Drug addiction refers to a dependence on a medication or illegal substance. Addicted people are unable to control the usage of drugs and continue using the substance despite the obvious harms associated with their behavior. Normally, drug addiction causes an intense craving for the substance making it hard for addicted people quit such behaviors. Drug addiction causes long-term consequences such physical and mental health, strained relationships, law and employments problems (Ries, Miller & Fiellin, 2009) . The affected persons are encouraged to inform their doctors, support groups, friends and families in order to overcome their addiction and stay safe. Some of the commonly abused drugs include; heroin, cocaine, bhang and alcohol. The treatment option for drug addiction within medical establishments depends on various factors such the type of the drug and how its affects the user. Treatment in many medical establishments combines psychotherapy services, inpatient and outpatient programs, self-help groups and sponsors (Ries, Miller & Fiellin, 2009). The treatment options aim at reducing dependency and restore normal lives of addicts. Specifically, heroin addiction is caused by both social and psychological factors. For instance, unpleasant feelings, stress and pressure can contribute to heroin addiction. According to National Institute of Drug Abuse (2004), factors such as cultural beliefs, drug availability and lack of education deficit can also contribute to heroin addiction. In the current world, heroin addiction is treated using various drugs namely; methadone, clonidine, buprenorphine and naltrexone. This paper explores the heroin treatment methods, problems faced, the most effective method and the way to improve the successful rate of rehabilitation.
Heroin addiction can be treated by combining both the pharmacological and behavioral methods. The two procedures helps in restoring the brain normalcy resulting to reduction in criminal behaviors, increased employment rates and low spread of HIV and other diseases. When people addicted to heroin usage first quit, withdrawal symptoms such as vomiting, pain, diarrhea and nausea becomes common (Fernandez & Libby, 2013). Medication helps during the detoxification phase easing the craving and other related symptoms. This often prompts an addict to relapse. Medication targets the opioids receptors just like heroin, but they are safer and have a low likelihood of causing addiction. The mechanism of heroin pharmacological treatment can grouped into various categories namely; agonists, (which activate opioid receptors), antagonists, which blocks the receptor and partial agonists, which also activate opioid receptors but produce a smaller response (National Institute of Drug Abuse, 2004).
Methadone is an opioid agonist characterized by a slow acting action (Dean, Bilsky & Negus, 2009). Methadone is administered orally in order to reach their brain in a slow manner, reducing the “high” associated with other drug administration routes. This reduces withdrawal symptoms. Methadone has been used in treating heroin addiction since 1960 and still remains an excellent option especially to those addicts who do not responds well to other medications. Methadone is one of the most affordable drugs used in the treatment of opioid addiction (Wormer & Davis, 2012). It is vital to note the methadone is effective when carried out in special institutional and hospitals compared to clinics. Some patients are unable to travel to such clinic while other fear stigmatization. Cochrane reviews. The drug is only available through legalized outpatient programs which allow daily prescription to patients. Additionally, coupling methadone treatment with encouragement measures such as job skills, recreation, friendship and family lifestyles can lead to more positive results. Those patients under the methadone regime get scared of reducing their levels on fear of losing the stability effect of the drug (Marlatt & Donovan, 2007). Patients taking methadone can continue with normal life activities. Methadone has also been found to have no serious medical interaction with other regimes. This implies that patients with conditions such as cancer, diabetes, HIV/AIDS and pneumonia among other can continue with their routine medications while also using methadone treatment. However, coordination of methadone with other drugs is essential. For instance, rifampin for tuberculosis and Dilantin used for epilepsy have been found to increase the body’s metabolism of methadone and thus the need raise the dosage. Methadone medications reduce the needle sharing and promiscuous behavior that can lead to HIV transmission and other diseases. This is because patients can be dosed once on a daily basis. The drug is also highly regulated (Wormer & Davis, 2012)
According to and Davis (2012), methadone causes symptoms such as fever, weight loss, diarrhea, vomiting and lacrimation among other withdrawal symptoms during the induction phase. Additionally, it is vital to titrate the initial dosage carefully since too rapid titration often produces adverse effects. In the past, respiratory depression, systemic hypotension, cardiac arrests and deaths have occurred owing to prescription of methadone. However, various studies have indicated that the majority of heroin addicts under methadone regimes successfully complete their treatment. However, this should be followed by intervention measures (Bernstein et al., 2005).
Naltrexone is another option used in treating heroin addiction. Naltrexone is an opioid antagonist, which blocks the receptor hence interfering with the rewarding effects of opioids. Researchers argue that the drug is neither sedative nor addictive hence reducing physical dependence of heroin. However, many patients find it hard in complying the treatment hence the reducing the effectiveness of the medication (Fernandez & Libby, 2013). This has forced the FDA to approve Vivitrol®, a long-acting formulation of naltrexone administered once in a month. The most common adverse effects arising from naltrexone are non-specific gastrointestinal complications such as abdominal cramping and diarrhea. FDA has also confirmed that naltrexone cause liver damage hence the need to check patients liver before prescription. Various studies have confirmed the toxicity nature of naltrexone to liver. Other studies have revealed that methadone is superior to buprenorphine (Hser et al., 2014). This indicates that the success rate is more compared to methadone on long term basis. Naltrexone treatment should be used in conjunction with counseling, family support and psychotherapy services. Researchers also argue that naltrexone activates receptors and this effect might continue even after stopping the drug usage. Additionally, increased sensitivity of receptors during medication put patients at the risk of opioid overdose. As a result, naltrexone therapy should be monitored and patient given support measures by medical practitioners. It is also vital for patient to avoid the usage of opioids during naltrexone medication. This is because can override the blockade with high dose subjecting patients to respiratory suppression and death. Other symptom of adverse effect of naltrexone includes; unusual tiredness, muscle pain, headache and trouble in sleeping (National Institute of Drug Abuse, 2004).
Buprenorphine (Subutex®) is another treatment option used in heroin treatment. Buprenorphine is partial opioid agonist capable of reducing carving without producing dangerous effects of other opioids. Evidently, Suboxone® is a formulation of buprenorphine taken sublingually or orally and is used in reducing chances of getting high by injecting the medication. The FDA approved its usage in 2002 making the drug the first medication eligible for physician prescription through Drug Addiction Treatment Act. The approval reduces the need to visit specialized clinic hence increasing access to treatment to those addicts in the dire need of the drug. It is believed that buprenorphine has a success rate of 73% to those patients who complete their treatment (Ziaaddini, Nasirian & Nakhaee, 2010). The FDA has also approved two other generics forms of Suboxone making the treatment option more affordable. Administration of Buprenorphine is manifested with adverse effects such as constipation, dizziness and headache. Patients should inform their doctors’ immediately they realize such symptom in order to address them in time. Measures such as eating diet rich in fiber, exercising and drinking plenty of water should be employed to address constipation. Researchers have also found allergic reaction owing to usage of Buprenorphine (Comer, Sullivan & Walker, 2005). Patients should notify their doctors the moment they realize the presence of rashes or hives in their bodies. Additionally, few patients have reported liver problems from the medication of buprenorphine. Those patients with liver problems should notify their doctors before the commencement of medication. Bunornorphine should be contraindicated to patient with skull injury since it increases pressure in the skull worsening the condition (Fernandez & Libby, 2013).
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- Patrick Kimuyu (Author), 2016, Treating drug addiction. Ways to improve the successful rate of rehabilitation, Munich, GRIN Verlag, https://www.grin.com/document/381346