Medication is not for everyone and not a cure for addiction, but can be very helpful. A variety of medications are available to help ease withdrawal symptoms, reduce the likelihood of relapse, and ameliorate certain psychiatric conditions (e.g., depression, anxiety, bipolar disorder) that are often intertwined with alcohol and drug abuse. Studies show that medication is often more effective when combined with behavioral counseling and other social supports than when given alone. Dr. Washton works closely with several private psychiatrists to insure that patients needing medication have access to appropriate high-quality psychiatric care.
Medications for Treating Alcohol Abuse
Antabuse (disulfiram) can make it easier to stop drinking and prevent an impulsive (unplanned) return to drinking. It strongly discourages drinking because it produces a very unpleasant physical reaction (nausea, vomiting, headache, etc.) when combined with alcohol. One Antabuse tablet usually provides approximately 24 hours of “protection” against drinking alcohol. Knowing that drinking any alcohol while on Antabuse will make you sick is likely to discourage you from taking a single drink and will help deter you from acting on your impulse to drink. Antabuse is not a cure, but it can help you to gain initial traction with abstinence. It also provides added protection against consuming alcohol in certain “high risk” situations that challenge your ability to refuse drinks.
Unlike Antabuse, naltrexone (ReVia, Vivitrol) and certain other medications (e.g., gabapentin, topiramate), do not create an unpleasant reaction with alcohol, but appear to work by blunting the effects of alcohol in certain areas of the brain. These medications can reduce the likelihood of intensive or “binge” drinking episodes in which an individual looses his or her “off switch” and ends up drinking far more than intended.
Medications for Treating Opioid Addiction
Buprenorphine (Suboxone, Subutex) can be a very effective medication for treating addiction to heroin and prescription painkillers. It can relieve withdrawal symptoms, block cravings for other opioids (e.g., heroin, oxycodone, etc), and minimize the chances of relapse. Buprenorphine can be used as a detox medication to facilitate the transition from opioid addiction to abstinence or it can be used as a substitute medication for an individually-determined period of stabilization and maintenance.
Naltrexone (Trexan, Revia, Vivitrol) is a powerful opioid blocking drug that is entirely nonaddictive and has no mood-altering effects of its own. It prevents other opioid drugs (e.g., heroin, prescription painkillers) from attaching to opioid receptors thereby neutralizing their effects throughout the body and brain. Taking one 50 mg naltrexone tablet each day provides 24 hours of blockade against opioid effects. While taking naltrexone, relapse to opioids is virtually impossible. The key is to take it. A period of at least several days or longer of total abstinence from all opioid drugs is required before taking a first does of naltrexone to prevent having an intense withdrawal reaction.
Psychiatric Medication and Addiction
Addiction is often accompanied and sometimes preceded by mood disturbances and other psychiatric conditions including depressive disorders, anxiety disorders, bipolar disorders, ADHD, etc. A wide variety of medications are available to treat these conditions in order to alleviate suffering and reduce the likelihood of relapse to alcohol and/or drug use. Evaluation by a skilled psychiatrist is needed to properly diagnose the problem(s), determine what medication(s) might be best, and monitor progress going forward.