Methadone Alternatives for Chronic Opiate Addiction
For decades, methadone has been considered the front-line approach for treating chronic opiate addiction. As a synthetically made opiate drug, methadone can easily pick up where addictive opiates like heroine and codeine leave off without posing as high a risk for abuse and addiction.
While effective, methadone does come with certain risks that can compromise its treatment effectiveness. In essence, this traditional treatment approach may not be right for everyone.
Methadone alternatives offer many of the same benefits of methadone without posing the same degree of risk that comes with long-term methadone treatment. Some of the medications commonly used as methadone alternatives interact with the brain in similar ways, while others employ a different mechanism of action.
The Need for Methadone Alternatives
Over time, chronic opiate abuse damages and weakens the brain cells responsible for producing neurotransmitter materials. After a certain point, pronounced imbalances take over the brain’s chemical system. These imbalances account for why people in recovery have such a hard time maintaining continued abstinence.
As an opiate-based drug, methadone also carries many of the same risks as addictive opiates in terms of its effects on the brain. According to the Journal of Addictive Diseases, the brain can develop a tolerance for methadone just like it does any other kind of opiate. Likewise, the potential for abuse soon follows once tolerance level increases begin.
Under these conditions, a person can just as easily start abusing other types of drugs while taking methadone, at which point methadone becomes a part of the abuse-addiction cycle. People most susceptible to falling into this pattern stand to benefit most from methadone alternatives.
First approved as an opiate addiction treatment in 2002, buprenorphine is also an opiate-based drug, but differs from methadone in effect. Like methadone, buprenorphine helps restore a normal chemical balance by stimulating normal neurotransmitter production rates in the brain.
Whereas methadone fully stimulates chemical-producing brain cells, buprenorphine only partially stimulates these same cells. This difference gives buprenorphine a lower abuse potential as its effects will start to level off once a certain dosage level is reached.
Rather than help restore a normal chemical balance in the brain, naltrexone works to prevent a person from abusing addictive opiates. Unlike methadone and buprenorphine, naltrexone has an opposite effect on neurotransmitter-producing brain cells, inciting harsh withdrawal effects when opiate materials enter the brain.
As a methadone alternative, naltrexone acts as a relapse prevention safeguard and also helps to break compulsive-drug using behaviors by changing a person’s expectations towards drug abuse.
Lofexidine acts as an antihypertensive agent, so it belongs to a completely different drug class than methadone, burpenorphine or naltrexone. Unlike the first two methadone alternatives, lofexidine specifically targets the neurotransmitter norepinephrine, reducing its production rates throughout the brain and central nervous system, according to the Journal of Psychiatry.
As an addiction treatment lofexidine helps reduce withdrawal symptom severity during the initial detox stage of treatment.
Methadone alternatives work well for people who’ve had little to no success with methadone treatment. Since these treatment approaches work in different ways, it’s also possible to combine medications to treat different aspects of an addiction problem.