Category Archives: Naltrexone

What Is Naltrexone

Naltrexone is an opioid treatment medication that works very differently than either methadone or buprenorphine.

Naltrexone functions as an opioid blocker that interferes with the euphoric effects of opiates. Unlike methadone, naltrexone does not eliminate opioid withdrawal. So it is typically only begun following a successful period of opioid detoxification.

Naltrexone is taken as a pill or as a time-released injectable. It blocks the feeling of getting high thus deterring a person from continuing in active drug use with opioids. If there’s no pay off for using, why do it?

Some individuals who don’t necessarily require methadone or buprenorphine can effectively utilize naltrexone as a component of their recovery program. Vivitrol is the time-released, branded version of naltrexone that is taken once monthly as an injection. With Vivitrol, the naltrexone remains active in the bloodstream for 30 days and blocks the effects of heroin or other opiate use. This reinforces one’s focus on recovery choices and can reduce opioid cravings.

Patients receiving naltrexone may develop a lowered tolerance to opioids over time, and should remain aware of the risk of opioid overdose should they relapse. The medication is also used in the treatment of alcohol dependency and has been shown to reduce the euphoric effects of alcohol consumption.

Naltrexone is not to be confused with Naloxone. Naloxone is the opioid overdose reversal medication that has recently been in the news for saving thousands of lives across the country.

21st Century Cures Act

opioid-treatment-fundingThe U.S. House of Representatives just passed a sweeping reform, called the 21st Century Cures Act, that will infuse $1 billion in new funding earmarked for opioid treatment and prevention services.

It has taken several years of alarming statistics on the national opioid epidemic, but Congress has responded. This USA Today article provides an overview of the numbers. In addition to the $1 billion for opioid services will be another $4.8 billion for cutting-edge research around treating Alzheimers, cancer, traumatic brain injury, and other medical issues.

The bill received enormous bipartisan support and passed 392-to-26. In 2016, death by drug overdose surpassed death by car crashes and gun fatalities. The public outcry for government intervention has been steady. With so many families having been affected by addiction issues, the new funding allowance should open doors for opioid treatment particularly in rural areas where opioid services have been severely lacking.

Methadone remains the #1 medication-assisted treatment option. Buprenorphine medications are; however, making a big impact in the treatment field with a wide variety of buprenorphine-based formulations coming to market. In addition to the familiar suboxone film, are probuphine (a buprenorphine implant), subutex (an uncoated buprenorphine tablet), and bunavail.

Stepping Onto The Path of Recovery

the-pathAn important consideration in examining the disease of addiction is the recognition that “recovery” is an incremental process. Many people facing their addiction will experience brief setbacks, and some will struggle for years before they are able to remain on the path of positive change.

As a counselor, I have listened to many recovering individuals talk about their resistance to change. Addiction is a persistent disease of disruptive thinking and behavior highly subject to repetition. Addicts will repeat the same bad “choices” as a result of many factors. Scientific research has shown that habitual patterns of behavior are neurochemically driven deep within the brain. These patterns can be reinforced by one’s social connections, immediate environment, and underlying belief system.

With severe levels of addiction sustained over years, it can become difficult for people to shift their lifestyle, thinking, and decision-making toward a healthy, recovery-oriented mindset. In 12 Step recovery, there is the popular expression called “hitting bottom”. This expression is typically used to describe a specific time in which a person has lost so much, or suffered such a painful crisis, that their readiness for change finally emerges. This window of opportunity is often times short-lived. Hitting bottom will compel some people to finally take the right action – to seek help – to admit they have a problem. If this happens, then a decision to step onto the path of recovery may actually occur.

Active addition is often characterized by a short range view in which consequences are not thoroughly considered. Focusing on consequences interferes with the compulsive desire to use. And even then, a recognition of consequences to oneself and family is often not enough to change the decision to get high. With opiate addiction, the decision to use is overwhelmingly controlled by opiate withdrawal sickness. This never-ending physical sickness takes people away from recovery and keeps them trapped in a desperate existence centered around doing whatever is necessary to avoid being “dope sick”.

