This article covers Unit 6 Discussion – Treatment of Addiction.
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Unit 6 Discussion – Treatment of Addiction
The use of illicit heroin is a global problem associated with high criminality rates, overdose, HIV infection, and hepatitis C (Schlag, 2020). One of the most commonly used drugs to treat opioid addiction is Naltrexone hydrochloride (Naltrexone), decreasing the rewarding effects of opioids and the craving for these drugs. Initially synthesized by Endo Laboratories in 1963, the development of Naltrexone- brand name ReVia- targeted to treat opioid addiction with the Food and Drug Administration (FDA) approving if for treatment of heroin, morphine, and oxycodone addiction.
The drug’s mechanism of action is that as a pure and long-lasting antagonist, it competes for opiate receptors. This competition leads to the displacement of the opioid drug from these receptors, thereby reversing the drug’s effect and aiding in addiction treatment (Bisaga et al., 2018). Naltrexone other medications used to treat substance abuse are methadone and buprenorphine.
Both methadone and buprenorphine are similar in that the two are opioids, a synthetic derivate of opiates. Another point of comparison between the opioids is that both methadone and buprenorphine mμ and delta receptor subtypes mediate adenyl cyclase activity and activate inward activation of potassium channels, causing the release of endogenous opioids like endorphins and enkephalins.
Lastly, the two opioids compare in their effectiveness at causing euphoria and analgesia. Despite these points of comparison, differences between the two medications abound in that the MOA of methadone is a full opioid agonist whose half-life is 36-48 hours. Its counterpart acts as a partial opioid agonist with a half-life of 24- 36 hours. Like any other drug, these drugs have contraindications with taking methadone mixture being contraindicated if one is a child, addicted to alcohol, labor, and respiratory diseases like lung disease or asthma attacks. Buprenorphine contraindications include but are not limited to patients with chronic Hepatitis or Hepatitis C, alcohol intoxication, untreated reduced level of the adrenal gland function, and low levels of thyroid hormones.
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There are several benefits and drawbacks to selecting one of these two medications over the other, and only a few can be highlighted. Studies indicate that methadone has advantages in comparatively lower maintenance cost and is also more effective for managing severe dependence. Moran et al. (2018) observe that a significant drawback of methadone is that it causes higher overdose-related fatalities predominantly mediated through respiratory depression. Similarly, buprenorphine offers the patient the benefit of low intrinsic activity at mμ receptors, while it is a potent kappa antagonist. It implies less dysphoria than methadone (Abuse et al., 2016). Buprenorphine’s unique pharmacologic profile means its potency is lower than methadone since it is not a full agonist, causing less euphoria and analgesia.
Abuse, S., US, M. H. S. A., & Office of the Surgeon General (the US. (2016). Health care systems and substance use disorders. In Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health [Internet]. US Department of Health and Human Services.
Bisaga, A., Mannelli, P., Sullivan, M. A., Vosburg, S. K., Compton, P., Woody, G. E., & Kosten, T. R. (2018). Antagonists in the medical management of opioid use disorders: historical and existing treatment strategies. The American journal on addictions, 27(3), 177-187.
Moran, L., Keenan, E., & Elmusharaf, K. (2018). Barriers to progressing through a methadone maintenance treatment program: The clients’ perspectives in the Mid-West of Ireland’s drug and alcohol services. BMC health services research, 18(1), 1-15.
Schlag, A. K. (2020). Percentages of problem drug use and their implications for policymaking: A review of the literature. Drug Science, Policy and Law, 6, 2050324520904540.