This is the second installment of a two-part series on drugs to treat drug and alcohol addiction. Currently, there are three categories of drugs used to treat drug dependencies.
Used for opiate withdrawal and replacement since the mid-1960s, methadone has been prescribed to thousands of opiate addicts. While methadone can be used to lessen withdrawal symptoms in early detoxification, it’s most widely known for its use in long-term maintenance.
The usual treatment course involves daily visits to a licensed clinic to receive a single dose of methadone to offset cravings and withdrawal symptoms. Clients should also receive psychosocial support services, including drug testing, to verify abstinence from other drugs.
Methadone is also prescribed for pain. Interestingly, Methadone accounts for only 2% of painkiller prescriptions in the United States, but the drug is linked to more than 30% of prescription painkiller overdose deaths according the Centers for Disease Control and Prevention. Health officials say most of the overdose deaths are people who take it for pain, not heroin or drug addicts. According to the CDC, methadone carries more risks than other painkillers because levels build up in the body and may interfere with a person’s normal heart rhythm or breathing.
Levo-alpha Acetyl Methadol (LAAM)
An alternative to methadone is a medication known as LAAM which is also primarily used as a replacement therapy for opiate drugs. LAAM is sometimes preferred to methadone because it requires less frequent dosing, allowing for fewer clinic visits. LAAM treatment outcomes are comparable to methadone with respect to reduction of opioid use, although retention rates are higher for clients treated with methadone. Longer LAAM treatments are associated with better outcomes.
In 2002, two forms of buprenorphine, Suboxone and Subutex, were approved for the treatment of opioid abuse and addiction. Outcomes appear to be similar to methadone, and some studies have produced promising results on the effectiveness. One advantage is that the client does not need to visit a registered clinic several times per week, increasing access and convenience. A disadvantage is that it makes it easier for the client to avoid or discount the importance of drug and alcohol treatment and other psychological support. Doctors who want to prescribe these medications have to meet special training criteria and agree to treat no more than 30 patients at any time in their individual practice.
There is one major difference between Suboxone and Subutex. Subutex is only comprised of Buprenorphine. Suboxone is a combination of buprenorphine and naloxone (a compound that blocks the effects of pain-killing opiates). Suboxone is a very safe drug, with minimal risk of overdose. An optimal dose can be achieved in a very short period of time: Suboxone usually takes less than one week, whereas methadone dosage needs to be increased slowly and carefully over a longer period of time.