For many individuals, relapse prevention medications (some of which are listed below) can be a useful tool in the treatment of substance use disorders.
MEDICATIONS FOR TREATING NICOTINE USE DISORDERS
- NICOTINE REPLACEMENT THERAPIES (NRT): Several forms of NRT have been marketed, including the nicotine patch, inhaler, nasal spray, gum, sublingual tablet, lozenge, and electronic cigarettes.
- BUPROPRION (Wellbutrin SR, Zyban): It makes smoking less pleasurable and reduces craving while you work on your smoking habits.
- VARENICLINE (Chantix): It blocks the effects of nicotine and reduces cravings and withdrawal symptoms. If you start smoking again while taking the medicine, you won’t feel as satisfied.
MEDICATIONS FOR TREATING ALCOHOL USE DISORDERS
- DISUFIRAM (Antabuse): Antabuse causes unpleasant effects if you drink even small amounts of alcohol such as flushing, headache, nausea and vomiting. It begins to effect alcohol metabolism within 1-2 hours and reaches a peak in 12 hours. It is slowly excreted from the body over 2 weeks.
- ACAMPROSATE (Campral): This medication is thought to work by restoring the chemical imbalance in the brain caused by chronic exposure to alcohol. This makes it easier for people not to drink.
- NALTREXONE: Naltrexone (ReVia) is an oral medication that reduces the craving for alcohol, and also reduces the pleasurable effects of alcohol. This effect can help people reduce their drinking. Vivitrol, a long-acting form of naltrexone, is used to treat problem drinking and alcoholism. This drug is administered by injection and each shot lasts about a month. Click here to view the brochure for Vivitrol. Click here to view a fact sheet on Naltrexone.
- TOPIRAMATE (Topamax): Reduces brain levels of the neurotransmitter dopamine (which is believed to create the pleasurable sensations alcoholics get from drinking), potentially resetting the brain’s chemistry.
- BACLOFEN: Increases the amount of GABA, a neurotransmitter in the brain which has a relaxing effect.
- GABAPENTIN (Neurontin): Its activity in the GABA neurotransmitter pathway suggests it might alleviate alcohol craving, which is believed to involve GABA activation in a specific part of the brain (amygdala). Previous studies have shown that Gabapentin reduces this activity. This may increase rates of sustained abstinence and no heavy drinking and decrease alcohol-related insomnia and sad or anxious mood.
- ONDANSETRON (Zofran): Ondansetron appears to work by acting on serotonin, one of the brain’s many neurotransmitters. An imbalance between two chemical messengers in the brain, serotonin and dopamine, is believed to create a craving for alcohol. Ondansetron blocks a serotonin receptor, which decreases alcohol-induced dopamine release, resulting in a decrease in alcohol-drinking behavior.
MEDICATIONS FOR TREATING OPIOID USE DISORDERS
- BUPRENORPHINE (Suboxone, Subutex, Zubsolv, Butrans): Opioids attach to receptors in the brain. Buprenorphine works by stimulating the brain opioid receptors but only partially satisfying them by not being a perfect fit. Thus Buprenorphine helps to ease withdrawal symptoms and drug cravings by activating the opiate receptors but not in an intense enough way to produce the heightened feelings of euphoria that heroin would produce. If a person attempts to take another opiate such as heroin while taking buprenorphine, there will be no effect.
- NALTREXONE (Revia or Vivitrol): Naltrexone blocks the part of your brain that feels pleasure when taking narcotics. Because it blocks the opioid receptors it prevents the body from responding to opiates. It can be taken by mouth once daily or every other day, has minimal side effects and is not addicting. Vivitrol, a long-acting form of naltrexone, is administered by injection and each shot lasts about a month. Click here to view the brochure for Vivitrol. Click here to view a fact sheet on Naltrexone.
Dr. Ascher is a psychiatrist in Philadelphia, serving clients in Devon, PA, Berwyn, PA, and Wayne, PA. To learn more about medications for treating addiction, please reach out via the contact form.Please share this post!