Why we use not opioid antagonists to treat addictions to opioids faster?
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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.
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