Many types of drug addictions can be treated with medication in addition to talk and behavioral therapies. Medications can be used both to treat withdrawal and to help prevent relapse. Some medications are only used during detox, while others may be used on a long-term basis throughout the recovery process.

Medications that treat withdrawal help to suppress symptoms during detox, which is typically the first step in the recovery process. Medications often help to alleviate withdrawal symptoms, lessening their severity but often not eliminating them altogether. Detox itself does not treat the underlying addiction; it only addresses the physical dependence on the substance. As a result, further treatment is always necessary in order to recover from a drug addiction.

Other medications are used to help prevent relapse while in recovery. These medications can help reestablish normal brain function, which eases cravings for the substance of abuse. Not all drug addictions can be treated with medication; however, there are FDA-approved drugs available to treat addiction to opioids, tobacco, and alcohol. According to NIDA, opioid addiction can be treated with methadone, buprenorphine, or naltrexone, while alcoholism can be treated with naltrexone, acamprosate, or disulfiram. Many nicotine replacement products exist to assist in the treatment of tobacco addiction.

In addition to these FDA-approved medications, other medications are used to treat specific symptoms during detox and recovery. For example, anti-nausea medications may be used to treat vomiting and stomach upset during detox, and antidepressants or anti-anxiety medications may be used in treatment to address psychological symptoms associated with early recovery.

Methadone

Methadone is one of the most commonly used medications in the treatment of opioid addiction. This medication is an opioid agonist, meaning it mimics the effects of opiate drugs. This allows methadone to ease withdrawal symptoms, while still not producing the “high” typically sought when abusing opioids. Methadone can be addictive, particularly if used incorrectly or for an extended length of time. Because of its abuse potential, it is only available via licensed methadone clinics, and it is highly regulated.

In addition to its intended effects, methadone can have some negative side effects. Side effects of methadone may include:

  • Muscle weakness
  • Headache
  • Nausea and vomiting
  • Loss of appetite
  • Weight gain
  • Stomach pain
  • Dry mouth
  • Sore tongue
  • Sweating
  • Flushing
  • Mood swings
  • Difficulty urinating
  • Changes in vision
  • Sleep disturbances
  • Sexual dysfunction
  • Disturbance in menstrual cycle

These symptoms are not usually dangerous and may subside over time. Occasionally, more serious side effects can occur. These include:

  • Seizures
  • Itching, hives, or rash
  • Swelling of the face or throat
  • Difficulty breathing or swallowing
  • Drowsiness
  • Hallucinations

Methadone overdose can be extremely dangerous. Symptoms of overdose include:

  • Pinpoint pupils
  • Shallow or stopped breathing
  • Difficulty staying awake
  • Cold or blue skin
  • Coma
  • Extreme muscle weakness

If overdose is suspected, call 911 immediately.

Buprenorphine

Buprenorphine is another medication used to treat opioid dependence. Like methadone, buprenorphine is an opioid agonist. Buprenorphine mimics the effects of opioid drugs, thereby lessening withdrawal symptoms and cravings. It is often combined with naloxone, which blocks some of the effects of opioid drugs. This limits buprenorphine’s abuse potential. Because of this, it is more readily available than methadone. Buprenorphine can be administered in a doctor’s office or prescribed for outpatient use, whereas methadone often requires a daily visit to a methadone clinic.

Side effects of buprenorphine can include:

  • Headache
  • Stomach pain
  • Constipation
  • Vomiting
  • Trouble sleeping
  • Mouth numbness and tongue pain
  • Blurred vision
  • Back pain

More dangerous side effects may include:

  • Hives, rash, or itching
  • Difficulty breathing or swallowing
  • Swelling of the face and extremities
  • Difficulty breathing
  • Upset stomach
  • Exhaustion
  • Changes in vision
  • Slurred speech
  • Confusion
  • Bleeding and bruising
  • Low energy
  • Loss of appetite
  • Stomach pain
  • Yellow skin or eyes
  • Pale stools
  • Dark colored urine
  • Nausea

An overdose of buprenorphine requires immediate medical attention. Symptoms of overdose include:

  • Pinpoint pupils
  • Extreme drowsiness
  • Dizziness
  • Blurred vision
  • Shallow breathing

Naltrexone

Naltrexone is used in the treatment of opioid addiction, but unlike methadone and buprenorphine, naltrexone is an opioid antagonist. Opioid antagonists block the effects of opioid drugs, rather than mimic them. Naltrexone is also effective in the treatment of alcoholism. This medication discourages relapse by preventing drugs and alcohol from having their intended effect, as well as by decreasing cravings. However, naltrexone can cause unpleasant side effects, so adherence to its treatment is often low.

Side effects of naltrexone can include:

  • Nausea and vomiting
  • Stomach pain and cramping
  • Diarrhea or constipation
  • Loss of appetite
  • Headache
  • Dizziness
  • Anxiety
  • Irritability
  • Teary eyes
  • Difficulty sleeping
  • Changes in energy level
  • Drowsiness
  • Muscle or joint pain
  • Rash

More serious side effects can include:

  • Confusion
  • Hallucinations
  • Blurred vision
  • Severe vomiting and diarrhea

Acamprosate

Acamprosate is used in the treatment of alcohol addiction. Drinking large amounts of alcohol for a significant length of time can change the way the brain works, and acamprosate helps to reestablish normal brain function. This drug cannot be administered while there is still alcohol in the body. Acamprosate does not treat withdrawal, but it can help prevent relapse.

Side effects of acamprosate include:

  • Gastrointestinal distress, including diarrhea, gas, and upset stomach
  • Loss of appetite
  • Dry mouth
  • Dizziness
  • Itching
  • Weakness
  • Anxiety
  • Difficulty sleeping
  • Sweating

More dangerous side effects include:

  • Burning, tingling or numbness in the extremities
  • Rash or itching

Taking too much acamprosate for too long can cause serious side effects, including the following:

  • Loss of appetite
  • Upset stomach
  • Constipation
  • Extreme thirst
  • Exhaustion
  • Muscle weakness
  • Restlessness
  • Confusion

Disulfiram

Disulfiram treats alcoholism by discouraging relapse. If a person drinks alcohol while taking disulfiram, the person will experience unpleasant side effects, including flushing, headache, nausea, vomiting, chest pain, weakness, blurred vision, confusion, sweating, difficulty breathing, and anxiety. These effects usually begin about 10 minutes after drinking alcohol, and they can last for over an hour. Disulfiram does not treat withdrawal or prevent cravings, but instead acts only to discourage drinking.

Adherence to this treatment tends to be low, so it is usually most successful among people who are highly motivated to stop drinking, and therefore more likely to take the medication as prescribed. Success with this medication generally increases if it is administered in a doctor’s office, thereby ensuring that the medication is being used.

Side effects of disulfiram include:

  • Rash
  • Acne
  • Headache
  • Drowsiness
  • Impotence
  • An odd taste in the mouth

Some people do not react well to disulfiram. The following side effects require immediate medical attention:

  • Exhaustion
  • Muscle weakness
  • Very low energy
  • Loss of appetite
  • Upset stomach and vomiting
  • Yellow skin or eyes
  • Dark urine

The Choice to Use Medications in Treatment

The decision regarding whether or not to take medications in recovery is an individual one that should be made in consultation with a client’s supervising physician. Oftentimes, medications may be used in early recovery in combination with other therapies, and then the client is gradually weaned off the medication over time. Medication, in and of itself, never constitutes adequate addiction treatment; it should only be used in combination with comprehensive therapy.