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Drug replacement therapy, also called drug substitute therapy, is a common practice in many rehabilitation facilities today. It’s an approach to addiction treatment that’s generally accepted and positively viewed by medical professionals. Still, there are some facilities and professionals who hold out on supporting this revolutionary approach to treatment. Keep reading to find out what drug replacement therapy is and the benefits and downsides to better understand if this is the right choice for you.
Understanding Drug Replacement Therapy
Drug replacement therapy is primarily used to help individuals withdrawing from opioid drugs (such as heroin, codeine, morphine, hydromorphone and oxycodone) and alcohol. As it’s so commonly used for treating opioid addiction, it’s also often called opioid substitution therapy (OST).
Individuals with severe addictions to opioids and alcohol are often prone to intense withdrawal periods. The withdrawal symptoms can be painful, potentially life-threatening and demoralizing, putting the patient at risk of relapse. Drug replacement therapy looks to make the withdrawal process a much less painful, stressful and dangerous experience. This approach gives the addict small amounts of a drug substitute to lessen withdrawal symptoms.
Withdrawal symptoms occur because the body has become dependent on the substance and the sudden removal of that substance is shocking. By offering a drug substitute (typically a slow-release morphine, buprenorphine and methadone), the body feels less of a shock and transitions through withdrawal much more smoothly.
It’s important to note that patients aren’t typically given an entire supply of their drug substitution with the expectation they can monitor themselves. Instead, patients have the drug administered by a professional. In an inpatient program, the patient receives the drug directly from a staff member daily. And in an outpatient program, the patient will be asked to visit a pharmacist for their daily dose.
Medications Used in Drug Replacement Therapy
The medications used in drug replacement therapy are typically slow-releasing. This means the effects of the drug are dispensed slowly throughout a few hours. Slow-releasing drugs are less likely to be abused, as they don’t produce an instant effect (such as a euphoric high) that people with a substance addiction often look for.
Some of the most popular medications used in drug replacement therapy are:
- Buprenorphine-naloxone (Suboxone®)
- Methadone (Methadose)
- Extended-release naltrexone (Vivitrol)
Comprehensive Approach: The Role of Counseling and Support in Drug Replacement Therapy
Drug replacement therapy is an evidence-based approach to substance addiction. A lot of research into this area has shown time and again that providing this medicine-supported withdrawal makes treatment more effective. However, it’s important to note that the highest chance for success is when drug replacement therapy is combined with counseling. Therapy allows individuals to understand why they turned to substance abuse, identify their triggers and learn coping strategies to avoid relapse. The combination of behavioral counseling with medicated detox is known as medication-assisted treatment (MAT).
And the data shows that MAT works. Here are some quick statistics on the MAT approach:
- One study found that heroin overdose deaths decreased by 37% when buprenorphine became accessible in Baltimore.
- Patients treated with medication were more likely to stay in therapy than those who opted out of medication.
- MAT increases retention in treatment and social functioning in the patient.
- MAT decreases opioid use, opioid-related overdose deaths, criminal activity and infectious disease transmission.
The Benefits and Limitations: Weighing the Pros and Cons
Before considering drug replacement therapy, it’s essential to understand the pros and cons of this approach so you can better grasp if this is the right choice for you.
Pros of Drug Replacement Therapy
The positives of drug replacement therapy are:
- Reduced substance cravings
- Reduced withdrawal symptoms
- Improved physical and mental health of patients in treatment
- Decreased substance-related criminal activity as the patient recovers from their addiction
- Increased ability for the patient to gain and maintain employment
- Improved participation in the rehabilitation program as withdrawal symptoms are lessened
- Reduced chance of relapse
Cons of Drug Replacement Therapy
Drug replacement therapy is an efficient way to help someone successfully complete an addiction treatment program. However, one 2022 study that analyzed people on drug replacement therapy found that the largest complaint was people wanting a more clearly defined plan for coming off the substitute drugs. Respondents mentioned they felt “locked up” and “tied up in every way.” Individuals complained that they couldn’t travel far, as they had to visit their clinic daily to receive their medication.
This is a valid complaint but one that can be addressed. Individuals can speak to their rehabilitation facility about creating a clear time line for weaning off drug replacement therapy. It’s essential to remember that drug replacement therapy isn’t a permanent solution. This approach gets people through the most challenging parts of addiction treatment. Once they’re strong enough to focus on sober living independently, a plan can be made to come off the substitution drugs safely and slowly.
Another short-term disadvantage of drug replacement therapy is that the substitute drugs sometimes have side effects. For example, Suboxone®. can cause drowsiness, fatigue, low energy, gastrointestinal issues, decreased pain tolerance, anxiety and a higher risk of depression. If you experience these side effects, you can speak to your doctor about options for trying another drug.
Addressing the Myths of Drug Replacement Therapy
Lastly, you can’t discuss drug replacement therapy without addressing the myths surrounding this treatment approach. Some worry about trying drug replacement therapy because they’re concerned they’re replacing one substance with another. This concern boils down to a fear that the patient may conquer one addiction by replacing it with an addiction to another substance.
However, as outlined above, this isn’t how drug replacement therapy works. The drugs used in drug replacement therapy are long-lasting, short-release drugs. They may offer comfort to the patient in subduing withdrawal symptoms, but they don’t provide a “high” and therefore don’t come with a habit-forming risk when used in appropriate quantities. To further combat this concern, the preventive step is taken by ensuring the substitute drug is regulated by a professional and not simply handed over to the patient in large quantities.
Trying Out Drug Replacement Therapy
If you’re struggling with substance addiction, know drug replacement therapy is a scientifically supported treatment option. And if the only thing holding you back from seeking help is the fear of withdrawal symptoms, this might be the solution you’ve been looking for.
FHE Health Offers Medical Detox
FHE Health can help you take the first step to living a sober lifestyle. Our medical detox program can be combined with behavioral therapy to give you the best chance to recover successfully. Contact us today to find out all the details about our medical detox. Your new life is waiting for you.
