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Medications Used in the Detoxification Process

Persistent withdrawal symptoms are a major cause of relapse. Certain medications can help to reduce the severity of withdrawal symptoms and increase the odds of a successful recovery.

Medications that are FDA approved for the treatment of acute withdrawal symptoms include:

  • For alcohol – benzodiazepines or barbiturates
  • For opiates – methadone, buprenorphine (Suboxone/Subutex), clonidine, naltrexone

There are no FDA approved medications for the treatment of cocaine, methamphetamine or marijuana withdrawal symptoms. 1

Methadone or Suboxone

Both methadone and Suboxone are opiate medications that can be used as detoxification or addiction treatment medications.

These medications are used in one of 2 ways:

  1. Very briefly, as medications to help reduce the severity of withdrawal symptoms during a medical detox
  2. Over a longer period of time in a maintenance program of addiction treatment

Both methadone and Suboxone stimulate the opiate receptors in the brain and both can keep an opiate dependent person from feeling drug cravings or feelings of withdrawal – and at appropriate doses, neither medication produces any significant intoxication.

When methadone or Suboxone are used for maintenance treatment, drug withdrawal symptoms are delayed, sometimes indefinitely. People on maintenance treatment are clearheaded and sober and able to live and work without needing to get high. Maintenance treatment helps a person retake stability and health.

Eventually, most people decide to stop their maintenance treatment. To stop treatment, methadone or Suboxone doses are gradually reduced to minimize the eventual withdrawal symptoms, but at a certain dose, users must “jump off” and will still experience withdrawal symptoms.

  • Methadone withdrawal symptoms are more severe and longer lasting than Suboxone’s withdrawal symptoms

Some people choose to stay on methadone or Suboxone indefinitely. These people have the lowest rates of relapse.

Neonatal Abstinence Syndrome (NAS)

Pregnant women who continue to abuse certain drugs can give birth to drug or alcohol addicted infants and these infants are at risk of NAS. Substances taken by pregnant women that can lead to NAS include:

  • Opiates
  • Alcohol
  • Benzodiazepines
  • Cocaine
  • And others

NAS is a period of withdrawal symptoms endured by infants born to drug or alcohol addicted mothers, shortly after birth. The symptoms of NAS will depend on what drug the mother took, and how often/heavily she used it, amongst other factors.

Some possible symptoms of NAS can include:

  • Fever
  • Inconsolable crying
  • Dehydration, diarrhea and vomiting
  • Tremors
  • Problems gaining weight
  • Poor breast feeding ability
  • Irritability
  • Seizures
  • Sweating
  • Others

Babies going through NAS may need medication (like benzodiazepines or methadone) to reduce the severity of symptoms. Babies may also need help with feeding, to ensure adequate weight gain and may need IV fluids, in the case of severe dehydration.2

References

  1. The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition, published 2008, Table 38-6.
  2. National Institute of Health

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