CH.33 - Pharmocological Interventions for SUDs

Question 1

Are transdermal nicotine patches effective?

Answer 1

MODERATELY EFFECTIVE

• they require about an hour for the blood nicotine levels to peak
• this time delay is inadequate for people trying to quit
• nicotine patch levels often lower than that of smoking a cigarette, thus inducing a “craving” for additional nicotine

Question 2

Why have pharmaceutical companies delayed creating drugs specific to SUDs?

Answer 2

• Pharmaceutical companies have delayed creating specific drugs for SUDs because they believe the market is too limited.
• Most of the pharmaceutical agents currently in use to treat SUDs are compounds originally developed to treat other conditions that were by chance found to also be useful as adjuncts to treating SUDs

Question 3

What is the danger in using a pharmaceutical for SUD treatment?

Answer 3

People can become “enamored” with pills. Their use of these pills might thus be, for at least some substance abusers, an extension of their “addictive thinking” rather than an adjunct to treatment.

Question 4

What are the common medications used to treat alcohol withdrawal symptoms?

Answer 4

• Benzodiazepines (Valium, Ativan, Xanax)

- Carbamazepine (anti-seizure med) (non sedating alternative to benzodiazepines)

Question 5

Is alcohol-disulfiram reaction dangerous?

Answer 5

Yes. Can be fatal

*Disulfiram = causes negative physical effects if combined with alcohol

Question 6

Is the use of naltrexone effective in treatment of SUDs?

Answer 6

No, however there is a use for certain individuals who are known as “reward” drinkers. (these people crave alcohol and experience a profoundly rewarding experience when they drink)

• Naltrexone blocks the “reward cascade” thus reducing the incentive for individuals to consume alcohol.
• 50% relapse within 12 weeks one study found
• many studies have found no benefit of naltrexone use in preventing relapse back to active alcohol use.

Question 7

Is there an effective treatment for amphetamine abuse?

Answer 7

No. At this point, there are no known, reliable, pharmacologic treatments for the use of amphetamine use disorders.

Question 8

Is there an effective treatment for cocaine abuse?

Answer 8

No.

Question 9

What is a pharmacological treatment of opiate overdose?

Answer 9

Naloxone hydrochloride (Narcan)

Question 10

Are “ultra rapid” methods of narcotic withdrawal effective?

Answer 10

• It has shown to be only as effective as traditional methods of opioid detoxification
• Little evidence to suggest that patients who go though this process are more likely to abstain from further opioid abuse than those who are detoxified through traditional methods

Question 11

Is the use of clonidine in opioid withdrawal safe and effective?

Answer 11

• It has been shown to reduce the individual’s withdrawal discomfort and distress.
• Can be dangerous. Can cause abnormally low levels of blood pressure (increase risk of patient falls)

Question 12

What is the history of methadone? Where did it come from?

Answer 12

-Developed by German chemists during WWII for use in battlefield injuries