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Once considered an individual moral failing, addiction, and substance use disorders are now recognized as medical conditions. Like with any other disorder type, treatment options have evolved to include pharmaceuticals alongside psychotherapy and support group attendance. Medication-assisted treatment can effectively help people achieve and maintain long-term sobriety when combined with interventions such as ongoing therapy and support.
Understanding Substance Use Disorder
The DSM-5 recognizes substance use disorder (SUD) as a mental condition in which a person can’t control their use of either legal or illegal drugs. People suffering from SUD compulsively use substances, such as alcohol, illicit drugs, or even prescription medications, despite adverse consequences. Symptoms include:
- Increased tolerance. They need increasingly larger doses of the substance to achieve the same effect.
- Withdrawal symptoms. When not using the substance, they experience physical or psychological symptoms like nausea, sweating, or anxiety.
- Cravings. They experience intense urges or desires to use the substance.
- Loss of control. They find reducing or controlling substance use impossible despite wanting to cut it down. They may have unsuccessfully tried to stop in the past.
- Neglecting responsibilities. They may fail to meet work, school, or family obligations in favor of substance use.
- High-risk behaviors. They repeatedly engage in hazardous behaviors, like driving under the influence or having unprotected sexual encounters.
SUD often begins with voluntary use, such as experimentation in college, but can quickly escalate into dependency. A family history of addiction and co-occurring mental health conditions puts people at higher risk of developing it.
The condition is far from uncommon. The U.S. National Survey on Drug Use and Health Survey estimates that 17.3% of Americans aged 12 and older suffered from SUD in 2022.
Treatment options for SUD are becoming increasingly tailored to individual needs. Behavioral therapies focus on modifying harmful behaviors and helping those affected by SUD develop coping strategies. Several medications are FDA-approved for opioids, alcohol, or nicotine use, helping reduce withdrawal symptoms and cravings. Most clinicians implement comprehensive treatment plans that combine these approaches with support groups and ongoing counseling.
Medications for Alcohol Use Disorder
Alcohol addiction impacts all aspects of a person’s life and can lead to health issues, such as liver disease and cardiovascular problems, and either cause or exacerbate mental health disorders. The medications available for treating AUD can help with withdrawal symptoms and reduce cravings:
- Disulfiram. Sold under the brand name Antabuse, disulfiram inhibits the body’s ability to metabolize alcohol. Drinking during treatment can cause some unpleasant reactions, such as flushing, nausea, and vomiting. This deterrent effect should lead to a person developing an aversion to drinking.
- Naltrexone. This drug lowers alcohol cravings by blocking the brain’s opioid receptors, which reduces the pleasurable effects associated with alcohol consumption. By removing the euphoric buzz people experience when drinking, this medication makes the prospect of breaking sobriety less enticing.
- Acamprosate. Sold as Campral, this drug is believed to help stabilize the chemical balance in the brain after chronic alcohol abuse. Typically used after detoxification, acamprosate can help ease the symptoms of post-acute withdrawal, such as anxiety, insomnia, and restlessness.
Medications for Opioid Use Disorder
Whether prescribed or illicit, opioid drugs create strong physical dependencies and psychological addiction, making it hard to overcome opioid use disorder without professional intervention. There are four FDA-approved drugs used to treat this condition and help people achieve long-term recovery:
- Methadone. This long-acting opioid agonist activates the brain’s opioid receptors without the euphoria associated with abuse. It’s generally administered through certified opioid treatment programs.
- Buprenorphine. Similarly to methadone, this partial opioid agonist activates the brain’s opioid receptors but to a lesser degree. It helps alleviate physical withdrawal while reducing the risk of misuse and overdose. The medication Suboxone® combines buprenorphine with naloxone.
- Naloxone. Also known as Narcan, naloxone is primarily an emergency overdose treatment. This critical tool can help prevent overdose deaths. Many rehab centers include it in treatment plans to provide immediate intervention in cases of relapse. First responders and caregivers often carry it due to its potential for reversing the effects of opioid toxicity.
- Naltrexone. Like with alcohol, naltrexone prevents opioids from producing their euphoric effects. Treatment usually starts after you’ve gone through detoxification and helps maintain abstinence. Vivitrol is the injectable form of naltrexone that’s administered once a month.
Emerging Treatments and Medications
Substance use disorders continue to pose a public health challenge. However, recent advancements in pharmacotherapy are promising. A limited number of medications treating opioid, alcohol, and nicotine addictions are FDA-approved, leaving a gap in treatment options for cocaine, methamphetamine, and cannabis use disorders.
Drugs like the Type 2 diabetes treatment pioglitazone and the dopamine agonist Rotigotine are being investigated for treating cocaine use disorder. Antidepressants such as mirtazapine have shown the potential to reduce stimulant use by improving mood and sleep. The naltrexone-bupropion combination, which targets both the opioid and dopamine systems, is showing promise in preliminary studies for methamphetamine users.
Medications like the newly developed drug known as AEF0117 and the hemp-derived CBD are in clinical trials for their potential to alleviate withdrawal symptoms and reduce cannabis use.
Medication-Assisted Treatment (MAT) and Recovery
Medication-assisted treatment is an addiction-treatment approach that combines the use of FDA-approved medications with counseling and behavioral therapies. The Substance Abuse and Mental Health Services Administration notes that studies consistently show MAT is effective at treating SUD and can help maintain recovery.
Integrating medications with therapy and support groups can improve recovery outcomes. Counseling and talking therapies, such as cognitive behavioral therapy (CBT) and motivational interviewing, address the underlying mental health aspects of addiction. Support groups, such as SMART Recovery and 12-step programs, provide a community of peers with similar experiences.
By addressing all components of addiction, MAT offers a more robust treatment option compared to medication or therapy alone. However, MAT isn’t a one-size-fits-all solution. Individualized treatment plans, regularly monitored and adjusted by healthcare professionals, also play a part in achieving and maintaining long-term recovery.
Treatment for Your Recovery
If you are struggling with substance abuse or feel MAT might be the solution for you, we can assess your needs and put together a personalized plan. Our team of addiction specialists can give you the support and treatment to get sober. Contact us today. Someone is here 24-7 to discuss your needs.
