Substance Use Disorder Pharmacotherapy

A medication used to treat alcohol dependence. It helps stabilize brain chemistry affected by alcohol withdrawal.

A medication used to reduce alcohol cravings and prevent relapse. It is thought to block the pleasurable effects of alcohol.

A type of medication used to treat opioid/opiate dependence. These medications are similar to the abused drug and are used to prevent withdrawal and cravings.

A medication used to treat opioid dependence, it can help reduce cravings and prevent withdrawal.

A medication used to treat opioid dependence. It is a partial opioid agonist, meaning it has some of the effects of opioids but without the same high potential for abuse.

A medical approach to treat substance use disorders (SUDs) by using medications to manage symptoms, cravings, and prevent relapse.

When a patient's medical condition or pregnancy status makes medication use unsafe.

Phases of substance use that can benefit from pharmacotherapy include intoxication/overdose, withdrawal/detoxification, abstinence initiation/use reduction, relapse prevention, and sequelae (such as psychosis or agitation).

Pharmacotherapy strategies include using agonist medications (replacements), antagonist medications (blockers), aversive medications (negative reinforcement), and addressing underlying disorders like depression.

Medications are available to treat opioid, alcohol, benzodiazepine, and nicotine dependence; but not currently available for cocaine, methamphetamine, hallucinogens, cannabis, solvents, or inhalants.

A medication that blocks the metabolism of alcohol, leading to an accumulation of acetaldehyde in the bloodstream. This results in unpleasant side effects like flushing, nausea, and rapid heartbeat, discouraging alcohol consumption.

Disulfiram can cause a toxic reaction when combined with alcohol. This reaction involves flushing, weakness, nausea, tachycardia, and hypotension. Supportive care, like fluids and oxygen, is the primary treatment.

Naltrexone is an effective treatment for alcohol dependence. It has been shown to reduce relapse to heavy drinking, decrease the likelihood of returning to any drinking, and prolong the time to the first drink. It is also effective at reducing cravings for alcohol and is considered superior to acamprosate in reducing relapse and cravings.

A medication that is similar in structure to naloxone (Narcan) and effectively blocks the binding of opioids to the mu-opioid receptor in the brain. This is thought to contribute to its reduction in relapse and cravings for alcohol because endogenous opioids are involved in the reinforcing effects of alcohol.

A type of therapy for opioid dependence that involves administering methadone to block withdrawal symptoms and cravings. Methadone is a long-acting mu opioid agonist, meaning it binds to the same receptors as opioid drugs. The goal is to stabilize the individual's lifestyle and health.

The use of methadone to treat opioid dependence is a widely accepted and effective treatment modality. Methadone is a long-acting opioid agonist that helps reduce cravings, block withdrawal symptoms, and decrease illicit opioid use. The length of time the medicine is effective ranges from 24 to 36 hours.

The dose of methadone prescribed for opioid dependence treatment is a crucial aspect. Different doses have varying impacts on withdrawal symptoms and illicit opioid use. Lower doses might block withdrawal but may not fully address cravings. Higher doses tend to be more effective in both reducing withdrawal and craving.

Methadone interacts with various medications. Some drugs decrease methadone concentrations, requiring dose adjustment or alternative treatment. Others increase methadone concentrations, potentially leading to adverse effects such as cognitive impairment, respiratory depression, or heart rhythm problems. Therefore, careful monitoring and appropriate measures are crucial for safe and effective treatment.

Methadone therapy offers numerous benefits for individuals with opioid dependence. These benefits include improvements in lifestyle, health, nutritional status, criminal behavior, employment, and reduced risk of injecting drug use. The overall aim is to help individuals regain stability and improve their overall well-being.