Summary: <p>Medication assisted therapy is becoming a very hotly debated topic. Some of these medications block cravings or the “high,” while others address the underlying mood and mental health issues that may be maintaining the addiction. In this episode we will examine the potential benefits and drawbacks of these medications.</p> <p> </p> <h3>Show Notes</h3> <p>Medication Assisted Therapy Alcohol and Opiates<br> Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC, NCC<br> Executive Director, AllCEUs<br> Objectives<br> Review some myths about Medication Assisted Treatment<br> Identify medications used to treat opiate dependence<br> Identify medications used to treat alcohol dependence<br> Discuss the mechanisms of action<br> Evaluate pros and cons of each<br> Myths<br> Medications are a crutch<br> We do what is more rewarding than the alternative<br> Medications can make sobriety “feel better” by addressing underlying neurochemical imbalances<br> Medications can remove the rewards from use by<br> Making it unpleasant (Antabuse)<br> Removing the “high” (Buprenorphine, Naltrexone)<br> Both (Suboxone)<br> Remember recovery is more than just NOT using.<br> Medications can help ease the transition until the brain has rebalanced and the new lifestyle is in full swing<br> Myths<br> Using medication goes against 12-Step Philosophy<br> Alcoholics Anonymous does not encourage AA participants to not use prescribed medications or to discontinue taking prescribed medications<br> The Big Book states, “God has abundantly supplied this world with fine doctors, psychologists, and practitioners of various kinds. Do not hesitate to take your health problems to such person …Try to remember that though God has wrought miracles among us, we should never belittle a good doctor or psychiatrist. Their services are often indispensable in treating a newcomer and in following his case afterward.”</p> <p>Pros<br> Medications Can…<br> Increase energy and motivation (dopamine and norepinephrine) while the person’s brain and body are recovering<br> Remove some of the reinforcing effects of the drugs<br> Prevent relapse by making relapse very unpleasant<br> Reduce the intensity of co-occurring disorders<br> Reduce conflict/improve social support<br> Reduce absenteeism from work<br> Cons of Medication<br> Physicians who are educated about addiction treatment and endorse a biopsychosocial model of treatment are difficult to find<br> Medications can give a false sense of security<br> Medications may provide false hope<br> Medications have side effects<br> There is a stigma associated with the use of medications<br> Costs money</p> <p>Opiate Dependence<br> Neurotransmitters<br> Mainly dopamine<br> Patients report feeling<br> Less pain<br> Less anxiety<br> Medications for opiate dependence<br> Buprenorphine<br> Methadone<br> Naltrexone<br> Naloxone (for opioid overdose)<br> Buprenorphine & Naloxone (Suboxone)</p> <p>Buprenorphine<br> Is as partial opioid agonist (ceiling effect)<br> Reduces the symptoms of withdrawal from misused opiates<br> Can be abused<br> Methadone<br> Full Mu opiate agonist (suppresses cravings)<br> Lessens the painful symptoms of opiate withdrawal and blocks the euphoric effects of opiate drugs<br> Considered relatively safe during pregnancy and breastfeeding<br> Opiate w/d during pregnancy can trigger contractions and miscarriage</p> <p>SAMHSA TIP 43 MAT for Opioid Addiction<br> Naltrexone<br> Decreases the pleasurable effects of alcohol or opiates by blocking opiate receptors<br> Alcohol abstinence is not required, but opiate abstinence is<br> Naltrexone will cause opiate withdrawal in dependent users<br> Third-Party Payer Acceptance:<br> Oral is covered by most major insurance carriers, Medicare, Medicaid, and the VA<br> Vivitrol is not covered in many cases</p> <p>Naloxone<br> Blocks opioid receptors<br></p>
