Substance abuse addiction is a serious disease that requires treatment to save the life of the afflicted person.

Addiction treatment is a complicated topic, as there are several modalities of treatment, and the best treatment for an individual struggling with substance abuse addiction depends on the type and severity of their addiction.

WHAT IS SUBSTANCE ABUSE ADDICTION?

WHAT ARE TREATMENTS FOR DRUG ADDICTION?

There are many options that have been successful in treating drug addiction, including:

• behavioral counseling
• medication
• medical devices and applications used to treat withdrawal symptoms or deliver skills training
• evaluation and treatment for co-occurring mental health issues such as depression and anxiety
• long-term follow-up to prevent relapse

A range of care with a tailored treatment program and follow-up options can be crucial to success. Treatment should include both medical and mental health services as needed. Follow-up care may include community- or family-based recovery support systems.

HOW ARE MEDICATIONS AND DEVICES USED IN DRUG ADDICITON TREATMENT? 

Withdrawal. Medications and devices can help suppress withdrawal symptoms during detoxification.

Detoxification is not in itself “treatment,” but only the first step in the process. Patients who do not receive any further treatment after detoxification usually resume their drug use.

One study of treatment facilities found that medications were used in almost 80 percent of detoxifications (SAMHSA, 2014). In November 2017, the Food and Drug Administration (FDA) granted a new indication to an electronic stimulation device, NSS-2 Bridge, for use in helping reduce opioid withdrawal symptoms. This device is placed behind the ear and sends electrical pulses to stimulate certain brain nerves. Also, in May 2018, the FDA approved lofexidine, a non-opioid medicine designed to reduce opioid withdrawal symptoms

Opioids: Methadone (Dolophine^®, Methadose^®), buprenorphine (Suboxone^®, Subutex^®, Probuphine^® , Sublocade^™), and naltrexone (Vivitrol^®) are used to treat opioid addiction.

Acting on the same targets in the brain as heroin and morphine, methadone and buprenorphine suppress withdrawal symptoms and relieve cravings. Naltrexone blocks the effects of opioids at their receptor sites in the brain and should be used only in patients who have already been detoxified. All medications help patients reduce drug seeking and related criminal behavior and help them become more open to behavioral treatments. A NIDA study found that once treatment is initiated, both a buprenorphine/naloxone combi-nation and an extended release naltrexone formulation are similarly effective in treating opioid addiction. Because full detoxification is necessary for treatment with naloxone, initiating treatment among active users was difficult, but once detoxification was complete, both medications had similar effectiveness.

Tobacco: Nicotine replacement therapies have several forms, including the patch, spray, gum, and lozenges.

These products are available over the counter. The U.S. Food and Drug Administration (FDA) has approved two prescription medications for nicotine addiction: bupropion (Zyban^®) and varenicline (Chantix^®).

They work differently in the brain, but both help prevent relapse in people trying to quit. The medications are more effective when combined with behavioral treatments, such as group and individual therapy as well as telephone quitlines.

Alcohol: Three medications have been FDA-approved for treating alcohol addiction and a fourth, topiramate, has shown promise in clinical trials (large-scale studies with people). The three approved medications are as follows:

• Naltrexone blocks opioid receptors that are involved in the rewarding effects of drinking and in the craving for alcohol. It reduces relapse to heavy drinking and is highly effective in some patients. Genetic differences may affect how well the drug works in certain patients.
• Acamprosate (Campral^®) may reduce symptoms of long-lasting withdrawal, such as insomnia, anxiety, restlessness, and dysphoria (generally feeling unwell or unhappy). It may be more effective in patients with severe addiction.
• Disulfiram (Antabuse^®) interferes with the breakdown of alcohol. Acetaldehyde builds up in the body, leading to unpleasant reactions that include flushing (warmth and redness in the face), nausea, and irregular heartbeat if the patient drinks alcohol. Compliance (taking the drug as prescribed) can be a problem, but it may help patients who are highly motivated to quit drinking.