Is Drug Abuse Really A Disease? Can It Be Cured?
Some drug abusers refuse to call themselves mentally ill or acknowledge that there’s a cure that can treat their addictions. Any combination of environmental, community and educational situations can cause an individual to develop drug-seeking behavior.
The definition of drug abuse being a curable, hereditary illness is hotly debated among critics and psychologists in the field. The DSM-IV defines drug abuse as a maladaptive pattern of substance abuse leading to clinically significant impairment, or distress. And, as with most “illnesses” defined by the DSM, a slew of pharmaceuticals have been marketed to cure drug addiction. These medications are used in a process known as a medical detox.
What Types of Medications Can Cure Alcohol or Drug Addiction?
All types of substance abuse disorder are defined as a single disease. They fall under the same category. However, depending on the addiction, each addiction can be cured using different types of medications. Most medications are prescribed during medical detox. These medications interact with the metabolic pathway of the drug being abused. In many situations, they have an inhibitory response to the drug. They prevent the drug of choice from acting on specific receptors on the central nervous system (CNS).
While medications can help cure or treat an addiction, it, alone, is not enough. A successful recovery also requires many other tools, like behavioral therapies and treatments. Patients learn how to retrain their brain. They also learn how to build healthier habits for a successful recovery. The goal is to maintain abstinence long after the drugs and alcohol have left the system.
Treating an Alcoholism With Medications
Alcohol abuse is more common in America than you’d think. It affects the younger generations more than the older generations. 1 in 4 Americans under the age of 30 is an alcoholic. Depending on each person’s genetics, age and more, different medications are deemed more suitable than others. Patients may have to try out different medications to see which one is most effective.
Medical professionals at the rehab center assess each patient to determine what may work best. With the right type of medications, alcohol addiction is curable. The two most common medications used include naltrexone, acamprosate, and disulfiram. We’ll be exploring both of these medications in more detail below.
Other medications are also used to treat specific symptoms. Some are over-the-counter, while others require a prescription. For example, many patients who struggle with alcohol abuse complain about insomnia. If left untreated, insomnia can interfere with recovery from primary alcohol addiction. It can also be a contributing factor to relapses within the first several months of recovery. Alcohol rehab centers will usually prescribe sleeping pills or weak benzodiazepines to treat insomnia. The type of drug used is up to the treatment center.
Naltrexone can treat alcoholism, as well as opiate addiction. It is also known as Vivitrol and is quite an effective medication. It’s known as an opiate antagonist. This means that naltrexone attaches to the opioid receptors in the brain to block them from being activated by any other substances. By taking up space in the receptors, they block opioids and alcohol molecules. Naltrexone treats both alcohol and opiate addictions because alcohol has a similar mechanism of action as opiates. Its mechanism of action relies on similar, if not the same, neural pathways.
In comparison to other medications, the administration method for naltrexone is quite unique. Instead of taking pills every day, patients receive an intramuscular injection to their buttocks once a month. Each patient receives the same dose. The dose does not need to be adjusted to each patient’s response to the drug. This means that doctors don’t need to keep an eye on patients when they’re on this medication. The ease of administration makes this drug ideal for intensive outpatient programs (IOPs). To qualify as an IOP, the American Society of Addiction Medicine specifies that the program must require a commitment of at least 9 hours per week.
It’s important to note that naltrexone is a maintenance drug. Doctors cannot prescribe patients this drug at the start of treatment. This is because patients must be alcohol and opiate-free for at least 7 to 10 days before taking this drug. If there are still alcohol or drugs in their body, they may experience acute, instant withdrawal symptoms.
Who Should Not Take Vivitrol?
Although naltrexone is effective, it’s not for everyone. Those who are interested in this medication must fully understand the risks involved with taking it. Some patients should be more wary of this drug than others. Patients who take this drug have an increased risk of the following:
- An opioid overdose
- Sudden opioid withdrawal
- Severe reaction at the injection site
This medication is not recommended for certain patients. Those who are exhibiting opioid withdrawal symptoms, for example, should not take this medication. Also, those who have a physical dependence on opioid-containing medicines will also have to stay away from naltrexone. In rare situations, some patients may even be allergic to naltrexone or any one of the ingredients in Vivitrol.
