Researchers from the Warren Alpert School of Medicine at Brown University and Rhode Island Hospital have attempted to answer these questions. They studied more than 26,300 adults who reported using prescription opioids within the past month of a survey conducted November 2005 through December 2009. The adults in this study were ages 18 to 70, whose drug use was being tracked through a national monitoring system called the National Addictions Vigilance Intervention and Prevention Program.

The research team found that many abused opiates in conjunction with other prescription and/or illicit drugs, and that many of these adults were suffering from psychiatric conditions along with their substance abuse. Only 19% were using the drugs as prescribed.

Dr. Traci Green and her colleagues classified the adults using opiate drugs into four groups: those who use them as prescribed (19%); those who had prescriptions but were misusing the drugs (27%); medically healthy abusers (36%); and illicit users (18%). Over 80% were determined to be at risk for death by overdose, and an additional 18% were at risk for blood-borne infections such as HIV.

The research team also studied these adults in terms of age, race, ethnicity, concurrent drug use, onset and duration of drug abuse, route of administration, and comorbid psychiatric and medical problems. They reported that patient education and expanding prescription monitoring programs would have little effect in stopping or helping opioid abusers, many of whom do not receive regular care from the medical profession. Many of the opioid abusers have psychiatric and medical problems that are not being addressed in formal treatment programs.

“Our results add to a growing body of research indicating that prescription opiate products are being abused and misused in ways that call for more nuanced and public health-oriented post-marketing surveillance and risk management responses that have been proposed heretofore,” said Dr. Green, lead author of the study.

The study appears in the journal PLoS ONE.

Majority of Opioid Painkiller Abusers Do Not Receive Medical Treatment is a post from: Drug Addiction Treatment

Our healthcare system, at that time, consisted of hospitals, mental institutes, religious paths, and short-term and street programs that housed addicts. These approaches were grossly negligent in providing what addicts needed, according to NJ.com, and eventually programs ventured into self-help and more long-term treatment and recovery programs. These programs were more effective in retaining the addict for treatment and getting them on a path towards long-term recovery.

In the past three to four years, there have been a number of avenues to help with detox and continuum care to meet the needs of those with addiction – and there has been plenty of research on their effectiveness. The role of the addict in helping themselves continues to be the mainstay of effectiveness in their recovery and ongoing treatment.

However, the federal government seems to be moving us back in time by favoring the short-term method popular in the 1960s. The role of the addict helping themselves is not part of the equation. The ACA, or Affordable Care Act, gives no mention of the need for long-term treatment as part of the plan for helping addicts. There is little reference to the addict helping themselves as part of the approach to recovery.

What Is the Best Way to Approach Addiction Treatment and Recovery? is a post from: Drug Addiction Treatment

As a result, it’s not uncommon for cocaine addicts to relapse within six months of treatment. Hope may be found in the form of a drug called Propranolol, currently prescribed for treatment of hypertension and anxiety but with promising results in animal-addiction models.

Researchers Devin Meuller and James Otis, of the University of Wisconsin-Milwaukee followed the behavior of addicted rats given the drug propranolol in order to see if it could diminish the memory associations between cocaine and environment. Propranolol has been experimented with in the treatment of post traumatic stress disorder (PTSD) for this same effect. In both cases the patient is influenced by powerful memories triggered by environmental stimuli.

In this study, rats were injected with cocaine in a particular cage & location until they learned to associate the environment with the drug high. At this point some of the rats were given propranolol and others given saline and then observed to determine if there existed a continued preference for cages with drug associations over cages without previous drug experiences. Results recorded that rats injected with propranolol failed to exhibit a preference for the cage with drug associations while the rats receiving saline continued to prefer the cage where cocaine had been administered. Furthermore, the drug’s effect appeared to last over a two week period indicating to researchers that the medication had affected memory.

Apart from the drugs currently used to treat symptoms of cocaine withdrawal the most common treatment for cocaine abuse recovery is ‘exposure therapy’ in which the patient is repeatedly exposed to the environmental stimuli which trigger drug cravings. Over time, as the patient is exposed to the stimuli without satisfaction of the drug hunger, the association weakens and the inducements to relapse diminish. The treatment has shown a limited amount of success to date. However, Dr Meuller postulates that the combination of exposure therapy with administering of propranolol could prove to be a highly effective treatment. Memories associated with a patient’s prior cocaine habit are considered to be the major cause of relapse. A treatment which addresses those memories behaviorally and pharmacologically could enhance the success rate.

Just how propranolol actually works in the brain remains uncertain. It does seem that the drug, while not completely erasing memories, somehow lessens the pleasurable associations the memory invokes. Dr Meuller believes that propranolol’s effects could prove to be permanent without requiring repeated dosages. There is much that bears further study, but the high blood pressure drug propranolol is giving hope to those seeking more effective treatment for cocaine addicts.

