Unit 6 Discussion – Treatment of Addiction

This article covers Unit 6 Discussion – Treatment of Addiction.

Instructions

Discussion Prompt

1. Naltrexone is often used in psychiatric mental health care for many reasons related to addiction and/or impulse control. It is also occasionally used to help patients with self-harm behaviors or weight loss. Considering the mechanism of action of naltrexone, how does it aid in addiction treatment?
2. Compare and contrast methadone and buprenorphine for substance abuse treatment. For this discussion, addiction use (what substances) includes the mechanism of action, contraindications, and the pros or cons of each option.

Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer-reviewed journal evidence to support the student’s position.

Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.

Please review the rubric to ensure that your response meets the criteria.

Solution

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.

This discussion has demonstrated that while Naltrexone, methadone, or buprenorphine do not cure addiction the way an antibiotic would to bacterial disease, prescribing them as part of the patient’s comprehensive treatment increases a remission from the addiction problem that can be sustained.

References

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.

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