R. Kranzler, M.D., Dominic A. Ciraulo, M.D.,  and Leah R. Zindel, R. Ph., M.A.L.S.

This is the conclusion of a three-part series.

In Part 1, we defined and lifted goals for evidence-based addiction treatment, and in Part 2, we listed several examples of evidence-based behavioral therapy.

Now, we will talk about the role that pharmacology – medication-assistance – plays in the treatment of substance abuse disorders.

As any counselor in any San Diego addiction recovery program will tell you, good intentions usually aren’t enough to overcome substance abuse disorders such as drug dependency or alcoholism.

Professional help is nearly ALWAYS needed – starting with interventionists, but also including counselors, psychiatrists, and other medical personnel who specialize in recovery from substance abuse disorders.

The treatment plan recommended will take months, and aftercare/maintenance can take years, because the road to regained sobriety is neither short nor easy.

An “Essential Component” to Recovery

However, that recovery path can be both shortened and smoothed by the proper prescription of certain medications. Dr. Nora Volkow, the Director of the National Institute on Drug Abuse, says –

 “Medications can be helpful in (the) detoxification stage, easing craving and other physical symptoms that can trigger a relapse episode. However, this is just the first step in treatment. Medications have also become an essential component of an ongoing treatment plan, enabling addicted persons to regain control of their health and their lives.”

How Does Medication-Assisted Recovery Work?

Medication-assisted recovery from substance abuse is so effective because addiction is a disease of the brain. Excessive alcohol or drug use affects the brain by interfering with sending, receiving, and processing of information by the brain’s neurons.

Most substances of abuse target the reward system of the brain, by stimulating overproduction of dopamine – a neurotransmitter involved in movement, emotions, motivation, and feelings of pleasure. Certain drugs can release up to 10 times the amount of dopamine produced by other healthy and natural activities, such as eating or having sex.

This overstimulation produces feelings of euphoria in substance abusers, thereby reinforcing the addictive action – drinking or using drugs. In short, substance abuse “teaches” a person’s brain to repeat the behavior.

Over time, however, the substance abuser develops a tolerance for their drug of choice, meaning they have to take ever-increasing amounts to achieve the same effect.

Over time, this tolerance can compromise long-term brain health. One of these changes that can create a difficult challenge for recovering substance abusers is reflexive behavioral conditioning, meaning that anything associated with an individual’s “drug routine” can trigger irresistible cravings, even after a period of abstinence.

Recovery medications primarily help by easing the worst withdrawal symptoms, keeping cravings at bay, so the individual can be clear-minded enough to receive the message of recovery.

What Are the Most Common Medications Taken during Recovery?

Various drugs of abuse affect the brain in different ways, so the medication prescribed depends upon the substance used:

  • Methadone – Opioids such as heroin or prescription painkillers
  • Buprenorphine – Also used for opioids
  • Naltrexone – Opioids and/or alcohol
  • Acamprosate – Alcohol
  • Disulfiram – Commonly sold under the brand name Antabuse, this medication helps curb drinking by creating an extremely unpleasant reaction whenever alcohol is consumed.

Encouragingly, there are currently clinical trials being held for many other drugs that can be used in medication-recovery settings.

It is important to remember that medication-assisted therapy (MAT) only gains appreciable effectiveness when combined with a professional program for drug and alcohol rehab. San Diego residents and others in Southern California are encouraged to contact Lasting Recovery – a nationally-accredited outpatient program offering individualized and multilayered treatment that addresses substance abuse disorder on many levels.

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