Most experts agree that therapy is the key to dealing with an addiction, but sometimes it’s hard for people with addictions to handle the demands of therapy sessions.
They may be so distracted by cravings that they can’t concentrate on the lessons in each class. Or, they may be unable to fight off cravings at all, so they relapse to drug use before they’ve even started to develop healthier habits.
It’s a serious problem, and there may be a novel way to handle it. The solution may be a medication known as naltrexone. This medication has the potential to help amend the chemical signals that make an addiction both possible and persistent.
It’s true that some people with addictions heal quite nicely without the help of any medications at all. But it’s also true that some drugs come with such severe damage that recovery can be difficult, unless there’s a little boost involved.
Researchers quoted by the Washington Post say that these chemical changes are very difficult to overcome. For example, in studies done on animals, researchers associated a light with a hit of drugs. Researchers then did studies on how the animals’ brains responded to that light. They found that portions of the brain that are touched by drugs fire up when the light is provided, long before the drug arrives. That change is remarkably persistent, so it’s hard for the animals to behave in any other way. Their brain cells respond to the light. That’s a cue for cravings.
The same process happens in people with addictions, but their cues may have nothing to do with light. For heroin users, brain cells may light up when they see needles, powder, or people they once took drugs with. For people with alcohol addictions, the triggers may involve ice rattling in a glass. Those cues spark brain changes that are almost impossible to ignore.
People with addictions may desperately want to change the way in which they respond to drugs and drug cues. They may have long lists of all the goals they’d like to accomplish and all the reasons that support sobriety.
But they may also have brain changes that undermine their plans. Unless those brain changes can be addressed, relapse will always be a possibility. Medications like naltrexone may help.
The Substance Abuse and Mental Health Services Administration (SAMHSA) says that naltrexone is an opioid agonist. That means this medication attaches to the receptors a drug like heroin might use, but the reactions naltrexone can deliver are very different than those heroin can deliver. Instead of sparking euphoric changes, naltrexone blocks any changes from happening at all.
To people accustomed to taking heroin, this could be a game changer. Instead of feeling happy, sedated and high with a dose of heroin, users may feel nothing at all. The drug has the ability to chip away at the reward system the brain expects. Those cells that are wired to demand a happy response to heroin may learn to expect nothing from the drug, and that could make heroin cravings drop.
While scientists clearly understand how naltrexone works in people who take heroin, they’re not quite sure why it helps people with alcohol addictions. It’s possible that opioid receptors play a role in a cascade of reactions alcohol can trigger, SAMHSA says, and that could explain why it tends to make alcoholic people more likely to stay sober. They, too, might find their drug of choice less rewarding when naltrexone is in play.
The goal of naltrexone treatment, SAMHSA says, is to help people with addictions to achieve a healthy state of mind that’s free of drug-induced highs and lows. Rather than feeling worried and concerned about drugs all of the time, naltrexone can free up a person’s mind, so he/she can focus on the long-term work needed in order to recover from an addiction issue.
While naltrexone has the capability of helping many people with addictions to alcohol and/or heroin, it’s not a drug that’s custom-made for every single person with an addiction. For example, the drug is typically provided in doses and the efficacy of the drug does wear off in time. People with a very low level of commitment to recovery might take heroin between their naltrexone doses, and they might still find the drug rewarding when the naltrexone isn’t active.Also, when naltrexone wears off, it exposes those heroin receptors once more. If a person has a great deal of heroin molecules floating in the blood, those molecules could latch onto all of the exposed receptors, and when that happens, a relapse could take hold.For these reasons, naltrexone is best provided either to people who have a strong desire to change or to people who have some kind of support that can ensure their compliance with treatment. People enrolled in a treatment facility, for example, might be able to skirt these risks, as they’ll have around-the-clock staff to help.Also, naltrexone doesn’t seem to work indefinitely for people with alcohol disorders. For example, in a study of 145 patients, researchers found that the medication worked best in people who had a drinking relapse very early in the treatment process. Those who had already achieved some kind of sobriety before they started naltrexone treatment didn’t get a bigger boost from the medication. That seems to suggest that the drug won’t help people over the long-term. It’s best thought of as a medication that helps the brain to make a shift in the very early stages of the recovery process.Addictions can also come with a score of mental illnesses, including:
Naltrexone isn’t meant to assist with these illnesses. For example, in a study highlighted in Psychiatric Times, researchers found that naltrexone couldn’t control bipolar disorder. This is a medication made for addictions, not mental illnesses.
People with mental illnesses may find that naltrexone helps them to boost their sobriety, so they can learn to gain control over mental illness. For these patients, the naltrexone might not be treating the illness overtly, but its impact could touch on the mental health disease process.
A researcher quoted in a piece published by NPR suggests that there’s no data about the efficacy of using naltrexone alone in order to tackle an addiction. It’s possible that some people could overcome an addiction with the help of pharmaceuticals alone, but the current research doesn’t really support that approach.
Instead, most experts recommend combining naltrexone with proven therapies that can help people to deal with an addiction. Putting psychotherapy in combination with naltrexone has the proven ability to assist people with an addiction. For example, in one study, researchers found that pairing naltrexone with psychotherapy helped people to avoid early relapse. Presumably, that meant they stayed in therapy for a longer period of time as a result. The drug didn’t cure their addiction, but it gave the therapies they’d use to cure an addiction more time to work.
If you’re a good candidate for naltrexone therapy, your team might provide the medication during the very early days of your recovery. The medication might help you to steer clear of an early relapse, and it might help to break the allure of drugs for your healing mind. Then, as you grow stronger in therapy and more capable of resisting the craving to use, you might find that you don’t need naltrexone, and you can work with your doctor to determine when and how to quit.
Stopping the drug without the approval of your treatment team isn’t smart, as you might feel more confident about your healing than you should be. Your team can advise you on the best way to heal and the best tools to use. Naltrexone may be just what you need to heal, or there may be another medication that would work better. Your team can help you to make the right decision so you can move forward with your sober life.
If you’d like to get in touch with a team that can help you with your addiction and any mental illnesses that complicate your recovery, please call. We have resources made just for people like you, and we’re happy to put you in touch with teams that can help. Just call and we’ll tell you more.
Integrated Treatment of Substance Abuse & Mental Illness