Why a Professional Oversees Drug Replacement Therapy

More than 2.5 million Americans have an opioid use disorder, an epidemic that has caused tens of thousands of deaths. 1 Some of the most effective treatments for those who are struggling with opioid addiction are drug replacement therapies. Substituting a safer, legal medication, given under close medical supervision, can be key to a successful recovery from opiate addiction.

Effective Medications Used in Drug Replacement Therapies

The medications used in drug replacement therapies differ, depending upon the type of opioid being replaced. Some of the effective medications available include:
  • Buprenorphine
  • Methadone
  • Naltrexone
Buprenorphine and methadone are considered to be essential medicines for managing opioid dependency. 2 It’s important, however, that these prescriptions are combined with behavioral counseling in order to treat all aspects of the disease.

About Opioids

Opioid drugs work to mimic the brain chemicals called endorphins. These neurotransmitters bind to receptor molecules in the brain’s pleasure center. Endorphin receptors also exist on nerve cells that transmit pain signals to your brain. The results of a natural endorphin release are feelings of pleasure and some relief from pain.

The endorphins that opioids attempt to mimic are even more powerful than the natural endorphins our brains release during, for instance, a healthy jog through the park on a beautiful day. Opioids induce pleasurable feelings with much more intensity, and they block pain, more effectively than our natural endorphins can.

While opioids can achieve the job of relieving pain, which is why many people receive prescriptions for the drugs in the first place. They are also highly addictive.

With continued use, you can develop a tolerance for the drug, requiring larger doses over more frequent periods of time in order to continue feeling the pleasure and pain reduction aspects of the medication. As the effects of an opioid wear off, the body experiences symptoms of withdrawal. In order to alleviate these withdrawal symptoms, such as nausea and anxiety, many people take more opioids to avoid feeling unwell.

When taken at higher and higher doses, it becomes easy for an accidental overdose to occur, leading to acute respiration difficulties and death.

Prescriptions Used in Medication Assisted Treatment (MAT)

Many recovery treatment programs for those with an opioid use disorder may combine behavioral therapy with either methadone, buprenorphine or naltrexone.

Methadone

Methadone is a drug replacement therapy used to help people recover from an addiction to heroin and opioid pain medicines. It works by reducing the pain that accompanies opiate withdrawal while it also prevents the brain from experiencing the pleasurable effects of opiate drugs. Methadone provides relief from painful symptoms of withdrawal for up to eight hours per dose. This drug replacement therapy enables people to remain longer in treatment recovery programs as they overcome their dependency on opioid substances.

Buprenorphine

Buprenorphine is a partial agonist opioid. It’s a drug that activates the brain’s opioid receptors much less fully than a full agonist does. 3 Examples of full agonists include heroin, methadone and other opioids. Buprenorphine decreases the potential for misuse, decreases painful withdrawal symptoms and cravings, and is safer to use in terms of mistaken overdosing.

Naltrexone

Naltrexone is a drug replacement therapy appropriate for people with substance and/or alcohol use disorders. Rather than activating opioid receptors as methadone and buprenorphine do, naltrexone blocks the euphoric and sedating effects of opioids in order to reduce cravings. This drug does not produce feelings of intense pleasure, but instead blocks these effects should someone relapse and use the problem substance.

How This Therapeutic Approach Works

Treatment of opioid addiction with drug replacement therapies assist people in recovery to attain a stable physical condition so they can successfully complete counseling and rehabilitation programs while under professional supervision.

While on a drug replacement therapy program, a person receives regulated doses of the medication being used and is strictly monitored by a physician. The dosage given keeps cravings for substances down and reduces the emotional upheaval and physical pain that can accompany withdrawal. These replacement medications allow for more comfortable and active participation in counseling, whether during individual or group therapy sessions.

Why Supervision Is So Important During Detox

The use of methadone, buprenorphine and naltrexone as a treatment for substance abuse is not a simple case of trading one addiction for a new one. These medications are carefully prescribed by a medical professional and given to those being treated under strictly controlled conditions. Although these medications are safe when used under medical supervision, they have some potential for addiction and should never be used on one’s own.

These drugs are not generally given by injection, snorting or smoking in the same ways that “street” drugs are, such as heroin. Rather, they are given in pill form, by mouth, in specific doses that correspond to the individual. The drugs’ effects are felt gradually; there is no quick “rush” of euphoria that wears off quickly, that might leave the person anticipating their next use of the drug with an intense craving.

Methadone and buprenorphine treatment maintains stable amounts of the drug in the brain, which reduces cravings for opioids. 4If a relapse occurs and the person in recovery attempts to take an opioid drug, the highly pleasurable feelings are deeply suppressed. Only a medical professional can determine how much to dispense and the length of treatment. Official clinical guidelines for physicians are in place for the treatment of opioid addiction when using buprenorphine and other drug replacement therapies. 5

Naltrexone is usually given as a monthly injectable, with the length of course and dosage dependent upon each person’s individual situation. It can’t be administered, however, until opioid or alcohol withdrawal has been accomplished and substances are completely out of the system for up to 10 days. Naltrexone helps reduce cravings, blocks the “rewarding” effects of opioids and alcohol should relapse occur, and it helps persons with substance use disorders more fully participate in counseling and behavioral therapies.

Methadone, Buprenorphine and Naltrexone

These medications, when used in combination with counseling and other types of behavioral therapies, are effective when treating opioid use disorder. The use of drug replacement therapies helps some complete and retain sobriety.

Medications used in MAT often give people lifesaving protection and the time to build a foundation in recovery. Drug replacement therapy helps people stay in recovery treatment programs, regain employment and re-establish social ties with friends and family. It also provides them with protection from overdose and relapse and the ability to function more fully in behavioral therapies.