It’s been clear for a while that “just say no” isn’t going to help us defeat the drug crisis in America. Instead, some scientists believe, we should be working to develop a drug that can actually end addiction once and for all.
America’s worsening opioid problem shouldn’t be news to anyone. In 2017 alone, more than 66,000 Americans died from opiate-related overdoses. The number of people using heroin and abusing prescription narcotics like fentanyl, hydrocodone and oxycodone have increased steadily for at least the past two decades.
As a result, we’ve seen a number of different addiction treatment medications rise in popularity. Drugs such as methadone and products like Suboxone have all become more widely prescribed by doctors. While each of these drugs has its own benefits, they all carry some risks and side effects, as well.
Opiate Addiction Treatment Drugs: The Pros and Cons
Currently, there are a number of medications used to treat drug addiction. Each rehab program and doctor has their own philosophy on which one is the most effective. These drugs include:
Methadone (Dolophine, Physeptone, and Methadose)
Among the earliest ORT (Opioid Replacement Therapy) drugs available on the market, methadone was the leading form of addiction treatment for quite a while. This and other ORT drugs help to eliminate the pain that the addict feels during withdrawal. It provides them with a hit of the opioid drug just large enough to satisfy their cravings without getting them as high. Ideally, addicts will take smaller doses over time until they’re able to function without any opioids in their system.
Because methadone was the only FDA-approved opioid replacement drug available before the 1990’s, it earned notoriety as the go-to med for treating opiate addiction. By 2006, more than 1,400 methadone clinics were operating in the United States, providing doses to addicts all over the country.
The Downsides of Methadone
In a certain sense, methadone was a pioneer drug in the addiction treatment industry. It enabled many addicts to manage their pain so that they could focus on recovery. However, it has decreased in popularity over the past few years due to the risks it carries in comparison to newer drugs.
As an opioid replacement drug, for example, methadone does not actually treat the addict’s cravings. Instead, it simply feeds their cravings, prolonging the addict’s chemical dependency on opioids. Although the addict won’t get high off of the drug (unless they take a lot of it, which some people do), their brain still recognizes that it’s receiving doses of the chemical. This makes it very difficult for addicts to truly overcome their addiction.
Additionally, methadone is an opioid in itself which means that addicts can actually overdose on it. Opioids, after all, work to slow down the central nervous system. An individual who takes too much of the drug, therefore, is at risk of bringing their nervous system (along with their heart rate, blood flow, and respiratory activity) to a screeching halt. According to the DEA, more than 65,000 emergency room visits are related to methadone each year.
Buprenorphine (Subutex and Suboxone)
Similar to methadone, buprenorphine is an ORT med used as a substitute for opioids. It was developed by doctors who wanted to create a safer, less addictive alternative to methadone.
Both buprenorphine and methadone are opioid agonists, meaning that they activate the opioid receptors on the brain and trick the brain into thinking that its cravings are fed. However, whereas the latter is a “full agonist”, the former is only a “partial agonist”. Essentially, drugs like Subutex and Suboxone provide the brain with a much smaller rush of dopamine and are therefore much less likely to be abused.
This is not to say, however, that no one abuses buprenorphine. Because the drug is opiate-based, it can be used in large quantities to get the user high. Most often, people who abuse the drug consume it by first crushing it up and snorting it. They might also cook it in a spoon and inject it like heroin.
Subutex vs Suboxone
Suboxone and Subutex, the two main forms of buprenorphine, are slightly different. Each has its own side effects and risks. The main difference between the two drugs is that the former contains a chemical called naloxone. Naloxone is an “opioid antagonist”, meaning that it prevents the user from feeling any effects of opioids. A Suboxone user who relapses on heroin, therefore, would be unable to feel its effects.
Like methadone, both products tend to prolong the addict’s opioid dependency by feeding them small doses over time. This is particularly dangerous for users who take Suboxone because the medication inhibits them from feeling the effects of drugs like heroin. An individual who relapses on heroin, therefore, might take a higher dose than their body can handle in order to try and get high. When someone takes too much heroin they increase their chances of overdosing.