Blood Pressure Drug to Fight Cocaine Addiction is a post from: Drug Addiction Treatment

Methamphetamine is a potent and highly addictive substance, and use of the drug can lead to severe health problems, mental health issues, and social problems. According to the National Institute on Drug Abuse, about 10 million people in the United States have used methamphetamine at least once.

Kim Janda and colleagues note in the report that methamphetamine addiction costs the United States more then $23 billion per year in medical and law enforcement expenses, as well as lost productivity.

The researchers developed and tested new vaccine formulations that could be effective for long periods of time, which would help prevent relapse and reduce costs. They found that three of the formulations were particularly promising, and produced a good immune response in mice.

Methamphetamine can be very difficult to quit, and many people trying to quit often relapse. The development of an effective vaccine would be a very important discovery for scientists, health care providers, and treatment centers alike. Previous vaccines that have been tested were either ineffective or too expensive.

Source: Science Daily, Toward a Vaccine for Methamphetamine Abuse, May 11, 2011

Scientists Developing Potential Methamphetamine Vaccine is a post from: Drug Addiction Treatment

Dr. Ronald G. Crystal, lead investigator of the study and chairman and professor of genetic medicine at Weill Cornell Medical College, said that the study shows that the vaccine can protect mice against the effects of cocaine, and could be promising in treating addiction in humans.

He added that the vaccine binds to cocaine molecule before the drug reaches the brain, preventing the effects of cocaine. This effect lasted for at least 13 weeks. Dr. Crystal said that while there have been other attempts to develop vaccine against cocaine, this is the first that likely won’t require multiple infusions that can be costly, and that will move quickly to human trials. He added that there is currently no FDA-approved vaccine for addiction treatment.

The vaccine is made up of a chemical that is very structurally similar to cocaine and components of the adenovirus, which is a common cold virus. The immune system is alerted to the virus and learns to view cocaine as an “intruder.” Once the cocaine is recognized, antibodies to the drug are produced and cocaine is prevented from reaching the brain.

Dr. Crystal said that the immune system doesn’t usually identify cocaine as an intruder, so the researchers engineered the response so that it does. For the study, a team of scientists from Weill Cornell Medical College, Cornell University in Ithaca, and the Scripps Research Institute in La Jolla, California, found that a strong immune response was generated against the vaccine.

Mice that received the vaccine were much less hyperactive after being given cocaine than those that did not receive the vaccine. This effect was even seen in mice that were given large, repetitive doses of cocaine.

Dr. Crystal said the vaccine needs to be tested in humans, but thinks that it will work best in people who are already addicted to cocaine and are trying to quit. He added that the vaccine may help people quit because if they use the drug, the immune system will destroy it before it reaches the brain.

Source: Science Daily, Vaccine Blocks Cocaine High in Mice: Approach Could Also Stop Addiction to Other Drugs, Including Heroin and Nicotine, January 5, 2011

New Vaccine Could Help People Addicted to Cocaine is a post from: Drug Addiction Treatment

The study found that chronic exposure to cocaine results in increased activity in D1 neurons and decreased activity in D2 neurons. Activation of D1 neurons increases cocaine reward, and activation of D2 neurons decreases cocaine reward.

The researchers used optogenetics, which is a technology that optically controls neuron activity in rodents. They activated neurons by disrupting brain-derived neurotrophic factor, which is a protein in the brain that is associated with learning, memory, neuronal survival, and drug abuse signaling through the receptor TrkB, found in D1 or D2 neurons.

Eric Nestler, MD, PhD, Chair of Neuroscience, Nash Family Professor, and Director of The Friedman Brain Institute at Mount Sinai and co-author on the study, said that this study provides new information on how cocaine takes over the brain’s reward center, and how it can affect two neuronal subtypes in the nucleus accumbens. This information could help develop new methods for cocaine addiction treatment.

Source: Science Daily, Why Cocaine Is So Addictive: Activation of Specific Neurons Linked to Alterations in Cocaine Reward, October 18, 2010

New Study Helps Explain Why Cocaine Is So Addictive is a post from: Drug Addiction Treatment

Vivitrol is a time-release version of naltrexone, which blocks the brain’s opiate receptors, eliminating the “reward” one normally experiences from taking opiates. Without the reward, cravings for the drug decrease dramatically.

A small study in Russia found that Vivitrol was 50 percent more effective than a placebo in keeping opiate addicts off drugs for five months. Naltrexone has previously been used to treat alcoholism.

The FDA’s approval will make it considerably easier for people to obtain the drug, as currently most insurance companies don’t cover the cost of the $1,000 monthly shot, and treatment can take a year or more. Naltrexone in pill form can be less effective for longer-term treatment, as people can just stop taking the drug.

Doctors note that Vivitrol won’t be successful alone—it needs to be combined with other forms of treatment, including counseling.

