What Medications Help With Heroin Addiction?

Medications Used for Long-Term Treatment

Medications for the long-term treatment of substance abuse disorder have been around for some time.

Since the 1970s, methadone was the long-term treatment of choice for people with a heroin addiction, and for decades, not a lot has changed. New forms of Medication-Assisted Treatment (MAT) have become available to treat a number of different addictions. While some drugs have been specially created to treat specific disorders, others are prescribed “off label.”

However, a great deal of research has shown that these off label uses can be effective. Yes despite this, the use of MATs can still be stigmatizing for some.

What Is “Long-Term” Treatment?

Treatment for a substance abuse issue is typically divided into stages, beginning with a medically supervised detox.

Treatment is followed by various kinds of therapy, and then an aftercare program after treatment is completed. In a clinical setting, “long-term treatment” generally refers to a program that lasts from 120 to 180 days in the form of inpatient, outpatient, intensive outpatient, or partial hospitalization (PHP) treatment. However, some programs may be even longer. According to The National Institute on Drug Abuse, highly structured long-term rehab programs where a patient lives at a therapeutic community typically lasts from 6 to 12 months.

Since everyone responds to treatment differently, the length of treatment may be more or less for any given individual. Likewise, any medication your doctor might prescribe will also vary.

In addition to physical cravings, someone with an addiction issue will also spend a tremendous amount of time thinking about their drug of choice. These thoughts become a compulsion and impossible to control, which leads to drug-seeking behavior that can sometimes be criminal.

Feelings of depression, sadness, anxiety, despair, and the like are often at the root of substance abuse. The substance might temporarily mask these feelings, but they return once the high wears off, creating a vicious circle of drug abuse.

Taking a substance will temporarily stop the cravings and compulsion for it, but soon the same feelings return. In time, it takes more and more of the same substance to achieve the same effect it once had.

People addicted to drugs and alcohol may feel like they have no control over their drug use. Refraining from using or stopping seems to be an impossibility for them. The substance controls them, rather than the other way around.

Someone addicted to drugs or alcohol will continue to seek them out even if their addiction has made them lose friends, family, spouses, and jobs. Drug-seeking behavior can even lead to diseases such as hepatitis and HIV/AIDS.

Prescription Medication and their Uses

As part of long-term therapy, some patients are prescribed specific medications to help with things like withdrawal symptoms, cravings, and the psychological effects of overcoming an addiction. Here, we’ll break down these medications according to the addiction disorders they are most commonly used to treat.

Alcohol

Acamprosate (Campral): In conjunction with traditional therapy, Acamprosate has been shown to be effective in helping people abstain from consuming alcoholic beverages. It was first used in Europe in 1989 and was approved by the FDA for use in the United States in 2004.

Baclofen (Lioresal): Prescribed to treat muscle spasms, multiple sclerosis, and spinal cord diseases, this drug has also been found to help the symptoms of alcohol withdrawal, although this is considered an “off label” use.

Disulfiram (Antabuse): Disulfiram has been used since the 1950s to help people with alcohol issues. People who drink while taking disulfiram will become very ill, thus discouraging further alcohol consumption.

Gabapentin (Neurontin): The official, FDA-approved use for Gabapentin is to treat epilepsy and other seizure and movement disorders. Like Baclofen, it’s also been found to help with symptoms of alcohol withdrawal and probably works through a similar biochemical mechanism.

Naltrexone (Vivitrol): This medication was specifically created to help prevent relapse by reducing cravings. In 2010, it was also approved by the FDA to treat cravings in people recovering from an opioid abuse disorder.

Topiramate (Topamax): Developed to treat epilepsy, it’s thought that Topiramate affects the gamma-aminobutyric acid (GABA) pathway in the body by increasing its supply, which brings it back up to normal levels a person had before their alcohol abuse began. Although an “off-label” use, there are many positive indications that it can help people reduce both alcohol and cocaine consumption.