Acamprosate works in a similar manner to Naltrexone. This prescription drug is solely used to treat alcoholism and alcohol use disorders. It works by modulating regulating glutamate and gamma-aminobutyric acid (GABA) levels. These neurochemical levels become deregulated with heavy alcohol use. When patients quit drinking, both systems enter a pathological hyper-excitatory state. This state is responsible for most of the alcohol withdrawal symptoms, like restlessness and anxiety, experienced.
Much like with naltrexone, acamprosate is only effective if alcoholics who have quit drinking take the medication. Unlike naltrexone, alcoholics don’t have to have quit drinking for at least a week. Acamprosate is often recommended for long-term medical detox. Many patients will continue to take this medication even if they don’t have any urged to start drinking again.
This medication often comes in the form of a delayed-release tablet. The Food and Drug Administration (FDA) recommends taking two 333 mg tablets three times a day. Some patients can get away with using a lower dose. Those with impaired renal function absolutely must take a lower dose. It’s vital that the pills are swallowed whole, and not crushed or broken.
Side Effects of Acamprosate
Although acamprosate is a safe and effective treatment for alcoholism, it does come with some side effects. Patients should be aware of these side effects before they start taking the drug. The side effects tend to be mild, and will usually slowly subside with each use. Patients may consider switching to another drug or seeking medical attention if the side effects persist or worsen. The most common side effects associated with acamprosate use include:
- Diarrhea and upset stomach
- Dry mouth
- Excessive sweating
- Fatigue, exhaustion, and weakness
- Loss of appetite
Seek medical attention immediately if you experience numbness in your extremities. This is a fairly serious side effect or reaction to the drug. Serious reactions are quite rare. Overall, acamprosate is deemed quite safe.
Another interesting medication used to treat alcoholism is disulfiram, or bis (dimethylthiocarbamoyl) disulfide. It’s an acetaldehyde dehydrogenase inhibitor. Disulfiram is often sold under the brand names Antabuse® and Antabus®. Approved by the FDA in 1951, this tablet is taken orally once a day. Unlike acamprosate, it can be crushed and mixed with water, coffee, tea, milk, fruit juice or even sodas.
Disulfiram is a unique drug because it is used in aversion therapy. It prevents the body from metabolizing alcohol. If alcoholics continue to drink, the drug will mix with the alcohol and cause intense and uncomfortable symptoms. Some of the symptoms include:
- Blurred vision
- Chest pains
- Excessive sweating
- Heart Palpitations
- Nausea and vomiting
- Respiratory problems
- Throbbing headaches
- Throbbing in the head and neck
In serious situations, mixing disulfiram with alcohol can result in respiratory depression, myocardial infarctions, and cardiovascular collapse. The effects of disulfiram can kick in as soon as 5 to 10 minutes after drinking. Even after stopping disulfiram, the drug can have an effect on your alcohol ingestion for the next two weeks.
How Does Disulfiram Work?
Disulfiram works by acting on the main alcohol metabolic pathway. An enzyme, known as alcohol dehydrogenase (ALDH), converts alcohol into acetaldehyde. This enzyme is found in the liver and the brain. Disulfiram inhibits ALDH from working. This causes a rapid rise of acetaldehyde in the blood when alcohol is consumed. This reaction is also known as the disulfiram-alcohol reaction and is responsible for the unsavory side effects experienced.
Once disulfiram is taken, 80% to 95% of it is absorbed into the gastrointestinal tract. The drug is then rapidly distributed to the tissues and organs via the bloodstream. The body excreted any unabsorbed fractions.
Curing an Opiate Addiction with Medications
Opioids and opiates are also another substance that is commonly abused in America. They’re incredibly dangerous, since overdoses are common and are also usually fatal. In 2016, more than 63,000 Americans lost their lives to a drug overdose. Of these overdoses, 42,249 of them involved the use of opioids. Opioids now kill more people than breast cancer.
With opioid overdoses on the rise, it’s important to understand how doctors treat opioid addictions. Opioid addictions are treated with Opiate Replacement Therapy (ORT). In short, the treatment for an opioid or opiate addiction is the use of a weaker substitute. These substances are taken on a taper schedule. This is because the medications used to treat an opiate addiction have some addictive potential themselves. With that said, these opioids tend to come with milder withdrawal symptoms. They are easier to taper off from.