Source: CNN, FDA Okays Drug to Fight Opiate Addiction, October 12, 2010

FDA Approves Vivitrol for Opiate Addiction Treatment is a post from: Drug Addiction Treatment

With his colleague W. James Ball, PhD, of the pharmacology and cell biophysics department at the University of Cincinnati, Norman is studying the development of a monoclonal antibody, or an antibody derived from a single cell to be used against a specific target) that could work against cocaine. When injected into the bloodstream, the antibody would attach to cocaine and prevent it from entering the brain, which would limit its pleasurable effects. Norman and Bell have previously shown that this antibody reduces the effects of cocaine in animals.

Norman said this grant is vital to their research, and that it will greatly enhance their development of this potential new form of addiction treatment.

NIDA also awarded William Brimijoin, PhD, of the Mayo Clinic, Jia Bei Wang, PhD, of the University of Maryland at Baltimore, and Daniele Piomelli, PhD, of the University of California, Irvine. Brimijoin and Wang are also researching cocaine addiction treatments, and Piomelli is researching a new treatment for smoking cessation.

NIDA Director Nora D. Volkow said that research has clearly shown that drug addiction is linked to disruptions of brain structure and function, which presents several potential targets for the development of new medications. Presenting the awardees with grants could help quicken the process of finding these much-needed medications for addiction.

Source: PsyOrg.com, Researcher wins $2.5 million award from National Institute on Drug Abuse, September 21, 2010

Researcher Given Grant to Explore Antibody Treatment for Cocaine Addiction is a post from: Drug Addiction Treatment

After meeting on Thursday, September 16, the FDA’s Advisory Committee agreed with Alkerme’s sNDA and its research that was first introduced at the 2010 American Psychiatric Association (APA) Annual Meeting in May, where four clinical studies demonstrated naltrexone’s ability to suppress both alcohol and opioid cravings and withdrawals. The FDA will consider the recommendation of the Advisory Committee and formally announce its final decision on October 12, 2010. The FDA is not obligated to agree with the recommendations of its Advisory Committee—a panel of outside experts—although the U.S. administration historically tends to follow suit.

The Advisory Committee voted 12 to 1 in favor of naltrexone’s use in the treatment of opioid dependency and found the sNDA to be particularly favorable since the clinical trials of the drug showed no apparent serious side effects. Although the clinical trials did show positive results among sample populations of alcoholics or opioid addicts compared to placebo-administered control groups, the Advisory Committee was concerned about the efficacy of a single research study that was held outside the U.S.

“Efficacy and Safety of Extended-Release Injectable Naltrexone (XR-NTX) for the Treatment of Opioid Dependence,” conducted by lead investigator Dr. Evgeny Krupitsky of St. Petersburg Regional Center of Addictions in Russia found that naltrexone injections successfully reduced drug cravings among opioid-dependent individuals. In a 24-week investigation involving 250 opioid-dependent participants who had opioid addiction for 10 years, the group administered naltrexone injections showed significant reductions in their cravings, physiologic dependence, and self-reported opioid use, and had better retention compared to the placebo group. These participants were more capable of suppressing their cravings, preventing relapse and sustaining abstinence.

Due to the disruption of normal neurotransmission in the brain’s reward system caused by opioid use, opioid abusers become physiologically vulnerable to their cravings and often relapse even after undergoing treatment. The experts from the clinical trials as well as the FDA Advisory Committee caution that naltrexone may not be an absolute cure-all to alcoholism or opiate addiction, but the benefits of this new injectable does give the field of addiction medicine more options when it comes to treating opioid addiction, which as of yet has no other pharmacological form of treatment.

Source: MedScape Today, Emma Hitt, FDA Panel Recommends Naltrexone Extended-Release Injectable Suspension for Opioid Addiction, September 17, 2010

FDA Committee Recommends Naltrexone for Opioid Addiction Treatment is a post from: Drug Addiction Treatment

There’s no need to agonize over which is best for your loved one, however, since your decision – and that of your loved one – can be based on practical considerations, such as type and duration of addiction or addictions, insurance coverage and/or cost, success rate of the facility in treating particular addictions, as well as personal preference.

Consider What’s Going On With Your Loved One Now – and the Family

For some family members who have a loved one with addiction, the first realization is that something has to change. Things become so intolerable at home, so disruptive to the family dynamic, that everything is in turmoil on a daily basis.
In addition to the abuse or addiction to alcohol or drugs causing serious physical, mental, and emotional changes to the loved one, often there have been serious consequences that also impact the family. These include the loss of the loved one’s job (being fired or laid off), demotion, loss of a promotion, accidents involving drunk driving, arrests for criminal offenses, legal problems, serious financial difficulties, and more.