Naltrexone is quickly gaining steam as a popular addiction treatment drug. It is currently only offered in one product, Vivitrol. Whereas methadone and buprenorphine simulate the effects of opioids in the brain, naltrexone does not. Instead, it prevents the user from experiencing the effects of opioids (and alcohol, as well!). Essentially, this means that someone who takes heroin or prescription narcotics will be unable to get high off of them. Doses are only administered once every month (as opposed to every day like methadone) because its effects last for 28 days.
The drug is becoming increasingly popular in the treatment industry because it eliminates the incentive to get high. A user who can’t get high from heroin, after all, has no reason to use it. Of course, the addict does still experience cravings while Vivitrol is in their system. If they are able to fight off those cravings for long enough, though, they are eventually able to overcome their addiction.
Another reason why it’s becoming more popular is that it can’t be abused on its own. Because it provides no euphoric feeling, recreational drug users have no use for it. You probably won’t find Vivitrol being sold on the street.
What are the Risks of Vivitrol?
Obviously, there is nothing to stop an addict from obtaining heroin or prescription pills when they have naltrexone in their system. Much like Suboxone, therefore, the drug increases the likelihood of an overdose in addicts who relapse while on the drug. When an individual can’t feel the effects of heroin, they are much more likely to take too much.
Additionally, patients who take Vivitrol run the risk of experiencing a condition called “precipitated withdrawal” if they relapse. Precipitated withdrawal occurs when opioids and opioid antagonists meet in the brain. Basically, the antagonist pushes the opioid out as fast as possible. This results in the immediate onset of withdrawal symptoms.
Precipitated withdrawal can be quite unpleasant. It is for this reason that doctors require all patients to remain opioid-free for up to 10 days before they are prescribed Vivitrol.
What is the Best Addiction Treatment Drug Currently Available?
As we’ve pointed out above, every rehab program and doctor have their own thoughts on how medicated rehab should be approached. At AspenRidge Recovery, we strive to provide the safest and most effective treatments to all of our patients.
At this time, we don’t advocate for the use of methadone in any capacity. Its mechanism of action, risks, and overdose rates don’t cohere with our treatment guidelines.
We believe that both Vivitrol injections and buprenorphine can be useful forms of treatment for addicts in recovery.
Naltrexone, in particular, is a particularly helpful aid for addicts going through the recovery process. It’s both effective and cost-efficient. Our Vivitrol services have helped hundreds of drug addicts and alcoholics to overcome their addiction struggles. When used in combination with a steady dose of therapy and counseling, this drug can help to ease the physical and mental discomfort of getting sober.
The Future of Drug Treatment
So, where does that leave us? Will there ever be a treatment medication with no side effects or increased risk of overdose? Can we look forward to a future where drug addiction can be truly solved with just a single pill?
A recent article in the New York Times outlines some important research currently being conducted into treatment alternatives. Apparently, immunologists working at the Walter Reed Army Institute of Research are developing a medication that can fight addiction in the same way other diseases are fought. As the article explains, the vaccine would produce heroin-fighting antibodies within the user’s body.
“You inject heroin, the antibodies basically grab all the heroin, bind it all up and the heroin can’t cross the blood-brain barrier,” Dr. Gary Matyas, the immunologist leading the research says in the article, “And so there’s no high.”
Eventually, all traces of the drug would be expelled from the user’s body through the digestive and endocrine systems.
The article points out that the vaccine would not diminish the addict’s cravings. We’ll need to rewire the human brain in order to eliminate the desire to use drugs. However, this vaccine would represent an enormous evolution in the treatment of addiction. If a non-addictive medication could simply remove opioids from the user’s system, it is likely that we’d see a drastic decline in overdoses.
Are You Struggling with Addiction? We Can Help You End It
At the moment, there aren’t any drugs on the market that can end the opioid crisis as a whole. Unfortunately, we have to cross our fingers and hope that we see some more developments in the near future.
Luckily, however, there are still plenty of resources available to individuals struggling with addiction. The current medications available have helped millions of people in their fight to overcome drug abuse.
At AspenRidge Recovery, we offer some of the finest detox and rehab services available to addicts today. Our doctors will work with you to develop a medicated (or non-medicated) rehab program that works for you. If you’d like to discuss potential treatment options, please reach out to us. We’re excited to help you work toward a drug-free future.