What Is Medication Management?
A medication management program is a process that oversees and manages the medications prescribed to individuals, making sure these medications are being used properly. Medication management therapy works to make sure individuals are benefiting from the medications they use as they work to overcome substance use disorders.
According to the American Society of Addiction Medicine (ASAM), medication management may improve treatment outcomes, especially long-term treatment outcomes. It’s most effective when used in a comprehensive treatment plan that includes therapies, counseling, and ongoing support.
Why Consider a Medication Management Program?
Medication management is a form of therapy that’s usually combined with AA attendance and some form of outpatient therapy or counseling. The medication may be prescribed for long-term or short-term use. Long-term use in people recovering from opioid addiction can reduce the risk of relapse.
Short-term medications are typically used to safely detox you from alcohol, benzodiazepines, and other drugs that can produce deadly withdrawal symptoms.
Many people with substance use disorder have concurrent mental health issues. These issues can make addictions worse. Meanwhile, addictions can make mental health issues worse. It’s a negative feedback loop. These conditions must be treated separately and concurrently with different medications.
You might also benefit from medication management if you experience chronic, severe, and untreated physical pain that you presently treat with illicit opioid drugs. This mainly applies to people with an addiction.
The Physiology of Addiction
Over time, opioid dependence can change the structure and chemistry of the brain. Neurotransmitters like endorphins and dopamine which are activated by opioid drugs may no longer be naturally available in the body.
The body’s production of these feel-good neurotransmitters can shut down altogether. When a person ends substance abuse, their endorphin system may not be able to supply them with the chemicals they need. This is called endorphin deficiency. Besides being a side effect of opioid dependency, it can also be caused by a genetic irregularity.
Endorphins regulate mood and pain in the body. When a person has an ample supply, they can experience contentment, joy, and a general sense of well-being. Endorphin insufficiency can cause depression, chronic unexplained pain, and low pain tolerance.
People in recovery with endorphin insufficiency are frequently misdiagnosed as having depression. They appear to experience low-grade withdrawal symptoms that never go away. Individuals may need medication management simply to feel normal and regulated.
How Does Medication Management Work?
An addiction professional will perform an in-depth assessment including physical and mental health histories and an analysis of your substance misuse patterns. A medication management program may be appropriate under certain conditions.
Your doctor may prescribe a predetermined daily dose of oral opioid medication. The dose is the amount of the drug you need to maintain a functional and comfortable level of awareness. An example of this is a methadone maintenance program where you visit a clinic every day to get a dose that lasts 24 hours.
According to the National Institute on Drug Abuse, 40% to 60% of recovering individuals experience relapses. Medication management can help people stay on track, which can significantly reduce the likelihood of relapse.
Medication Management and Opioid Addiction
Drugs Used to Treat Opioid Addiction
The FDA has approved three primary medications to treat opioid dependence: methadone, buprenorphine, and naltrexone. Their use is governed by and articulated according to federal guidance reported by SAMHSA.
METHADONE
This long-acting opioid is used for chronic pain management and to reduce intense withdrawal symptoms during detox. The amount dispensed can be gradually tapered off as the detoxification process continues.
Once the client is stable, they may receive a maintenance dose daily via a safe and professional clinic. It is important to have the supervision of a medical professional to avoid issues related to methadone use and abuse. A medical professional will assess whether the benefits of methadone outweigh the risks for each individual patient.
BUPRENORPHINE
Unlike methadone, which is approved for chronic pain management as well as opioid addiction, buprenorphine is only approved for the treatment of addiction. Methadone activates all of the brain’s opioid receptors. Buprenorphine, on the other hand, partially activates the opioid receptors. Therefore, it may come with less risk of addiction than methadone.
Buprenorphine is thought to reduce withdrawal symptoms and cravings without producing the high you’d expect with morphine. Additionally, once you ingest a certain amount, the drug stops having an effect. That greatly reduces the likelihood of taking more than the prescribed amount.
This medication can be dispensed in a tablet or through a sublingual film or patch. A doctor will determine the proper dosage. Buprenorphine is initially dispensed daily at a treatment facility. However, after medications have been stabilized, individuals might also receive a prescription for buprenorphine that they can take at home.
Naloxone can be given in combination with buprenorphine. The naloxone has no effect unless the buprenorphine is ground up and taken intravenously. If that happens, the naloxone kicks in, blocks the desired effects, and brings on withdrawal symptoms. Naloxone is also used to block the effects of opioid overdose.
NALTREXONE
Whereas naloxone is used as an antidote to opioid overdose, naltrexone is used to help recovering opioid addicts stay clean. This medication is dispensed by injection every month. It prevents opioid receptors from receiving drugs. If a person uses an illicit opioid drug, they won’t experience any of the desired effects.
Medication Management for Alcohol Addiction
Medication can also help to treat alcohol dependence. These drugs are formulated to create unpleasant effects if a person drinks alcohol.
Disulfiram
Disulfiram (brand name Antabuse) discourages drinking by producing disagreeable symptoms upon alcohol consumption. The symptoms range from severe nausea and headache to vertigo. Antabuse is dispensed in tablets that are taken daily. Dosing should begin at least 12 hours after the last drink and after detox is complete.
Acamprosate
Regardless of its effectiveness in helping to stop alcohol ingestion, disulfiram does nothing in and of itself to help with mood. A new abstinence medication called acamprosate may reduce cravings and thereby help to prevent relapse. The medication is taken in tablet form three times daily after one week of abstinence or detox. Since acamprosate does not relieve alcohol withdrawal symptoms, individuals should not use it during detox.
Naltrexone for Alcohol Dependence
As with opioid dependence, naltrexone can help to treat alcohol dependence. It prevents people from feeling the pleasant effects of alcohol. In doing so, this medication helps to prevent relapse.
Benefits of Medication Management Treatment
Medication management works to improve the quality of life for those who sincerely want recovery but find the ongoing cravings and withdrawal symptoms unmanageable. The underlying reasons for this should be addressed in therapy, and any mental health issues should be treated concurrently. For many recovering individuals, medication management is the key to staying free from addiction.
The objective is to maintain the patient on the lowest possible medication dose that achieves the desired effect. After this baseline is established, patients can explore with their doctors reducing dosages or tapering off the medication altogether.
If you suffer from mental health issues, medications like antidepressants can be added to the mix to treat drug, alcohol, and mental health issues concurrently.
Outpatient Medication Management Treatment in Austin, Texas
Our medication management program offers outpatient treatment that will require you to check in regularly for a sobriety evaluation and to monitor medication dosages. Counseling and behavioral therapies are usually part of the treatment process.
Addiction doesn’t have to be a part of your present or your future. It can simply be a component of your past. You can begin the journey to end substance dependence in your life today! Call our BRC Recovery team now to learn more about our medication management services. We look forward to walking with you as you move forward in your recovery.
REFERENCES:
- https://www.fda.gov/drugs/information-drug-class/information-about-medication-assisted-treatment-mat
- https://www.samhsa.gov/homelessness-programs-resources/hpr-resources/mat-can-improve-health-outcomes
- https://pubmed.ncbi.nlm.nih.gov/9672434/
- https://www.drugabuse.gov/publications/research-reports/medications-to-treat-opioid-addiction/how-do-medications-to-treat-opioid-addiction-work
- https://www.drugabuse.gov/publications/research-reports/medications-to-treat-opioid-addiction/how-do-medications-to-treat-opioid-addiction-work
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4527156/