Medication-Assisted Treatment: Is Medication Your Best Bet in Opiate Detox?
Addiction to heroin and opiate painkillers like OxyContin or Percocet is a life-changing medical disorder. Characterized by an intense withdrawal process that includes both physical and psychological withdrawal symptoms, the process of stopping the use of any opiate drug when addiction is present can be daunting.
The good news is that there are a number of different options to help people navigate the process of opiate detox. In fact, in terms of treatment choices for different drugs of abuse, there are a host of options for people living with heroin addiction or painkiller addiction, more so than for other drugs of choice. Many of them are medication-based with the goal of making the detox process more comfortable and swift – but not everyone will find these methods useful, necessary, or desirable.
Is medication maintenance the best choice for you in opiate detox?
Vivitrol, methadone, and buprenorphine may all be potential choices for clients who are detoxing off an opiate drug. Each one is different in terms of rules for dispensation. Depending on the dose of the drug of choice at the time of detox as well as other factors, different medications may be more or less appropriate.
- Vivitrol: Also known as naltrexone, this drug helps to protect the individual against relapse because it binds to opiate receptors in the brain and stops other opiate use from creating a high in the user. Usually administered in a once-monthly injection, it can be especially helpful for clients who have a difficult time remembering to take medication on their own or who are transient and cannot regularly get to a methadone clinic.
- Buprenorphine: Sold under the brand names Suboxone, Subutex, Bunavail, and Zubslov, buprenorphine is the only medication that is FDA-approved for nothing but the treatment of opiate detox. It is available through any doctor who is certified to dispense the drug and can be taken at home. It is especially appropriate for those who have a low-dose opiate addiction at the time of cessation of use.
- Methadone: Methadone has long been considered the gold standard in opiate detox treatment, but there are a number of restrictions on the drug. For example, in the first months, all patients are required to attend regular group sessions as well as meet with a case manager and come into a certified clinic daily to receive the liquid dose of the drug. Over time, with a track record of compliance, patients may “earn” take-home doses of the drug for the weekend or over a holiday. Additionally, at a dose of 80 milligrams or higher, methadone blocks the effects of other drugs, and may therefore be most appropriate for high-dose opiate users and those who would like to taper at a very slow rate because the dose can be adjusted milligram by milligram as needed.
It is important to note that ultra rapid detox has been found to be ineffective and, in some cases, extremely dangerous depending on the method. If medications are to be used as a maintenance option, they should be administered under the care of a substance abuse treatment professional. Any program that advertises a sedated detox or a super quick detox and total freedom from addiction with no mention of the provision of therapeutic treatment of any kind should be avoided at all costs. Real recovery takes time, work, and patience. There is no cure, no silver bullet, and no magical medication that will make it all go away.
- Medication is not a comprehensive treatment for opiate addiction. Physical dependence is just part of the equation when it comes to opiate addiction, no matter what the drug of choice or how the addiction began. Long-term therapy is absolutely necessary to address the issues underlying the addiction as well as any co-occurring mental health disorders and to provide the client with coping mechanisms that will increase stability, lower stress, and decrease the risk of relapse.
- Many of the medications are addictive themselves. Though the medications listed above can be helpful in mitigating the withdrawal symptoms experienced during detox and allow the person to more quickly turn to the therapy and begin to heal and grow on that front, some of the medications are addictive substances in their own rights. Abuse can lead to relapse.
- Addiction is still an issue. As long as the individual continues to take any addictive substance of any kind for any reason, there is still a physical addiction present, which can be a tough line to walk when the person is attempting to make a new start in recovery.
- Withdrawal symptoms may still be experienced. Even with the use of maintenance medications, the individual will not be completely comfortable. For example, those who take high doses of methadone regularly may experience heavy sweating, low energy, constipation, gastrointestinal issues, and other physical complaints. Though not as overwhelming as full-blown detox, the use of medications does not provide the experience of a high to the user and it does not mean total physical comfort either.
- Medication is not the best approach for everyone. No one wants to experience the withdrawal symptoms that accompany opiate detox, but it may just be that going through a few weeks of discomfort in exchange for freedom from physical dependence on all substances is worth it.
What Is Right for You?
Depending on your past attempts at getting clean and sober, your current dose of your drug of choice, your co-occurring mental and physical health issues, and a number of other considerations, maintenance medications may or may not be appropriate in your case. Contact River Oaks today to speak to a counselor and learn more about the treatment options that are available so you can begin the process of determining the best course of action for your unique needs.