Treatment of Drug Addiction

Evidence does not exclude the participation of psychogenic factors in the modification of the opiate abstinence syndrome (6). The reaction of the subject to his discomfort and to the meaning of withdrawal of drugs certainly contributes to the total picture of abstinence. Addicts with the same degree of physical habit react to the discomfort of withdrawal with widely different degrees of mental intensity. The hypothesis that withdrawal symptoms are entirely psychic is not tenable in view of the definite abstinence syndromes which have been produced in various lower animals and in view of the work of Wilder with chronic spinal and decorticated dogs. Wikler s results indicate that some components of physical dependence still develop under conditions where they can have no symbolic significance for the animal. These components are definitely nonmental (noncerebral). 

Withdrawal is the least important part of the treatment of drug addiction, and it should be accomplished in the quickest, smoothest, and most humane manner possible. Many patients are extremely apprehensive of treatment and expect to suffer more intensely than they actually will and 

Due to the intense study of the problem of drug addiction, the methods of treatment are improved annually. Substitution of the administration of methadone for morphine followed by withdrawal from methadone is a recent advance in withdrawal therapy. Methadone suppresses the signs of abstinence from morphine and, during rapid withdrawal of methadone, the signs of abstinence are milder than those observed during rapid withdrawal of morphine. 

Only about 25 % of the Lexington patients were able to benefit by other than coercive treatment. The remainder were persons whose characters had been so disordered from childhood that they have never grown up and made mature adjustments or established the proper relationships with other persons. Voluntary patients frequently leave the hospital prematurely and against medical advice. 

Withdrawal schemes which involve purgation, hyoscine, belladonna, lecithin, blisters, auto-hemotherapy, and hypnosis are valueless and some are dangerous. Insulin was valueless in preventing or ameliorating abstinence signs and it increased the discomfort of addicts undergoing withdrawal. Abrupt withdrawal is seldom used since it carries a small risk of death and because it is unnecessary and cruel. Sudden or too rapid withdrawal may cause death but unwise treatments have contributed to most withdrawal deaths (6). 

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Treatment of drug addicts can be sqDarated into two phases detoxification and relapse prevention. Detoxification programs and treatment of physical withdrawal symptoms, respectively, is clinically routine for most drugs of abuse. However, pharmacological intervention programs for relapse prevention are still not veiy efficient. 

Cousins, M. S., Roberts, D. C., and de Wit, H. (2002) GABAb receptor agonists for the treatment of drug addiction a review of recent findings. Drug Alcohol. Depend. 65, 209-220. 

The treatment of drug addiction has become big business. Private treatment centers charge thousands of dollars a week to get people off cocaine, alcohol, marijuana, narcotics, and tranquilizers Twelve-step programs modeled on Alcoholics Anonymous have proliferated m all cities, and special programs now exist to treat the relatives of dependent persons — Adult Children of Alcoholics and Codependents Anonymous, for example. Despite the boom in the treatment industry, the rate of addiction has only increased. 

The Alcoholism Report. (1993). Drug czar calls for treatment of drug addicted criminals. The Alcoholism Report, 21, 6-7. 

Shippenberg TS, LeFevour A, Chefer VI (2008) Targeting endogenous mu- and delta-opioid receptor systems for the treatment of drug addiction. CNS Neurol Disord Dmg Targets 7 442 153... 

Siegel S, Ramos BM (2002) Applying laboratory research drug anticipation and the treatment of drug addiction. Exp Clin Psychopharmacol 10 162-183... 

Peptization therapy is certainly indicated in the treatment of drug addiction. 

Naltrexone (trade names Revia , Vivitrof , Nemexin is a pure opioid antagonist like naloxone, however with a more pronounced and longer-lasting effect. It has sufficient oral bioavailability to be used for the treatment of drug addicts. Its synthesis proceeds in an analogous manner to that of naloxone. 

It is noteworthy that the identification and treatment of drug-addicted mothers early in pregnancy has resulted in great reduction in the harmful effects of the addiction on infants. 

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