Strife at home may result in physical, as well as verbal, abuse or violence. If the loved one is the sole support of the family, the problems may become even worse. Arguments, often loud and occasionally violent, may seriously weaken the family bonds. Children who witness such conflict often become withdrawn or overly aggressive, begin to fail in school, and may take up drinking or doing drugs in an effort to escape from the stress. If it’s the child that’s abusing or dependent on alcohol and/or drugs, the parents often are completely lost and unsure what to do. Their formerly loving, happy, well-adapted child has become surly, secretive, prone to wild and erratic mood swings, hangs around with unsavory friends, gets in trouble at school, and causes heartbreak and turmoil in the family.

If you’ve had enough of the constant promises to quit drinking or doing drugs that always fail, if you don’t know where else to turn, and if you and your loved one are committed to getting help to overcome addiction, you may find that residential treatment is the best choice.

When Residential Treatment Makes Sense

Addiction recovery experts, backed by numerous research studies on the effectiveness of various types of addiction treatment programs and settings, recommend residential treatment for individuals who have chronic and debilitating addiction, multiple addictions, substance abuse and co-occurring mental health disorder, or addiction and process disorder (such as compulsive gambling, sex, work, or spending, among others).

In general, the more severe the problems a person experiences as a result of his or her addiction, the more likely it is that residential treatment can offer the best opportunity to overcome the addiction and live a healthy, happy, and productive life. Those with long histories of drug abuse or addiction, involvement with the criminal justice system, and/or seriously impaired social functioning are perhaps better suited to treatment in a residential treatment program of a long-term duration.

Residential treatment programs may also make sense if your loved one would benefit more from an intensive treatment program that’s fully integrated in one location. Such a comprehensive residential treatment facility includes all services, either provided by professionals and staff at the facility, or coordinated and carried out under the administration of the treatment facility, either on-premises or off.

There are also residential treatment facilities that have programs for specific groups: men, women, seniors, adolescents, gay and lesbian, handicapped, and others. In addition, there are residential treatment facilities that have professionals that speak various languages, to enable them to provide care to patients of different ethnicities.

Short-Term Residential Treatment

In short-term residential treatment, patients receive intensive but relatively brief treatment for addiction in a residential setting. Such treatment is based on a modified 12-step approach and was originally developed to help clients overcome problems with alcohol. In the 1980s, during the height of the nationwide cocaine epidemic, many residential treatment facilities began to treat illicit drug abuse and addiction.

Typical duration of short-term residential treatment is 30 days or less. After active treatment is completed, the patient continues recovery by attending 12-step meetings and participating in aftercare or continuing care, if this is part of their addiction treatment program.

Beyond 30 days, some patients may transition to extended care programs offered by the residential treatment facility. The purpose of the extended care treatment is to provide a safe and supportive environment for individuals who have completed residential treatment but are not yet ready to transition from treatment to their home environment. During this early stage of recovery, the extended care treatment program helps patients build upon the gains they made during treatment and addresses issues that arise as they rejoin the workplace and return to their homes.

Long-Term Residential Treatment

As the name implies, long-term residential treatment encompasses many more months than its short-term counterpart. Long-term residential treatment involves 24-hour care, and is generally provided in non-hospital settings, otherwise known as residential treatment facilities.

Long-term treatment is that which lasts 30 to 90-plus days. Some long-term treatment may be 6 months or more. Some individuals with persistent severe problems, involvement in the criminal justice system, and/or co-occurring disorders may be transitioned to a structured living environment, known as therapeutic communities, and remain there for a period of 6 to 12 months. The focus of TCs is resocialization of the patient to a drug-free and crime-free lifestyle.

Which Residential Treatment Program is Right for Your Loved One?

Choosing the type of residential treatment program is a decision that you and your loved one will make based on the recommendations of the professionals at the residential treatment facility you choose. After a thorough interview and assessment of the patient, a personalized treatment plan will be created that will address the patient’s needs and concerns.

You will have the basic treatment program, as well as a number of options or additional services available through the residential treatment facility. Be sure to ask all the questions that come to mind, including whether financial assistance is available, the facility’s overall success rate in treating specific addictions, the credentials and licenses of the facility and staff, what’s included in the treatment plan and what is extra cost, how long the treatment program will last, and what’s included following completion of the active treatment phase (continuing care, additional counseling, etc.).

Remember that the end goal is that your loved one establishes a firm foundation for recovery from addiction and is able to return home better prepared to live a healthier lifestyle, one that’s free from drugs and alcohol. The homelike and relaxed treatment setting of residential treatment facilities has proven to be very conducive to the recovery and healing process.
Does your loved one really need residential treatment? Hopefully, by now you will be able to answer that question. At the very least, you will have more information that can assist you in making your decision.

How to Tell if My Loved One Really Needs Residential Drug Addiction Treatment? is a post from: Drug Addiction Treatment