At this moment, there are three types of medications that are commonly used to treat an opiate addiction at opioid addiction recovery centers. The first is naltrexone, which has been explored above for treating an addiction to alcohol. The other two, which will be explored in more detail below, are methadone and buprenorphine.
Methadone is one of the most popular options used to treat an opiate addiction. Methadone is a full opioid agonist. This means that it acts in the same manner as stronger opioids. It works on the same neural and biochemical pathways. This drug will attach to the same opioid receptors in the central nervous system (CNS). It stimulates the system to ease withdrawal symptoms.
Unlike opioids, like heroin, methadone comes with milder side effects. It’s much easier to wean off of at a later date. The withdrawal symptoms that come with this drug are also milder. With that said, since methadone works in a similar manner to strong opioids, like heroin, it does have addictive potential. It’s possible for patients to develop tolerance and dependence on this drug.
Methadone comes in many forms. It can come in the form of a tablet, capsule, powder or a liquid. The tablet form is the most popular. Depending on the intensity of the symptoms, doctors will prescribe different doses of this medication to patients. Various factors are involved in calculating the right dose. Doctors will need to take into account the patient’s age, health, weight, height, among many other factors. Patients take pills several times a day.
This drug is involved in long-term medical detoxes. Patients should take it for a minimum of 12 months. Some patients will even continue to take this type of treatment for years.
Warnings and Tips for Avoiding a Secondary Addiction
Since methadone is addictive, patients need to slowly taper off of this drug. Patients slowly decrease their dose day after day until they no longer need it. If they don’t, they will experience withdrawal symptoms that may cause them to relapse. Since methadone is a long-acting drug, its metabolites will remain in the body for a much longer time.
It’s possible to develop tolerance to this medication. The body may need more and more of the drug to achieve the same effects. To avoid a secondary addiction and to get the best results possible, patients should also follow these tips:
Only use the amount prescribed. It’s vital that patients do not take an extra dose if they accidentally miss one.
Avoid consuming alcohol while on methadone. Since methadone is an opioid, concurrent use of methadone and alcohol can lead to a higher risk of overdoses. Side effects may also be more intense.
Store methadone at room temperature and away from light. This preserves the active ingredient in the medication.
In addition to developing a secondary addiction, it’s also possible to overdose on methadone. In the event of an overdose, call 9-1-1 immediately. An overdose can be dangerous. It can also do some serious damage to the mind and body.
Buprenorphine is a partial opioid agonist. This means that it has a similar mechanism of action as methadone and other strong opioids. The only difference is that it has a “ceiling effect”. This means that there is a maximum dose of buprenorphine that can be taken before the drug no longer has an effect on the body. If the patient tries to take a larger dose, the larger dose will not have an effect on the body.
Because of this “ceiling effect”, buprenorphine is one of the safer medications to take. It’s hard for patients to develop a tolerance or a dependence on the drug. As a result, it has a fairly low addictive potential. Most patients are able to taper off of this drug with relative ease. Secondary addictions are less of a concern.
This medication is often sold under the name Subutex. It comes in many forms. It can be taken as a pill under the tongue, as an injection, as a skin patch or as an implant. The effects of buprenorphine usually kick in within an hour and can last up to 24 hours.
Are Buprenorphine and Suboxone the Same?
Many people hear buprenorphine and automatically think it’s Suboxone. The two are actually different medications. Suboxone contains both buprenorphine and naloxone. Naloxone is an opioid-reversing medication that’s explored in detail below.
Since Suboxone contains buprenorphine, it also has a ceiling effect. The naloxone prevents overdoses. These two chemicals work together to ensure that Suboxone is one of the least addictive medications that can be taken. It’s difficult for patients to develop any type of tolerance or dependence on this drug. There are some side effects associated with taking this prescription drug.
In most cases, Suboxone is prescribed to patients who are addicted to short-acting opioids. Patients usually start off taking 0.5 mg or 1 mg tablets four times a day. The dose is upped on the second day, and will continue to increase until the drug eases acute withdrawal symptoms.
