Modifying Addiction - Agonist + Antagonist Subsitution

Question 1

Agonist

Answer 1

Medication drug that mimic the effect of addictive substance

Methadone mimic opioids (heroin) - bind to dopamine receptor
-without the ‘high’
-no high = reduce withdrawal since do not experience compulsive + disruptive behaviour of heroin user (reduce withdrawal 24-36 hours)

-still addicted to methadone to function
-once withdrawal stabilise using methadone, dosage slowly decrease (detoxification)
-until can stop taking completely (abstinence)

Question 2

Agonist extra detail

Answer 2

Given orally
-no infection + blood vessel damage from needle
-longer effect (more sustainable)

Under supervision for first 3 month every day
-dosage right
-prevention of taking multiple doses
-prevent selling

Question 3

Antagonist

Answer 3

Medication drug that block effect of addictive substance

Naltrexone - occupies + block dopamine receptor from being attached
-if take heroin no high or pleasure
-make drug less rewarding when taken
-help to prevent relapse
-only can use for 6 months after addict completely overcome withdrawal

Also taken orally - prolong effects
Should be used alongside other psychological intervention
May even be effective on behavioural addiction (gambling)

Question 4

Strength effectiveness

Answer 4

Whalen + Remski et al - methadone mimic effect of addictive substance = retain patient, addict prefer feeling = more likely to continue
-Lee et al - methadone adherence rate 82%

Gowing et al - due to long term effect of methadone = reduce physical + social harm related to drug use (pursuing the drugs)
-naltrexone very effective for those highly motivated to quit

Lahti et al - small sample of gambler
-take naltrexone before gambling or when have urge to
-significant decrease in gambling level
-but study included no placebo to compare = need more research

Question 5

Weakness effectiveness

Answer 5

NICE - reviewed 31 reviews of effectiveness on methadone
-although decrease in illegal drug use compared to placebo or control
-increase retention in those taking methadone

Most studies only follow patient up to a year
-common for relapse to occur months or years after abstinence
-research not catch this

Question 6

Ethical strength + weakness

Answer 6

Treat those who can’t have talking therapies
-argue more ethical to treatment them to protect society

Ethical weakness
Side effects - constipation, fast heart beat

Drug addict may be pressured into treatment programme if under prosecution
-Gowing et al - Naltrexone only effective if willing to change

Can also be used to subdue prisoners
-easy way to reduce trouble behaviour than struggle to help them through treatment programme

Question 7

Social implication strength

Answer 7

National treatment agency
-treat heroin user with methadone immediate positive effect on society
-reduce criminality caused by drugs (selling)

Doward
-tax money out into good use in methadone
-if addict can go back to society, contribute to it
-argue Gyngell overestimate fund

Question 8

Social implication weakness

Answer 8

Gyngell - too expensive on economy + patient
-each year methadone course cost £3-5k per person
-cost UK economy £800 million every year
-better use on rehabilitation encouraging abstinence

Not fix root cause
-environment stress or social surrounding
-may even be a root cause
-methadone may be introduced as new drug by addict tight in budget
-addict can’t relapse since no methadone