Substance use disorder (drug or alcohol addiction) is a chronic, relapsing disease that significantly impacts a person’s physical and mental health. If substance use is out of control, it is important to get help as soon as possible. Treatment at a professional drug rehabilitation facility can increase the chances of achieving long-term sobriety and recovery from addiction.

During the initial stages of addiction treatment, the body gets rid of the substances that were being abused. This is the detoxification period and it can last anywhere from several days to several weeks. During detox, recovering addicts can experience a range of uncomfortable withdrawal symptoms such as anxiety, depression, sweating, muscle aches, nausea, seizures, and hallucinations.

One of the key reasons people have relapses in drug and alcohol abuse is the inability to cope with withdrawal symptoms. Doctors use several medications to make it easier for recovering addicts to stay sober. Some medications used during addiction treatment mimic the effects of addictive drugs and help to relieve withdrawal symptoms. Other medications reduce symptoms like anxiety, depression, sweating, or muscle aches. Yet others decrease drug cravings or block the pleasurable effects of a drug and subdue the urge to use it.

Medications for Substance Abuse Withdrawal

Some of the medications used during substance abuse withdrawal and addiction treatment are described below.

Benzodiazepines may be prescribed to manage symptoms of anxiety and depression during withdrawal from drugs like heroin and cocaine as well as alcohol. These medications must be used with caution because they are addictive.

Antidepressants like Prozac and Zoloft are used during substance withdrawal to relieve symptoms of anxiety and depression.

Clonidine is prescribed to people recovering from alcohol or opiate drug abuse to reduce symptoms such as sweating, cramps, anxiety, tremors, and seizures.

Acamprosate (Campral) reduces cravings in recovering alcoholics and helps to maintain abstinence.

Disulfiram (Antabuse) is used during alcohol addiction treatment. This medication causes unpleasant effects like nausea and vomiting if the person drinks while on the medication. The thought of feeling sick helps prevent the person from drinking.

Naltrexone (Vivitrol) blocks the pleasurable effects of alcohol and opiate drugs (prescription painkillers and heroin) in the brain, reducing the urge to use these substances.

Naloxone (Narcan, Evzio) reverses the effects of opioid drugs by binding to opioid receptors in the brain. It is available as an auto-injector for emergency use during a known or suspected opioid overdose.

Methadone (Dolophine, Methadose) is an opiate medication that is used to treat moderate to severe opiate addiction. It binds to the same receptors in the brain as heroin and prescription painkillers but does not cause the person to get high. It is used to suppress withdrawal symptoms and cravings in recovering opiate addicts. Methadone is prescribed through specialized methadone clinics that dispense the drug daily. This is necessary because methadone itself is an opiate with a risk of dependence.

Buprenorphine (Suboxone) works in the same way as methadone. However, it has a lower potential for addiction and is, therefore, less regulated.

Combination buprenorphine and naloxone is a prescription medication that comes in the form of a sublingual tablet (Zubsolv) or buccal film (Bunavail). It is used to treat addiction to opioid drugs. It reduces withdrawal symptoms and opioid cravings.

Lofexidine (Lucemyra) is an FDA-approved prescription medicine that is used to manage the symptoms of opioid withdrawal.

Over-the-Counter Medications for Substance Withdrawal

The medications used for substance abuse withdrawal are prescription medications and should be used under the supervision of healthcare providers. Withdrawal from drugs and alcohol can be unpleasant and uncomfortable. There can be serious signs and symptoms during detoxification, some of which may be life-threatening. Therefore, it is not recommended to attempt substance withdrawal at home without medical supervision. However, some over-the-counter supplements may help while undergoing withdrawal, such as vitamins, minerals, kudzu (an ancient Chinese herbal supplement), milk thistle, and L-glutamine. The efficacy and safety of these supplements in decreasing drug and alcohol cravings are unproven.

Common Side Effects of Substance Withdrawal Medications

Benzodiazepines can cause side effects like dizziness, confusion, memory problems, slurred speech, unsteadiness, and muscle weakness.

Common side effects of antidepressants include nausea, indigestion, diarrhea, nervousness, dry mouth, and tremors.

Acamprosate can cause sadness, irritability, loss of appetite, muscle weakness, sleeplessness, tiredness, and trouble concentrating.

Potential side effects of disulfiram include headache, drowsiness, tiredness, metallic taste, skin rash, sore or swollen tongue, and impotence.

Naltrexone can cause headache, dizziness, drowsiness, nausea, vomiting, fatigue, insomnia, and anxiety.

Possible side effects of naloxone include fever, sweating, shivering, body aches, weakness, irritability, restlessness, nausea, and vomiting.

Side effects of methadone include restlessness, anxiety, nervousness, drowsiness, nausea, vomiting, diarrhea, constipation, dry mouth, lack of appetite, and a decrease in sex drive.

Buprenorphine can cause side effects such as headache, drowsiness, low blood pressure, slow breathing, nausea, and vertigo.

Lofexidine can cause side effects like slow heart rate, low blood pressure, dizziness, lightheadedness, and fainting.

Common Questions

What is an opioid antidote?

An opioid overdose can lead to slowing or stopping breathing and may potentially be fatal. Naloxone (Narcan) is a prescription medication that acts as an opioid antidote. It can reverse the effects of prescription opioid painkillers and the illegal opioid drug heroin in case of an overdose. If administered in time, naloxone can help prevent overdose death. It is administered nasally or by injection under the skin or into a muscle. Naloxone restores breathing in 2-8 minutes and is available for emergency use by auto-injector.

Which is better – methadone or buprenorphine?

Both methadone and buprenorphine are opioid agonists that reduce withdrawal symptoms and cravings in recovering opioid addicts. Methadone has a high potential for abuse and is therefore distributed through licensed methadone clinics that patients must travel to daily to receive their medication. Buprenorphine has a lower potential for abuse and is prescribed along with naloxone as a safety precaution (naloxone prevents the body from absorbing buprenorphine if it is injected). Buprenorphine is available from doctors’ offices and patients can use the medication at home. If you are a recovering opioid addict, your doctors can help you decide which is a better option for you.

Can I get a discount on substance withdrawal medications with BuzzRx?

Yes, you can get discounts on some medicines—including substance withdrawal medications—as long as you have a signed prescription from your doctor.

References:

1.    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3767185/

2.    https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112

3.    https://pubmed.ncbi.nlm.nih.gov/9660305/

4.    https://lucemyra.com/

5.    https://www.mayoclinic.org/drugs-supplements/naloxone-nasal-route/side-effects/drg-20165181

6.   https://www.vdh.virginia.gov/epidemiology/naloxone/

7.    https://www.semel.ucla.edu/dual-diagnosis-program/News_and_Resources/FAQ_Substitution_Therapy_CS