Fortunately, this dilemma can be addressed through medication-assisted treatments (methadone, suboxone, naltrexone). These do not replace the need for a recovery program, but they become an important part of one’s overall personal recovery program. Staying on the path of recovery is the next critical phase after stepping onto the path. Medication-assisted treatment greatly aids recovering addicts in staying on the proper path. Science has proven that those with the greatest chance of long-term, successful sobriety are those that remain in treatment and recovery. Said differently, a person’s chance of recovery success is statistically improved the longer they remain in treatment.

When a person no longer has to face the crippling weight of daily withdrawal sickness, they have a chance to re-approach their overall recovery and the opportunities that lie ahead of them.

Opioid Addiction Spiking in Guilford County North Carolina

policeGuilford County is the third most populated county in the state of North Carolina. Located within Guilford County are the cities of Greensboro and High Point – both of which are experiencing a surprising increase in opioid addiction and related overdoses.

The High Point Enterprise news reported that the High Point Vice and Narcotics unit has begun to make a favorable impact on the problem with multiple arrests of those trafficking heroin locally. The article documents that 70 reported High Point opioid overdoses have occurred thus far in 2014 with 9 of those ending in death. Six people were arrested the week of July 14 and are being held on multi-million dollar bonds for their roles in selling or trafficking heroin. To emphasize the local impact, the HP Enterprise reported that 7 overdoses occurred within a 24 hour period on May 16, 2014.

Just 15 miles away in the neighboring city of Greensboro, Rhino Times covered the local explosion in heroin addiction much of which has been driven by individuals turning to heroin when they could no longer obtain prescription opioids like oxycodone. Rhino Times interviewed the Director of Guilford County Emergency Services, Jim Albright, who stated that a particularly strong strain of heroin hit the streets of Greensboro in late April, 2014.

Over the weekend of April 25, the Guilford County EMS responded to an avalanche of calls in response to people overdosing on the new potent version of heroin. Mr. Albright is reported to have identified that 21 overdoses and 5 deaths occurred just in that one weekend. Due to the potency of the drugs, some victims were found with a needle still in their arm.

Highlighted in the article was the life saving properties of Narcan, a drug that quickly reverses the dangerous overdose effects of opiates. Narcan can be administered by injection or squirted into the nasal cavity. As it is absorbed into the body, it restores breathing to those that have overdosed. Narcan is now kept in first responder vehicles, firetrucks, and ambulances. Visit Alcohol & Drug Services for more on Narcan and opioid overdose prevention kits.

For information on methadone as a treatment for opioid addiction, click here.

Medication-Assisted Treatment for Teens and Young Adults

There is increasing momentum building for opioid addiction treatment in response to the growing opioid addiction problem in the United States. Many teenagers and young adults who are being introduced to prescription opiates are at risk for developing a crippling drug dependency. The risk is increased as these youth discover that heroin is a relatively cheaper alternative than pain pills purchased on the street.

The Partnership at DrugFree.org has published a 36 page guide outlining opioid addiction and the therapeutic role that medication-assisted treatment can have even for teens and young adults. Methadone, suboxone, buprenorphine, and naltrexone are highlighted in the guide with an accompanying description of each medication and its use in opioid treatment.

Opioid replacement therapy has historically been used as a treatment of last resort in adult populations. The dilemma is that a high percentage of opioid addicted individuals are unable to remain drug free with traditional models of treatment that do not include medication assistance of some variety like naltrexone, buprenorphine, or methadone. Overcoming opioid withdrawal without effective symptom relief presents a serious obstacle in the recovery process.

The Partnership at DrugFree.org recognizes that the wave of opioid addiction in America is mounting. The news media have been covering this issue too with some regularity over the past year. Effective remedies need to be in place as all ages seek help for opiate addiction. If we are to save lives, the stigma of medication-assisted therapy and the misunderstanding around it must be finally removed.