Successful Buprenorphine/Naloxone Treatment For Opioid Addiction?
Buprenorphine is an opioid narcotic medication used to ease a reliance on stronger narcotics during recovery from active drug addiction. For specific reasons, doctors often combine the use of this medication with a secondary medication called naloxone. In a study published in November 2013 in the journal Addictive Behaviors, researchers from the State University of New York, Buffalo explored the reasons some people successfully complete buprenorphine/ naloxone treatment for opioid addiction, while others do not.
Dependence Risks Of Using Opioids
All opioid substances produce two primary effects when introduced into the human body: a highly pleasurable (euphoric) mental state and a significant reduction in the ability to feel pain. Doctors rely on the pain-relieving effects of prescription opioids to relieve serious forms of pain, but must constantly monitor the possibility for the onset of opioid dependence and the subsequent development of an opioid addiction. Since illegal or illicitly used opioids produce the same basic effects as suitably prescribed opioids, intake of these substances also comes with serious dependence and addiction risks.
How Buprenorphine Is Used For Addiction
Buprenorphine is a significantly less powerful drug than the popular legal and illegal opioids of abuse. When an opioid addict switches over to buprenorphine use, he or she commonly experiences a reduction in euphoric and painkilling sensations, and also gradually reduces his or her level of physical dependence on narcotics in general. Doctors take advantage of these qualities by prescribing the medication during opioid addiction treatment. Instead of facing intense, potentially overwhelming symptoms of opioid withdrawal during the early stages of the treatment process, patients who switch over to buprenorphine typically avoid withdrawal and set themselves up for an increased likelihood of long-term addiction recovery.
In the U.S., the manufacture and distribution of buprenorphine (and all other legal and illegal opioids) are regulated under a federal law called the Controlled Substances Act. This law specifically stipulates that doctors who give their patients buprenorphine during opioid addiction recovery must also either provide access to some sort of therapeutic counseling or direct their patients to other counseling resources. The counseling options most commonly offered to individuals receiving buprenorphine are a reward/punishment approach called contingency management (CM) and a gradual behavior modification therapy called cognitive behavioral therapy (CBT). However, in reality, not all buprenorphine recipients end up participating in a counseling program, even when they have access to such a program.
How Naloxone Is Utilized With Buprenorphine
Naloxone is not an opioid drug. In fact, it was originally developed as an anti-opioid medication, and has the ability to rapidly halt the effects of opioid intoxication inside the body. Doctors use the combination of buprenorphine and naloxone to reduce the chances that a person going through opioid addiction treatment will abuse buprenorphine instead of using that medication as directed. When the two medications are dissolved together under the tongue, enough buprenorphine reaches the bloodstream to help relieve opioid withdrawal; at the same time, the presence of naloxone limits buprenorphine’s impact and reduces its usefulness as a target of drug abuse. A prescription medication called Suboxone contains the proper proportions of buprenorphine and naloxone to achieve the desired treatment objectives.
Buprenorphine/Naloxone Opioid Addiction Treatment
In the study published in Addictive Behaviors, the SUNY Buffalo researchers used an examination of 356 opioid-addicted adults to explore the factors that contribute to the successful completion of addiction programs centered on the combined use of buprenorphine and naloxone. All of these adults were enrolled in a six-month treatment course that provided access to counseling resources. 127 of the participants successfully completed the course, while the remaining 229 participants did not.
After assessing the impact of a range of potential factors, the researchers concluded that the individuals who successfully completed a naloxone and buprenorphine opioid addiction treatment differed from those who did not complete treatment in two key ways. First, they took advantage of the counseling resources made available to them and established good records of counseling attendance. Interestingly enough, they also had histories of previous, significant physical injuries.
The authors of the study published in Addictive Behaviors don’t know for sure why prior experience of a physical injury increases the chances that an individual will complete buprenorphine/naloxone-based opioid addiction treatment. However, they do have a potential explanation. Previously injured people may have a history of exposure to chronic pain; in turn, use of buprenorphine during addiction treatment may help relieve that pain in addition to decreasing a reliance on the addictive effects of stronger opioids. It is the combination of withdrawal avoidance and ongoing pain reduction that may account for the link between prior injury and successful buprenorphine/naloxone treatment outcomes.
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