Which solution is better? At the moment there is no single method of drug addiction treatment or pharmacological agent that would guarantee 100% оf success in treatment of addiction. NIDA (National Institute of Drug Addiction, USA) in its understanding of curing addiction states that treatment should be prolonged, complex and individually chosen to maximum. We absolutely agree with that. Respectively, there are many people who left the drugs with help of naltrexone implant, and also there are a lot of people to whom methadone addiction treatment gave an opportunity to escape harm to health and avoid legal problems due to abandon the street drugs. Each of these people is actively campaigning for the technique that helped him. We believe that both sides are worth of respect, because their decisions changed their lives. Our program provides opioid antagonists therapy or so called opioid blockers therapy. For many patients impossibility to use opioids due to that blockade helped to overcome their doubts, hesitation and protected them from relapse. Many of them were looking for a radical solution and left not only opiates but also other psychoactive substances as well.
Why is there so much criticism for both Naltrexone and Methadone?
Because each drug addiction treatment method requires discipline. Because stable mental condition does not occur immediately after beginning of the treatment in both cases. Neither methadone or naltrexone therapy extinguish craving for drugs during the first days of treatment. None of the tablets is able to restore a person’s identity, to force him to part with old friends, to get a job or to spend more time with a family. For full recovery complex rehabilitation from drug and psychological assistance are absolutely necessary.
What suits me better?
The success of naltrexone implant therapy depends on many factors: motivation, compliance (the ability to comply with the rules of treatment), level of volitional mechanisms, integrity of personality, family support, health status, duration of addiction, experience from previous treatment attempts. On analysis of all these factors optimal drug addiction treatment can be chosen. Most experts in treatment of addiction problems agree that for motivated young patients at the age from 15 to 25 with short drug experience more appropriate, more successful therapy is that one which aims the complete refuse of drugs than the one that switches a person from heroin to methadone or buprenorphine.
What drug addiction treatment is safer?
It is safer not to take drugs, alcohol and benzodiazepines. Their use is forbidden in both methadone and naltrexone treatments. In many countries driving is prohibited for patients who are on Methadone treatment. In some countries work in certain professions is impossible for those who are on methadone or other opioid containing substitutional therapy due to the risk of developing severe withdrawal syndrome in case of a sudden discontinuation.
What is the final result of the treatment?
Every day of being on blockers without opioids contributes to rehabilitation of sanity, to restoration of natural endorphins, alienates a drug user from the drugs. With every passing week and month there are less and less bad days, hours, minutes. Desires, thoughts, memories about the drugs lose their former intensity and charm. Current treatment protocols recommend regular use of blockers during 12-24 months,with a complete cessation afterwards. After a year of sobriety, there are practically no differences in the physiological, neurochemical and morphological parameters of the ex-addict and a man who never abused opioids. On methadone or subutex drug addiction therapy the great progress in sense of mental stability is also possible. However, the grasped result is very fragile and may easily break down in case of loss of tablets, for example, during a trip or a jorney. Patient depends on his medication. Quite often for many methadone becomes a fetish. The patient is constantly checking its amount and the idea of losing methadone plunges him into a panic.
NALTREXONE versus METHADONE
|Ability to cause addiction, physical and psychological dependence||No||Yes|
|Ability to induce euphoria, flash||No||Yes|
|Addictive potential, risk of abuse||No||Yes. Medium-High|
|Ability to cause physical dependence and withdrawal symptoms in case of sudden discontinuation||No||Yes. Withdrawal symptoms from methadone may last up to 21 days. Much more severe than from heroin.|
|Effect of concentration||Does not affect||Can cause confusion, dulls emotions, strengthens laziness|
|Restriction in driving, and in some kind of other activities||No||Methadone in some states it is not allowed to drive, to be engaged in such activities as medicine.|
|Impact on physical health||It is not recommended in cases of severe hepatitis, cirrhosis.||Can cause weight gain, tooth decay, liability to infections|
|Risk of overdose in the case of use opioid||Yes||Yes|
|Risk of poisoning in the case of receiving large amounts of alcohol or benzodiazepines||Below||Above|
|Possibility to change or discontinue the therapy||Does not require pre-detoxification, does not cause rebound effect or withdrawal||Requires long-term phasing out or detoxification. Accompanied by withdrawal.|
|Cost||From 50 euros per month for the oral form. up to 200 euros per month for long-acting forms||Free. When you purchase additional doses on a black market, the cost depending on the tolerance may be up to 500 euros a month.|
|Impact on craving||Gradually decreases||Gradually decreases (only in case of receiving the same daily doses)|
|The need to monitor therapy||Necessary||Necessary|
|The ultimate goal is to stop taking drugs||Yes||Yes, only in case of receiving the same daily doses|
|The ultimate goal is to complete sobriety||Yes||Not always. Only in the case of a program targeting gradual dose reduction.|
From recently naltrexone is widely used not only for the treatment of opioid addiction. It demonstrates its effectiveness in randomized, placebo-controlled trials for the treatment of alcoholism, stimulant abuse, gambling.