Medications for Substance Use Disorders
The Food and Drug Administration (FDA) has approved several different medications to treat Alcohol and Opioid Use Disorders. These relieve the withdrawal symptoms and psychological cravings that cause chemical imbalances in the body. Medications used for treatment are evidence-based treatment options.
Some of the medications used as part of a treatment protocol are controlled substances due to their potential for misuse. Drugs, substances, and certain chemicals used to make drugs are classified by the Drug Enforcement Administration (DEA) into five distinct categories, or schedules, depending upon a drug’s acceptable medical use and potential for misuse. Learn more about DEA drug schedules.
Acamprosate, disulfiram, and naltrexone are the most common drugs used to treat alcohol use disorder (AUD). They do not provide a cure for the disorder but are most effective in people who participate in a MAT program.
- Acamprosate – is for people in recovery, who are no longer drinking alcohol and want to avoid drinking. It works to prevent people from drinking alcohol, but it does not prevent withdrawal symptoms after people drink alcohol. The use of acamprosate typically begins on the fifth day of abstinence, reaching full effectiveness in five to eight days. It is taken in tablet form three times a day.
- Disulfiram – treats chronic alcoholism and is most effective in people who have already stopped drinking alcohol or are in the initial stage of abstinence. Taken in a tablet form once a day, disulfiram should never be taken while intoxicated and it should not be taken for at least 12 hours after drinking alcohol. Unpleasant side effects (nausea, headache, vomiting, chest pains, difficulty breathing) can occur as soon as ten minutes after drinking even a small amount of alcohol.
- Naltrexone – blocks the euphoric effects and feelings of intoxication and allows people with alcohol use disorders to reduce alcohol use and to remain motivated to continue to take the medication, stay in treatment, and avoid relapses.
To learn more about medications for AUD view Medication for the Treatment of Alcohol Use Disorder: A Brief Guide and TIP 49: Incorporating Alcohol Pharmacotherapies Into Medical Practice.
Buprenorphine, methadone, and naltrexone are used to treat opioid use disorders (OUD) to short-acting opioids such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone. These medications are safe to use for months, years, or even a lifetime. As with any medication, consult your doctor before discontinuing use.
- Buprenorphine – suppresses and reduces cravings for opioids.
- Methadone – reduces opioid cravings and withdrawal and blunts or blocks the effects of opioids.
- Naltrexone – blocks the euphoric and sedative effects of opioids and prevents feelings of euphoria.
To learn more about medications for OUD view TIP 63: Medications for Opioid Use Disorder.
Opioid Overdose Prevention Medication
Naloxone saves lives by reversing the toxic effects of overdose. According to the World Health Organization (WHO), naloxone is one of a number of medications considered essential to a functioning health care system.
- Naloxone – used to prevent opioid overdose, naloxone reverses the toxic effects of the overdose.
Under federal law 42.CFR 8.12, patients receiving treatment in Opioid Treatment Programs (OTPs) must be able to receive counseling, along with medical, vocational, educational, and other assessment and treatment services. Learn more about these treatments for substance use disorders.
Regardless of what setting medication is provided, it is more effective when counseling and other services are available to provide patients with a whole-person approach and to support their recovery.
Co-Occurring Disorders and Other Health Conditions
The coexistence of both a substance use disorder and a mental illness, known as co-occurring disorders, is common among people with Substance Use Disorders. In addition, individuals may have other health related conditions such a hepatitis, HIV and AIDS.
Training and Resources
SAMHSA offers tools, training, and technical assistance to practitioners in the fields of mental health and substance use disorders. Find information on SAMHSA training and resources.
Source: Substance Abuse and Mental Health Services Administration; U.S. Department of Health and Human Services
Retrieved 3/4/2023 from https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions
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