Which Addiction Medications are Used in Rehab?

Photo of Dr. Susanne Reed Dr. Susanne Reed Info icon
Calendar icon Last Updated: 01/20/2022

Reading Time: 7 minutes

More than 20 million people in the U.S. over age 12 struggle with an addiction to alcohol, opioids, cocaine, or other substances. Of that number, 1.6 million have an opioid use disorder, and nearly 15 million have alcohol use disorder.1 Fortunately, rehab programs can help people obtain and maintain sobriety. And many rehabs utilize addiction treatment medications to aid in the recovery process. The Food and Drug Administration (FDA) approves addiction medication used in treatment, and currently, there are several FDA-approved medications for the treatment of opioid addiction and alcohol addiction. Medication for addiction is combined with behavioral therapies to provide a comprehensive treatment plan.2

Opioid Addiction Treatment Medications

Opioids are natural and synthetic drugs derived from the poppy plant. Heroin, morphine, fentanyl, hydrocodone, and oxycodone are the most misused opioids today. Those with an opioid addiction engage in compulsive opioid misuse despite consequences in their lives.3

When attending rehab for opioid use disorder, the treatment team may prescribe an opioid addiction treatment medication to reduce cravings and prevent the risk of relapse. However, medication for drug addiction alone is not typically sufficient for sustained recovery. Instead, medication must be combined with therapy and counseling so that you can address the underlying issues motivating your opioid misuse and learn helpful coping skills and strategies.

Several types of addiction medication are used to assist with opioid treatment, in something called medication-assisted treatment (MAT).

Methadone

Methadone, a long-acting synthetic opioid, is a commonly used medication for opioid addiction. It decreases opioid withdrawal symptoms and cravings and blocks the effects of other opioids, like heroin.4

Because it is a long-acting opioid, a person doesn’t feel the euphoria or sudden rush of relaxation that they might feel when misusing opioids. Methadone can only be administered at a SAMSHA-certified facility and under the supervision of a physician.4

Buprenorphine

Buprenorphine is a synthetic partial opioid agonist medication for addiction deemed safe enough to prescribe in a doctor’s office, filled at a pharmacy, and taken home by the person with an opioid use disorder. Like methadone, it reduces craving and opioid withdrawal symptoms. It is also less likely to be misused than methadone and has a lower risk of overdose due to its ceiling effect—this means that its opioid effects level off at moderate doses, so if someone tries to take a large amount to get high, they won’t experience intense euphoria.5

Suboxone

Suboxone is a combination addiction medication comprised of buprenorphine and naloxone, an opioid antagonist. The addition of naloxone to buprenorphine deters misuse even further, because if someone tries to inject Suboxone they will go into immediate opioid withdrawal.6

Suboxone is proving to be just as effective as methadone and can offer more than buprenorphine alone. Suboxone may be a better choice for those who cannot visit a methadone clinic each day and are at risk of misusing methadone or buprenorphine alone.6

Naltrexone

Naltrexone is an addiction medication injected once a month by a SAMSHA-certified physician. While it can also be taken daily in pill form, the injection can increase treatment compliance. Because naltrexone is an opioid antagonist, it blocks any euphoria or sedation. This means anyone who uses opioids while on naltrexone will not feel the opioid effects.7

Potential for Misuse and Dependence

Since methadone, buprenorphine, and the buprenorphine/naloxone are opioids, they can lead to dependence, even if you take your addiction medication exactly as prescribed. This is a normal physiological adaptation and doesn’t mean you are addicted to your medication. It simply means your brain and body have adjusted to the presence of the drug, and if you want to quit taking it, your provider will create a tapering schedule to prevent withdrawal symptoms.

However, these medications also have a potential for misuse. Misusing methadone or buprenorphine involves taking your medication in a way other than prescribed. Examples include:

  • Taking higher or more frequent doses than prescribed
  • Taking someone else’s addiction medication
  • Injecting your medication
  • Snorting your medication
  • Mixing your medication with other substances, such as alcohol or illicit drugs

Misusing these substances increases your risk of developing a dependence or opioid addiction. If you are struggling with medication misuse, you may need a higher level of care, such as an inpatient treatment program. Call our 24/7 helpline at 800-926-9037 (Info iconWho Answers?) to find an inpatient program that’s right for you.

Alcohol Addiction Treatment Medications

Alcohol use disorder is the most common addiction in the U.S.1 Unlike illicit drugs, alcohol is easily accessible almost everywhere and it is prevalent in advertising, TV, movies, music, and other media.

Three types of medication for addiction have FDA approval that, when combined with behavioral therapies, can help you quit drinking.

Naltrexone

Naltrexone is an addiction medication available as a once-a-day pill or as an extended-release injection. It blocks the receptors in the brain that are activated when you misuse alcohol, preventing you from feeling the rewarding effects like euphoria or relaxation. Research shows the injection to be much more effective because some intentionally skip doses of the oral tablet so they can feel the effects of alcohol.10

Disulfiram

Disulfiram comes in pill form and requires daily dosing. If you choose to drink while taking disulfiram, you will have an unpleasant reaction. Specifically, you will experience flushing, dizziness, nausea, vomiting, and more. Having the pill dispensed each day by a friend or family member is more effective for compliance than allowing you to self-administer the addiction medication. If a person is not highly motivated for sobriety, this medication for addiction may not be as effective.10

Acamprosate

Acamprosate works by reducing protracted withdrawal symptoms that may trigger a relapse. It regulates mood and improves sleep, which are protective factors against misusing alcohol. Over time, acamprosate restores the damage to your brain caused by alcohol misuse.10

How Effective are Addiction Treatment Medications?

