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Opiate Addiction

Suboxone / Subutex / buprenorphine
 

These are medication that serve as a "partial agonists" for the treatment of opiate and narcotic abuse.  Suboxone is a  new medication FDA approved for the  treatment of opiate dependence.  It has no desirable euphoria or "high", even if taken in larger doses, because it does not fully activate the body's opiate receptors.  Think of it as having a "ceiling effect" or a "governor" or built-in  limiter. This  makes buprenorphine very safe because it is difficult to "overdose".  Buprenorphine also interferes with the ability of other opiates to make someone euphoric or "high" because it is "sticky" and other opiates have to displace it off the receptors before they can work.

The Drug Enforcement Agency (DEA) requires special training and special "waiver" in order to prescribe Suboxone.  There is also a federally designated limit to the number of patients a practitioner can treat, making access to Suboxone a precious limited resource.

(Suboxone is buprenorphine mixed with another drug that is an INACTIVE INGREDIENT when taken as prescribed.  This drug, Naloxone, is an antagonist or "antidote" to opiates.  When taken sublingual or orally it is essentially not absorbed into the blood,  When Suboxone is taken sublingually as directed, this other ingredient has no significant effect.  However, if Suboxone is crushed and "cooked" and injected intravenously, the Naloxone RIPS EVERY OPIATE OFF EVERY OPIATE RECEPTOR in the body!  This would cause immediate severe withdrawal and be extremely unpleasant!  This other drug is mixed in  ONLY to ruin Suboxone abuse for needle users.  Active opiate addicts will avoid injecting Suboxone as if it were a poison!)

Alcohol Addiction

Naltrexone / Vivitrol

You may be surprised to learn that medicines used to counteract opiates are also successful in the treatment of other addictions.  It turns out the opiate antagonist naltrexone significantly helps alcoholics stop drinking and reduces the craving for alcohol.  It has been shown in studies that using naltrexone increases the chance of finding abstinence and sobriety.  Vivitrol is simple injection that works for an entire month and can be a significant help in getting alcoholics to stop drinking.

Antabuse

Disulfiram works by changing the way the body metabolizes alcohol.  If you drink alcohol while taking disulfiram you become very ill.  This medicine works well when taken in the morning when most alcoholics can realize their desire to escape from their disease.  The morning "angel" who doesn't want to drink takes the medication and sabotages the afternoon and evening "devil" who wants to take control of the person and drink.  Many people do well by this method of inoculating the survivor against the behavior of the addict.

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    Methamphetamine / Cocaine / Stimulant Addiction
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    There are numerous prescription drugs that work in a variety of ways to help stop addiction to methamphetamine and other stimulants such as cocaine.

    Stimulant abuse is an especially difficult problem in the field of addiction medicine.  Amphetamines increase the brains "reward" neurotransmitters 600% above normal!  It takes a great deal of work to recover from amphetamine addiction, and several prescription drugs help restore brain function to normal.

    Provigil/Nuvigil (modafinil) is a medication normally used to treat narcolepsy (a rare disorder where people are unable to stay awake and pathologically fall asleep at inappropriate times).  This medication works by stimulating the "awakeness" part of the brain, but it does not produce any intoxication or  "high".  Using this drug for stimulant addiction shows promise in helping people find recovery.

    Wellbutrin (buproprion) is an antidepressant that changes the balance of neurotransmitters in the brain and shows promise for treating stimulant addiction.  Many patients feel an energizing effect when they take

    Antabuse  (disulfiram) is a drug used to treat alcohol abuse, yet surprisingly it can help reduce cravings for stimulants like cocaine and methamphetamine.  We don't yet know why it has this effect, and it may help in the treatment of stimulant addiction.

    Tranquilizer/Sedative Addiction

                It is extremely important to adequately treat addiction to benzodiazepines or other tranquilizer/sedatives to prevent serious medical complications.  These drugs cause severe chemical changes in the brain that can be treated with medications.

    Marijuana Addiction

                It is important to address the underlying biochemical mood problems involved in this complicated problem.

     

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    Last modified: 10/11/09