Addiction Treatment: New Prescriptions (cont.)
Among the drugs most frequently prescribed is Suboxone, which is used to treat addiction to painkillers like OxyContin (what hooked Rush Limbaugh) as well as heroin, and last year doctors wrote some 80,000 prescriptions.
"This medication is one of the most exciting things to happen in the world of drug treatment, not only because it works so well, but because you don't have to go to a drug treatment center or clinic to get it -- any psychiatrist or even a regular family doctor can prescribe it, and that alone helps to bring in a lot of people who might not ordinarily go for treatment," Upadhya tells WebMD.
While all addictive substances affect slightly different areas of the brain, the one thing they share in common is stimulation of the reward centers, the areas of the brain that release the pleasure hormones that make us feel good.
In the past, treatment was limited to those drugs that stimulated these same pleasure centers. But those drugs also produced a similar high. In the case of heroin addiction, the treatment drug methadone was often widely criticized because of its similarity to the substance being abused and its potential for abuse as well as dangerous overdosing."It was like substituting one addiction for another," says Upadhya. Suboxone, however, works in an entirely different way. By competing with heroin or opiate painkillers for the same receptors deep within the brain, Upadhya says it's able to knock out the withdrawal symptoms without "producing the high."
In addition, he says, because the drug has a built-in "ceiling effect" -- meaning that increasing the dosage will not enhance the satiation effects -- it becomes virtually impossible for addicts to abuse. And that, he says, makes it safer to prescribe without risk of overdose.
While Suboxone is fast proving successful -- one clinic boasts an 88% success rate after six months of treatment compared with just 50% for methadone -- not everyone has equal success. For some addicts the effects are simply not strong enough to cut the craving, while for others, side effects including headache, withdrawal syndrome, pain, nausea, and sweating can make treatment difficult. Still, experts say for most who try it, it offers the promise of treatment success with far fewer problems.
Addiction Treatment: Treating Alcoholism the New Way
Some experts believe that one of the factors responsible for the success of Suboxone lies not only in the power of the primary drug, but also in a second compound contained in this drug -- a medication known as naloxone. A powerful anti-addiction drug in its own right, naloxone, sold under the brand name Narcan, has also become a mainstay in the modern treatment of alcohol addiction. In fact, it's one of just two medications approved by the FDA for this purpose.
"When used in alcohol addiction, naloxone reduces cravings and diminishes the length of time alcohol is used while increasing the length of time an abstinent person might remain abstinent, " says Marc Galanter, MD, director of the division of alcohol and substance abuse at NYU Medical Center/Bellevue in New York.