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Get Help: Types Of Treatment

For some people, Medication-Assisted Treatment may be an appropriate option:
There are a number of medications that may be used to help lessen cravings and get through withdrawal. The first two, methadone and buprenorphine are themselves opioids and some people view these treatments for opioid dependence as just the substitution of one addictive drug for another. But taking these medications as prescribed allows patients to hold jobs, avoid street crime and violence, and reduce their exposure to HIV by stopping or decreasing injection drug use and drug-related high-risk sexual behavior. Patients stabilized on these medications can also engage more readily in counseling and other behavioral interventions essential to recovery.

• Methadone
Methadone is a long-acting synthetic opioid agonist medication that can prevent withdrawal symptoms and reduce cravings in opioid-addicted individuals. It can also block the effects of illicit opioids.
It has a long history of use in treatment of opioid dependence in adults and is taken orally. Methadone maintenance treatment is available in all but three States through specially licensed opioid treatment programs or methadone maintenance programs.
Combined with behavioral treatment: Research has shown that methadone maintenance is more effective when it includes individual and/or group counseling, with even better outcomes when patients are provided with, or referred to, other needed medical/psychiatric, psychological, and social services (e.g., employment or family services).

•Suboxone (Buprenorphine)
Buprenorphine is a synthetic opioid medication that acts as a partial agonist at opioid receptors—it does not produce the euphoria and sedation caused by heroin or other opioids but is able to reduce or eliminate withdrawal symptoms associated with opioid dependence and carries a low risk of overdose.
Buprenorphine is currently available in two formulations that are taken sublingually: (1) a pure form of the drug and (2) a more commonly prescribed formulation called Suboxone, which combines buprenorphine with the drug naloxone, a blocker, at opioid receptors. Naloxone has no effect when Suboxone is taken as prescribed, but if an addicted individual attempts to inject Suboxone, the naloxone will produce severe withdrawal symptoms. Thus, this formulation lessens the likelihood that the drug will be misused or diverted to others.
Buprenorphine treatment for detoxification and/or maintenance can be provided in office-based settings by qualified physicians who have received a waiver from the Drug Enforcement Administration (DEA), allowing them to prescribe it. The availability of office-based treatment for opioid addiction is a cost-effective approach that increases the reach of treatment and the options available to patients.

• Naltrexone (Vivitrol)
Naltrexone works differently than the medications listed above. It blocks opioids from acting on the brain, so instead of curbing cravings, it takes away the reward of getting high on the problem drug. This feature makes naltrexone a particularly good choice for preventing relapse. It may also be an option if you are completely past withdrawal and are highly motivated to stay in recovery or if you are in the early stages of opioid addiction.
Naltrexone comes in both a pill and in an injection form. The pill is taken every day for one to three days as prescribed by your clinician. It also comes in an extended-release form that is injected into the buttocks. This injection, trade-named Vivitrol, is administrated by your treatment provider in their office once per month.
Like most medications, naltrexone can cause side effects in some people. Those include upset stomach or vomiting, headache, nervousness, changes in sleeping, joint and muscle pain and on the more serious side, could cause major liver problems. You can get more information on Naltrexone from the Substance Abuse and Mental Health Services Administration .

For others, a period of detox to get the drugs out of the patient’s system is the best option:
It is important that following any detox, a comprehensive treatment plan should be put in place. The treatment may occur outpatient setting, or inpatient if the patient is dependent on other drugs. Insurance coverage for these services varies, but the Executive Office of Health and Human Services is working with insurers on this (see Working Group Recommendations-hyperlink).

With any treatment course, long-term recovery strategies are important.
Counseling: One-on-one or group counseling can motivate people to participate in drug treatment, offer strategies for coping with drug cravings, teach ways to avoid drugs and prevent relapse and help individuals deal with relapse if it occurs. There are a number of types of behavioral therapy that can be helpful.
Group therapy reinforces the idea that the patient is not alone. Support from co-group members can promote a community of abstinence and a non-drug-using lifestyle. Cognitive-behavioral therapy seeks to help patients recognize, avoid, and cope with situations in which they are most likely to misuse drugs. Family counseling works particularly well for adolescents with substance misuse issues, as they work with their families to address a range of influences on their drug misuse patterns.
These various types of counseling and behavioral therapies generally appear to be more effective when combined with medication-assisted treatment than when used alone.

Other Treatments:
Addiction is a brain disease that affects multiple brain circuits including those involved in motivation, learning and memory, and control over behaviors. It’s been well documented that people who are addicted to drugs often suffer from behavioral illness (depression/anxiety), occupational, legal, familial, and social problems all of which should also be addressed in treatment. No individual with substance misuse is alike and treatment for one individual may look different from that of another. The development of a comprehensive treatment plan to manage all the aspects of the patient’s disease is essential to recovery.

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*From the Massachusetts Substance Abuse Information and Education Helpline and the National Institute on Drug Abuse
Posted June 2015
Disclaimer: The contents of this website are not intended to offer specific medical advice and should not be used for diagnosing or treating particular conditions. For questions about your own health, ask your doctor.