MEDICATION AND ADDICTION TREATMENT

Recent studies have indicated that 60-70% of alcoholics and drug abusers have co-existing mental health problems. In the past the addictions field felt that a “clean brain” was the best way to avoid a relapse. Therefore, use of any medication was discouraged. Today the field has seen massive changes.

The use of anti depressants, mood stabilizers, and drugs like the atypical anti psychotics is often appropriate and safe. Used for suitable indications these medications can enhance the recovery process. Conversely, if not used when indicated could very well hinder recovery.

Last year I attended a NADAC seminar on Pharmacotherapies for Alcohol Abusers where they discussed the “new” medications for addictions. These “new” drugs include Campral, Vivitrol, and Buprenophine (Subutex and Suboxone). Campral was released in this country about two years ago. It’s mechanism of action is to block sensors that causes cravings for alcohol. According to the data I have seen Campral is safe, relatively free of side effects, and helpful to many patients. Campral alone helps to reduce the urge to drink. However, it does not take the place of the psycho-social changes needed to accomplish recovery from alcohol.

Vivitrol is a new presentation of an old drug Naltrexone. Naltrexone, an opiate receptor blocker, was marketed as Revia. Revia comes in a tablet form and is designed to reduce alcohol cravings. Some practitioners report a fair amount of side effects with this medication. Vivitrol is an intramuscular (IM) form of Naltrexone which is administered once a month. Reports indicate that Naltrexone is a safe, non addictive drug which has shown some promise in reducing alcohol consumption. Campral and Vivitrol can be used together as they use different mechanisms of action. Buprenophine (Subutex and Suboxone) has been released and marketed for outpatient detoxification for opiates. Physicians must take an eight hour course to prescribe this medication and are issued a special DEA number. Suboxone and Methadone share many characteristics. Without question Suboxone is safer since overdoses, accidental or intentional, are virtually impossible. That is not true for methadone. However, like methadone Suboxone patients often have a very difficult time all the way off the drug completely. Since the ultimate goal is to become drug free, this can often be difficult. Some professionals fear that this may lead to Suboxone maintenance.

My office offers State of Georgia approved alcohol and drug evaluations, ASAM .5 treatment (education), and ASAM Level 1 treatment.