As a human service professional, it is my obligation to provide evidence-based treatment. According to an US Department of Health and Human Services study estimates that substance abuse costs the United States $510.8 billion and wreaks immeasurable damage on lives and personal relationships. One in four deaths can be attributed to alcohol, tobacco, or illicit drugs. Despite these facts we remain stuck in myths, misconceptions and stigma. These misguided beliefs also seem to prevent opportunity for life saving pathways to recovery and the innovation and use of medical assisted recovery. A very important myth to disperse is, “not every alcoholic is a fallen down drunk.” Individuals may hold responsible jobs and maybe be well liked by their peers. However, many of these individuals know in their own hearts that their drug and alcohol use has become a problem. When many of them use drugs or alcohol they do so with the intent of intoxication. They cannot predict the outcome of their use and may suffer consequences. They may be aware that there may be consequence but will continue to use drugs or alcohol. A comprehensive evaluation is necessary and will provide not only a diagnosis but also an effective treatment plan. As identified in the last issue of the Woman’s Journal, the relevancy gender specific treatment must be a primary consideration. The evaluation may also include a referral for medication assisted recovery. The use of medication is not appropriate for all individuals but has been proven to be a lifesaving tool for many.
MEDICATION ASSISTANT RECOVERY
Research has shone light that addiction causes changes to take place in the brain. The way we learn to survive is based on a reward system. When we do something that aids in our survival, like eating or exercising, our brain’s limbic system rewards for this behavior by releasing dopamine, a chemical that makes us feel good. Since we like the way we feel, we learn to repeat the behavior. Different substances approach the limbic system -- the reward center --in our brains in different ways, but all substances of abuse cause the brain to release high levels of dopamine. This release can be two to 10 times the amount our brain releases normally, giving the user a sense of a “rush” or “high.” Over time, prolonged use of a substance can lead the brain to stop producing as much dopamine as it naturally does. This creates further withdrawal, leading to a physical dependency -- the addict needs to use more of the substance just to feel normal, craving drugs or alcohol and creating a vicious cycle that can be difficult to break Medication-Assisted Recovery is a practical, accurate, and non-stigmatizing way to describe a pathway to recovery. Medications have been developed that may support an individual in their recovery by reducing cravings. Decreased impulsive or situational use of alcohol can lengthen periods of abstinence and prevent a lapse from becoming a full-blown relapse. It is also necessary that an individual to be involved in other individualized treatment that may include peer support, group and individual therapy. Although medications have been utilized for a number of years to assist individuals, the lack of awareness of professionals and the stigma has stunted the use. A brief description of some of the medications is provided here only to increase awareness. These medications can only be prescribed by an individual who is licensed to prescribe medication and who will be able to explain the use of these medications in more detail.
Naltrexone (ReVia®) is a medication that reduces the craving for alcohol. It is now available by injection and is known by the brand name of Vivitrol. The benefit of the injection is that the medication last for twenty-eight days. In addition to reducing the cravings for alcohol, the medication is also prescribed for opioid dependence because it blocks the drug’s effects. It is important for people who use heroin to go through detox first, so they are heroin free before starting to take naltrexone.
Campral ® (Acamprosate calcium) is a medication that helps people stay alcohol free in combination with counseling or support groups, once they have stopped drinking. Campral ® helps reduce the emotional discomfort and physical stress (e.g. sweating, anxiety, sleep disturbances) associated with staying alcohol-free.
Suboxone contains a combination of buprenorphine and naloxone. Buprenorphine is an opioid medication. Buprenorphine is similar to other opioids such as morphine, codeine, and heroin however, it produces less euphoric (“high”) effects and therefore may be easier to stop taking. Naloxone blocks the effects of opioids such as morphine, codeine, and heroin.
The most important myth that this article can disperse is that people do not recover. Everyday people are deciding to stop their abuse and dependency on drugs and alcohol. Unfortunately, for many others they experience severe consequences and even death. With the stakes as high as death of people we love, exploring all options available seems to be the right approach. Today, we have options for the addicted individual who wants to experience the freedom of recovery.