Curing Addiction With Amino Acids
If one looks at addiction as not as a disease, but as a deficiency, the deficiency can be balanced by supplementing the body and brain with the deficient neurotransmitters. Considering most drug addictions are caused by an influx of certain neurotransmitters, rebalancing these neurochemical levels may end drug-seeking behavior. For example, most amphetamines cause a release of dopamine. Alcohol floods the GABA system. MDMA causes a huge release of serotonin.
Here are some amino acids that are believed to help treat or cure addiction. At the very least, these amino acids may have the ability to ease withdrawal symptoms.
L-Tyrosine is a key amino acid involved in the synthesis of dopamine. If the body has trouble producing L-Tyrosine, it won’t be able to produce a sufficient amount of dopamine.
Another amino acid that can boost dopamine levels is L-Phenylalanine. L-Phenylalanine is metabolized directly into L-Tyrosine.
The only difference between L-Phenylalanine and L-Tyrosine is L-Phenylalanine readily passes the blood-brain barrier. This allows for a greater concentration of L-Tyrosine to actually reach the brain. The L-Phenylalanine will cross the blood-brain barrier and be converted into L-Tyrosine by various enzymes. This process will take a bit longer since the body needs to metabolize L-Phenylalanine. However, this supplement will ensure that more L-Tyrosine reaches the brain. If L-Tyrosine is taken directly, it may be absorbed by other organs. Only minuscule amounts may reach the brain. This makes the supplement less effective.
L-Tyrosine can also improve sleep quality and decrease mood disturbances. It can even enhance a person’s focus and alertness. Dopamine plays a crucial role in regulating many bodily functions. It’s even involved with the brain’s reward system. This supplement may ease withdrawal symptoms and help curb cravings for a smoother recovery.
Picamilon is a supplement that is metabolized into GABA once it crosses the blood-brain barrier. This amino acid can reduce stress and induce feelings of relaxation. Drug addicts and alcoholics often have deficient GABA levels. The deficiency causes an increase in stress and anxiety. These feelings can encourage relapses. Some studies claim that the body becomes drawn to alcohol and drugs when GABA levels are low. The brain and body start to crave addictive substances. It hopes to artificially regulate these neurochemical levels.
Some studies have shown that picamilon can activate GABA receptors to reduce anxiety. It’s an effective alternative to benzodiazepines since it ha a similar effect. This supplement can ease psychological withdrawal symptom. It makes it easier for recovering addicts to avoid relapses.
Many people may wonder why they shouldn’t take GABA supplements directly. Taking GABA supplements will actually be a waste of time and money. No appreciable amount of the amino acid will cross the blood-brain barrier. The GABA is metabolized before it can even reach that far.
Picamilon can also improve not only one’s quality of sleep, but also improve sleep continuity. Those who take picamilon maintain deeper sleep over the night. They wake up feeling more energized and more refreshed. Poor sleep becomes a thing of the past.
Many people who take picamilon suggest that this supplement can offer other benefits as well. Unfortunately, this supplement is understudied. There’s not a lot of scientific literature on the subject.
If someone struggles with an addiction to MDMA, they might want to look into taking 5-HTP supplements. 5-HTP, or 5-hydroxytryptophan, is directly metabolized into 5-hydroxytryptamine, otherwise known as serotonin. Serotonin is responsible for creating feelings of love and contentment. It also has other physiological effects and plays many other fundamental roles.
5-HTP is often taken after someone uses MDMA. MDMA causes an influx of serotonin to enter the brain. As a result, the body gets drained of serotonin once the drug gets cleared. These drug users have 50% to 80% less serotonin in their brain. This is probably why they often feel moody, depressed and unmotivated. To replenish the drained serotonin, MDMA user can consider taking 5-HTP supplements. These supplements help users feel more comfortable when coming down from the drug. It also helps ease withdrawal symptoms.
Some recovering addicts also claim that 5-HTP can help ease symptoms of depression. The benefit of taking this supplement is that it comes with no side effects. Recovering addicts may have to play around with the dosage to find the amount that works best for them. While this is a claim in the community, it has yet to be studied. There is not a lot of research in this area.
