Opiate dependence treatment
Opiate addiction treatment – methadone therapy
Very effective medicament used to treat opiate and opioids dependence and to reduce relapse risk is methadone – the same medicament which is in use during opiate withdrawal supressing. There are some indications that because of methadone risk of overdose and death is much more smaller.
Methadone as one of opiates and opioids
Interestingly, methadone is one of opiates and opioids. As an addictive substance is danger just like all other opiates. Is it safe to treat patients by replacing one opioid e.g. heroin by other – methadone? It may look like totally full.
But it's not. According to medical knowledge methadone intake in appropriate dosage is safe in people who are dependent from another opiods. In fact: methadone blocks action of opioid which is abused. Moreover methadone effects are not possible to see. In other words: neither opioid abused nor methadone affects our body and mind. It's like one substance would rule another one out. Additionally methadone do not alter elementary functions of organism so that patient can function in society as he or she would be health.
Advantages
Advantages of methadone are long-term acting on abused substance (up to 36 hours), long half time (more than 24 hours) and small, rather relatively convenient side effects like sweating, constipation and decreased sexual activity.
Opiate addiction treatment course
At start, first doses of medicament are in range 20-40 mg – this stage of treatment is called intraductory stage. Next one is induction stage with doses higher than intraductory. Each dose is +5 or +10 mg bigger than previous. Usually max dose is achieved when it is 80 mg a day.
Induction stage last until the situation when patient do not feel any need to use his addictive opiate happens. It may take from few days to even weeks. During this period of time patient should be under medical control. Analysis of urine helps physicians to get to know therapy development inside body better. Sometimes also blood analysis is prepared to find out how many methadone is present in blood (medicament concentration is measured). That helps to assess appropriate dosage which is crucial for effective dependency treatment (not only within opiates but all addictive substances).
Psychoteraphy – ssupplement to pharmacological treatment
In majority of cases it was shown that pharmacological treatment carried solely is not effective. On the other hand psychotherapy used as the only one way to treat also do not lead to long-term success because all may finish with relapse. That's why, according to medical opinions, opiate addiction treatment should always be done both with pharmacological and psychological (depression, PTSD) help at once because problems that arise from this type of addiction are both psychological and physical. Moreover medical treatment is not only methadone therapy but also concerns additional pharmacological treatment because opiate addicts very often suffer from some other addiction-characteristic diseases like HIV, hepatitis B and hepatitis C.
Opiate addiction treatment centers – methadone therapy
There is not so many opiods addiction treatment centers in U.S. because there are some law restrictions related to methadone use. It's not so common as other addictions treatment centers – please use internet locators (for example on SAMHSA website) to find out. You may also contact with your family doctor for help or call specialists from one of telephone helplines which are usually available 24 hour a day.
Buprenorphine therapy – an alternative?
Buprenorphine was shown to be very effective in opiate dependence treatment and methadone treatment may be successfully replaced by buprenorphine. Additional advantage of this medicament is that it is much more available than methadone. Methadone use is very restricted by law while buprenorhine is not and every physician can use and prescribe it if only he or she take a small training and get a certificate. Buprenorphine induces tolerance by binding to opiate repceptors in nervous system and blocking them. This binding is strong and buprenorphine is connected with receptor for a long period of time (long-term acting). This blocking causes that positive effects of opiate use are not able to be seen, tolerance is induced. Additionally when used with appropriate doses – just like in the case of methadone – this medicament is safe and harmless during treatment, there is no intoxication risk and no risk of tolerance or dependency. Sedation is small or none but occurs for sure in patients who use other drugs or alcohol during treatment (it's prohibited). Buprenorphine is long-term acting medicament and thus it can be intaken even twice a week only which is a situation convenient for patients.
Suboxene is a drug composed of buprenorphine and naloxene and can be used not only to dependence treatment but also as a medicament for detox.
Opiate addiction treatment – naltrexone therapy
Naltrexone is not as much effective as buprenorphine and methadone – statistically more patients stops treatment and risk of relapse is higher. Moreover, during use of naltrexone tolerance to addictive opiate decreases and falls into zero what causes big risk of overdose after opiate intake in dose that patient used to intake before therapy. It's life-threading situation that is not common during buprenorphine and methadone therapy when tolerance is induced and risk of abrupt overdose is small.
