Why we use not opioid antagonists to treat addictions to opioids faster?
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Naltrexone, sold under the brand name Revia among others, is a medication primarily used to manage alcohol or opioid use disorder. Naltrexone is an opioid antagonist and works by blocking the effects of opioids, including both opioid drugs as well as opioids naturally produced in the brain
We do. Naltrexone is an opioid antagonist that is used to treat opioid use disorders, as well as other substance use disorders. It is often given as an injection into the muscle which then provides medication over about a month.
The problem is the withdrawal. If a patient is dependent upon opioids, giving naltrexone (or other opioid antagonists) can cause severe withdrawal syndrome. In some cases, acute withdrawal syndrome can require hospitalization and/or admission to the ICU. Opioid withdrawal is no joke.
This is why naltrexone can only be used in certain patients who meet a strict set of requirements.
We do, but it’s going to be very uncomfortable, which makes it less likely that the person will voluntarily do it.
Two large factors in addiction are withdrawals (physical symptoms like headache, nausea, restlessness, muscle aches, etc.) and having the drug be a big part of your life. The former is physical and can be “powered through,” by some people, but the latter basically involves learning how to live your life again, which is a lot harder to do if your going through withdrawals.
Ideally you’d want to taper someone off a drug. Give them less and less over time while at the same time allowing them to put more and more of their life back together.
Suboxone is an opioid antagonist but is also mixed with an opioid to prevent withdrawal symptoms. People trying to come off opioids can be given suboxone, which is slowly tapered off over time.
Opioid antagonists mimic having less opioid in your body than you actually do. We have an easier way to cause someone to have less opioid in their body. It’s called taking less opioids.
We use opioid antagonists is to reverse overdoses because in those cases waiting for the opioid to leave someone’s body isn’t fast enough. We also use them to treat addiction in combination medications like suboxone, which contain enough opioids to keep someone out of the worst withdrawal symptoms and an opioid antagonist to keep them from using extra drugs at the same time to get high. But someone who wants to undergo discomfort to get out of opioid dependence as quickly as possible can already do that without taking opioid antagonists.
There is one that hasn’t been referenced yet ibogaine. not legal in most places and reputable clinic screen their patients intently because it can be very hard on the body. It’s not recommended for long term or old patients.
It’s an opiate antagonist with a very long effect time as in days. It is also a powerful psychedelic which is the second reason the medical community won’t touch serious research In most countries.
there are a couple of non psychedelic derivatives that are being worked on.
I am not sure the derivatives will pan out nearly as well, as some close friends who went through it, they personally believe that the psychedelic aspect was very important. apparently the trip is very introspective and helps people deal with issues that got them into opiates in the first place
It’s a great question! There are actually two reasons:
– the brain adjusts to get used to having opiods in it when people use regularly. When you suddenly remove the opioids (by introducing a blocker or antagonist) the brain goes haywire and you get the opposite effect (lots of pain, agitation, not able to sleep etc)
– opioid antagonists block the effects of use but not cravings. The longer people don’t use their brains go back to normal and they lose their tolerance. After a couple of weeks what would normally be a recreational dose can become a lethal dose. But they still have an ongoing desire to use.
This means that people who have a rapid detox or are on antagonist treatment are at a very high risk of relapse, and if they do relapse they are at a high risk of overdose and death. Naltrexone (long acting naloxone) has been used but is often ineffective as people can stop taking the tablets and use after a couple of days, or wait until their implant is removed.
In comparison, an ongoing level of opioid agonism (methadone or Suboxone) can not only reduce cravings, but also block the effects of recreational opioid use due to the opioid receptors being filled up.
Addiction is not the same as having opioids in your body. OA basically rapidly converts the opioids in your system into something that doesn’t trigger your receptors. Now let’s think of this another way. Do you know what it feels like to be thirty? How about the relief you feel when you get a drink? Now imagine, no matter how much you drink, the feeling of dry mouth and sticky tongue and chapped lips doesn’t go away. The feeling instead gets worse and worse because you can’t sate the need. So even tho you’re getting what you need, your warning system (aka symptoms) doesn’t go away. In this case (which is also how addiction works) no matter how much water you drink the symptoms of thirst continue. So addiction is basically the symptom of desire going on and on and on…. How do you cure your brain from desire? By eliminating the water? By taking so much water your bladder will burst like a water balloon? Neither. By reprogramming your brain. You can reduce the symptoms by still giving the drugs and by slowly lowering the dose, the brain will learn how to function without the desire plaguing you every moment. Eventually you can remove the effects of the drugs (tho sometimes the desire is not addressed which inevitably leads to relapse) but the desire and the effects of the drug are not the same. It’s two separate things that must be addressed together for the greatest chance of success
to all the smokers who posted: quit now while you still have lungs left. I didn’t now I’m 61 and on O2, 2 heart attacks, and now lung disease. amazing how much you need your lungs. I can’t lift a sheet over my head to make my bed. Im out of air just walking to the kitchen. My life is over
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