Naloxone: The Medication to Counter Overdoses
Unlike the other medications explored above, naloxone is unique because it’s not used to treat withdrawal symptoms, but to treat overdoses. Naloxone is an opioid-reversing medication that prevents fatal overdoses. It can also be used in medically-assisted treatments. Most rehab centers, and even first responders, have this drug handy. In fact, 41 states have legalized the sale of this drug without a prescription due to its life-saving capabilities.
This drug is an opioid antagonist. It attaches to opioid receptors in the central nervous system (CNS) so that opioid molecules can’t. By taking up space in the receptors, it reverses the toxic effects of opioids. Naloxone will easily beat opioid receptors when it comes to making an attachment because it has a higher affinity. Since drug users who abuse opioids have a high risk of overdosing, they should learn more about overdoses and this medication.
Naloxone comes in various forms. It can be injected intramuscularly, subcutaneously, or intravenously. Intramuscular injections are the simplest. Drug users would simply inject the drug into their thigh muscles or even into the buttocks. This opioid-reversing drug also comes in the form of an intranasal spray. Once injected or sprayed, the effects of naloxone should be noticeable within 5 minutes. If the medication doesn’t seem to have an effect, a second dose may be necessary.
Even if naloxone is working, call 9-1-1 immediately. A drug user who has overdosed will need immediate and attentive medical supervision.
How to Identify an Opioid Overdose
Most opioid overdoses are fatal. Even if they aren’t, they can cause a significant amount of damage to the body and mind. An overdose can cause significant brain damage to the point where the affected individual may suffer from extreme memory loss. Permanent cognitive impairment is also not uncommon.
Unfortunately, an opioid overdose is not always easy to identify. In most situations, the drug addicts will look like they’re simply falling asleep. This isn’t unusual after using lots of drugs. The problem lies in the fact that they’ll stop breathing once they fall asleep. Those who abuse opioids or are around opioid abusers should know how to identify an opioid overdose. Common signs include:
- Blue hue around the lips and fingers
- Drowsiness leading to a loss of consciousness
- Slowed breathing or lack of breathing
- Slowed heartbeat and heart rate
- Small or pinpoint pupils in the eyes
Opioid overdoses can kick in within minutes. It’s vital that those around the opioid abusers act quickly.
Prescribing Medications To Cure Addiction Is Only Part of The Solution
Medications are only part of the solution. Addiction recovery involves a lot more. It involves the use of behavioral therapies, counseling, life skill classes and more. Patients need to also learn how to better themselves. They need to build better habits and relearn how to handle stress.
Currently, addiction is treated with other medications. Unfortunately, some of these medications are addictive. Drug users who use these medications for long periods of time may become reliant on them. They become addicted to prescription drugs rather than illegal substances. Instead of calling their drug dealers for a fix, they go to their pharmacy instead. This doesn’t mean that they’re not addicts. It simply means that their drug dealers have become pharmacists instead of criminals.
The only way to cure addiction completely is to address the underlying causes. Therapy and counseling are great tools. Patients should learn how to become self-aware of their own thoughts and actions. They also learn how to lead healthier lives. Some may start exercising and others may start eating healthier.
It takes more than medications to treat addiction. Patients need to be motivated and make a conscious decision to get sober. After all, sobriety must be something that they want. It can’t be forced.
Do You Need Drug Rehab or Detox?
If you’re looking to start addiction treatment, then you need to understand the importance of medical detox. It’s a critical part of the recovery process. The right type of medications can ease withdrawal symptoms, curb cravings and prevent relapses. They keep patients feeling healthy, and make the transition to recovery as smooth as possible.
Northpoint Washington is an outpatient facility located in Edmonds, Washington. We offer a wide range of treatment options for our clients. Our medical staff assesses each patient that walks through the door to determine what will work best. Each treatment plan is customized to each patient’s needs and expectations. Many of our staff members are in recovery, so we know exactly what you need. Don’t worry. You can get sober and seek treatment here without any judgment at all.
If you’re looking for an inpatient treatment center, we can also refer you to one of our other locations. We can connect you with an addiction specialist or to the admissions team.
Sobriety is definitely attainable with our help. To get more information, take a look at the answers to some of the most frequently asked questions. If you have any more questions or concerns, don’t hesitate to contact us. We’re available all hours of the day!