Addiction Treatment Medications
Pursuing New Medications
In recent years, people from all walks of life have sought treatment for addiction to powerful narcotic pain-relieving medications, such as OxyContin and Vicodin, that they have abused outside of a medical regimen. These medications share many properties with heroin, which currently ensnares more than a million people nationwide in the web of addiction. Those who become addicted to legal painkillers or street opiates now have a new medication to help them reclaim their lives. Approved by FDA in 2002, buprenorphine joins two other approved opiate treatment medications–methadone, used in long-term treatment, and the NIDA-developed opiate blocker naltrexone, used to help patients remain drug-free after they have stopped using opiates.
Buprenorphine is the first medication for opiate addiction treatment that can be prescribed by private physicians in offices and clinics. Use of this medication in mainstream medicine should help reduce the stigma still associated with drug abuse treatment, while encouraging more patients to seek treatment for addiction to heroin and other opiates. NIDA also is pursuing medications for cocaine and methamphetamine abuse and addiction, for which no medications are yet available. To fill this void, the Institute is applying the same scientific medications development methodologies that put effective opiate treatment medications into the hands of clinicians and their patients.
On one research track, clinical researchers are screening medications previously approved to treat other disorders. In these small-scale trials, several agents have appeared to weaken the addictive cycle of drug-craving, drug-seeking, and drug-taking. Among them are amantadine (currently used for Parkinson’s disease), disulfiram (Antabuse), baclofen (an antispasticity agent), tiagabine and topiramate (antiepileptics), and modafinil (used in narcolepsy). Disulfiram and naltrexone, both effective in treating alcoholism, may fill a critical need for medications that can help cocaine-abusing individuals who also abuse alcohol. Propranolol, a medication used to lower blood pressure, may help substance abuse patients stay the course during the critical early days of treatment, by alleviating their unpleasant withdrawal symptoms. Researchers are now conducting larger, longer studies to confirm these encouraging results. Because the medications work by a variety of different mechanisms, some of which may complement each other, researchers also will examine whether they may be more effective in combination than alone. Some may also work optimally with specific behavioral therapies.
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