Cocaine and Methamphetamines

Bupropion (Wellbutrin, Zyban): This is an anti-depressant that is also used to treat bipolar disorder. It’s also been found to help smokers reduce their craving for cigarettes. Because it has a chemical composition similar to amphetamine, it has an uplifting effect and can help reduce cravings for both cocaine and meth.
Modafinil (Provigil): This drug is prescribed to treat people with narcolepsy, which is a condition that makes it difficult for those afflicted to stay awake – people with narcolepsy can fall asleep at any time, even while driving a vehicle. Since Modafinil has a stimulating effect, it may help some people overcome their cravings for methamphetamines.
Topiramate (Topamax): Research indicates this drug may also be useful for treating cocaine addiction. For more information on Topiramate, please see “alcohol,” above.
Vigabatrin (Sabril): Like Topiramate, Vigabatrin was created to treat epilepsy. Taken to treat cocaine addiction, it increases certain “GABA” chemicals in the body, which has the effect of reducing withdrawal symptoms.

Opioids

Buprenorphine (Probuphine, Suboxone). Prescribed to treat chronic pain, buprenorphine is also used to help reduce cravings for opioids in someone working to overcome such an addiction.
Naltrexone (Vivitrol): See “alcohol,” above for more information.

General Use

Mirtazapine (Remeron): This is another antidepressant used to treat depression, anxiety, and related issues. The medication reduces stress and elevates mood, and it’s thought to help some patients with a substance abuse disorder to get through the withdrawal process.

Pros and Cons of Prescription Medications

The drugs outlined above have been shown to help people reduce their cravings, get through intense withdrawal symptoms, and deal with psychological issues such as depression and anxiety. In addition, The National Institute on Drug Abuse has found that these medications can help:

Reduce the rate of opioid use
Lower overdose deaths related to opioids
Decrease criminal activity
Lower rate of infectious disease transmission
Increase retention in treatment programs and social functioning
Improve outcomes for babies born to mothers battling opioid addiction and fewer symptoms of neonatal abstinence syndrome

While this all sounds well and good, there are some downsides to prescribing medications for the treatment of substance abuse disorders.

First of all, most of these drugs come with a rather lengthy list of side effects that range from mild to severe. In addition, they can be addictive in their own right, which can potentially lead to new problems that weren’t there before. Some of these drugs might also make people feel disconnected from their emotions, which can add a further barrier to psychological progress and healing.

People might also mistake them as a “cure-all,” falsely believing that just by taking a pill they can overcome their issues. Although the medications can help, MATs almost always compliment additional therapeutic support.

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Stigma Around Long-Term Use of Medication to Treat Substance Abuse Disorders

The use of medications for substance abuse treatment is not without its controversies.

Some believe it’s inherently a bad idea to treat a drug addiction with another drug. Even some within the healthcare community attach a stigma to their use, as pointed out by the NCBI.

There’s also a variety of myths that come along with this kind of treatment. For instance, some people believe that methadone clinics promote crime. The fact is that these clinics can actually reduce crime and lower rates of HIV/AIDS. Unfortunately, methadone clinics are frequently blocked from opening in various communities around the country due to these misconceptions.

People also tend to cling to old, traditional ways of thinking, so even while research shows the great potential in these medications, some medical practitioners cling to the idea that they are of little or even no use and only cause more problems.

Some members of Narcotics Anonymous (NA) frowns on methadone use and won’t award “sober keychains” to people who have abstained from heroin, but not from methadone, but this is often rare. NA allows individual groups to discourage or deny members who are taking a medication to help with an addiction from sharing during meetings. Although NA has “no opinion” on practices outside their community, they encourage a principle of complete abstinence may include the use of MATs.

Treatment Considerations

Remember, medication-assisted therapy is only one part of a much more comprehensive program. If you’re considering treatment, it’s important to look for a qualified center staffed by an appropriate mix of professions that offer a variety of complimentary services. These modalities typically include a variety of therapeutic techniques, counseling, group work, and long-term aftercare.

If you or a loved one are suffering from a substance abuse disorder and would like more information on getting help, contact Nexus today for a free and confidential consultation.

If you or a loved one are suffering from drug or alcohol addiction, we’re here to help. Contact us today and speak with one of our trusted recovery advisors.