Medication for addiction is both effective and safe when taken exactly as directed, and it is more effective when combined with evidence-based therapies and counseling approaches.

Methadone is the addiction medication with the longest history of success. It has technically been in use since the 1940s. Studies show methadone enhances outcomes, primarily with support through groups and peer activities. Studies also show participants have fewer opioid-positive drug tests, are over four times more likely to remain in treatment, and experience reduced crime and spread of diseases.12

As for naltrexone, it has promising results as well. Compared to a placebo group, 90% of those taking naltrexone for opioid use disorder achieve abstinence, compared to 35% of those in the placebo group.12

Through 24 trials, acamprosate proves to be an effective tool for supplementing psychosocial therapies. Compared to a placebo, acamprosate reduces the risk of relapse by 86% after detox. When compared to naltrexone, acamprosate use leads to more extended periods of abstinence, but naltrexone is better in reducing heavy drinking and cravings.13

Disulfiram, especially when combined with 12-step facilitation groups, shows it can help reduce the number of days you spend misusing alcohol and cocaine. Separately, though, neither treatment shows significant results.15

More than 500 people participated in a study analyzing long-acting buprenorphine medication for drug addiction over twelve months. There were 425 who made it to the 12-month follow-up. Out of those, 51% reported they were still abstinent. Also, those taking buprenorphine have fewer withdrawal symptoms, minimal depression, higher employment rates, and improved overall quality of life.16

Find a Rehab That Offers Medication-Assisted Treatment

With so much research supporting the use of addiction medication and behavioral therapies, many treatment facilities are adopting these practices to provide you with comprehensive and integrated care.

When looking for a rehab that provides addiction medication assistance, inquire about their certifications for approval. They should have either a SAMSHA certification, opioid treatment program certification, or certified practitioners. Also, choose a facility that integrates counseling sessions and recovery activities into your treatment plan.

You can call our helpline to find a treatment facility in your area. We are here to help at 800-926-9037 (Info iconWho Answers?) .

Resources

  1. The National Center for Drug Abuse Statistics. (2022). Drug Abuse Statistics.
  2. National Academies Press. (2017). Trends in Opioid Use, Harms, and Treatment. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division. Board on Health Sciences Policy. Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse. Phillips JK, Ford MA, Bonnie RJ, editors. Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use. Washington (D.C.).
  3. Dydyk AM, Jain NK, Gupta M. (2021). Opioid Use Disorder. StatPearls [Internet]. Treasure Island (F.L.): StatPearls Publishing.
  4. Substance Abuse and Mental Health Services Administration. (2021). Methadone.
  5. Substance Abuse and Mental Health Services Administration. (2021). Buprenorphine.
  6. Chen, K. Y., Chen, L., & Mao, J. (2014). Buprenorphine-Naloxone Therapy in Pain Management. Anesthesiology,120(5), 1262-1274.
  7. Substance Abuse and Mental Health Services Administration. (2021). Naltrexone.
  8. National Institute on Drug Abuse. (2021). Prescription Opioids Drug Facts.
  9. National Institute on Alcohol Abuse and Alcoholism. (2021). Understanding Alcohol Use Disorder.
  10. U.S. Department of Health and Human Services. (2016). Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health.
  11. National Institute on Drug Abuse. (2018). Methadone and Buprenorphine Reduce Risk of Death After Opioid Overdose.
  12. National Institute of Drug Abuse. (2021). How Effective Are Medications To Treat Opioid Use Disorder?
  13. Yahn, S. L., Watterson, L. R., & Olive, M. F. (2013). Safety and Efficacy of Acamprosate for the Treatment of Alcohol Dependence. Substance Abuse: Research and Treatment, 6, 1-12.
  14. Rzasa Lynn, R., & Galinkin, J. L. (2018). Naloxone Dosage for Opioid Reversal: Current Evidence and Clinical Implications. Therapeutic Advances in Drug Safety, 9(1), 63-88.
  15. Carroll, K. M., Nich, C., Shi, J. M., Eagan, D., & Ball, S. A. (2012). Efficacy of disulfiram and Twelve-Step Facilitation in Cocaine-Dependent Individuals Maintained on Methadone: a Randomized Placebo-Controlled Trial.Drug and Alcohol Dependence, 126(1-2), 224-231.
  16. Ling, W., Nadipelli, V. R., Aldridge, A. P., Ronquest, N. A., Solem, C. T., Chilcoat, H., Albright, V., Johnson, C., Learned, S. M., Mehra, V., & Heidbreder, C. (2020). Recovery From Opioid Use Disorder (OUD) After Monthly Long-acting Buprenorphine Treatment: 12-Month Longitudinal Outcomes From RECOVER, an Observational Study. Journal of Addiction Medicine, 14(5), e233-e240.
  17. Substance Abuse and Mental Health Services Administration. (2022). Medication-Assisted Treatment.
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