Addiction Medicine

Addiction Medicine

Substance abuse treatment is a medical specialty that deals with the diagnosis, prevention, evaluation, treatment, and recovery of those suffering from substance abuse disorders as well as people who show unhealthy use of substances such as alcohol, nicotine, prescription medicine, and other illicit and licit drugs. 

Substantial aspects of addiction are found within a number of other fields, including public health, psychology, social work, mental health counseling, psychiatry, internal medicine, and so on. 

Addiction medicine involves many different processes, such as detoxification (detox), rehabilitation, abstinence-based treatment, group therapy, individual therapy, withdrawal treatment, and long-term therapies that help reduce the chance of experiencing a relapse.

Specialists with additional expertise in family medicine or internal medicine may also provide treatment for diseases commonly associated with substance abuse, such as hepatitis and HIV infection.

Why is the Field of Addiction Medicine Important?

The nation’s largest preventable health problem is unhealthy substance use and addiction, yet only about 10% of patients receive treatment for it. 

By recognizing that addiction is a preventable, treatable disease and providing patients with access to credentialed physicians, this new subspecialty will help eliminate the personal and public health consequences and stigmas associated with addiction. 

In addition, it provides physicians with rewarding career opportunities, recognizes their expertise, and provides access to science-based prevention and treatment for patients, families and communities.

What Types Of Addictions Can Be Treated With Addiction Medicine?

Addiction medicine physicians treat a wide variety of addictions and substance use disorders (SUDs), and some specialize in specific types of addiction, in the same way that some cardiologists specialize in interventional cardiology and others specialize in heart failure. 

Here are the three most common types of addiction:

Tobacco Use Disorder

First, a physician specializing in addiction medicine diagnoses tobacco use disorder, assesses its severity, and then recommends treatments. 

In the treatment of tobacco use disorder, motivational interviewing is typically used to help patients set their own treatment goals.

The following treatments may be used to treat tobacco use disorder:

  • Cognitive behavioral therapy
  • Mutual support
  • Nicotine replacement therapy
  • Pharmacotherapy, such as varenicline and bupropion
  • Combinations of the above

Alcohol Use Disorder

An addiction medicine physician first diagnoses alcohol use disorder, assesses its severity, and then offers treatment. 

When a patient has alcohol use disorder, it’s vital to determine if they need acute medical stabilization and withdrawal services, otherwise known as detoxification. 

Providers can assist in arranging these services in a monitored inpatient setting, if needed. 

When the person has safely completed medical detoxification, he or she can start planning for the next step in therapy. 

The use of medications to treat alcohol use disorder is quite effective and should be offered to patients.

FDA-approved medications for alcohol use disorder include:

  • Acamprosate
  • Disulfiram
  • Naltrexone


Group and individual therapy, like Alcoholics Anonymous or Smart Recovery, are other treatment options.

Opioid Use Disorder

An addiction medicine physician first diagnoses opioid use disorder, assesses its severity, and then recommends treatment options. 

Treatment for opioid use disorders, the prevention of opioid withdrawal, reducing the risk of communicable diseases, reducing relapses, and retaining people in treatment can be achieved with a number of life-saving and effective medications. 

Standard medications include:

  • Buprenorphine
  • Methadone
  • Naltrexone


Educating patients about topics such as naloxone overdose prevention and safe injection practices, among other interventions, can reduce a patient’s use of opioids and prevent death. 

Peer recovery assistance, mutual support from groups such as Narcotics Anonymous or Heroin Anonymous, and formal addiction treatment are also available to patients.

Medical treatment can ease the difficult aspects of the treatment process and help those in recovery to stay sober. 

Most people who try to give up drugs or alcohol relapse because they can’t handle withdrawal symptoms.

Certain medications can mimic the effects of addictive drugs, relieving withdrawal symptoms and cravings.

Inpatient or outpatient rehab programs may prescribe medications for addiction treatment. 

To help individuals with a substance use disorder (SUD) achieve sobriety, doctors may adjust dosages during treatment.

Drug Withdrawal And Detox

The body must rid itself of drugs during the first stages of recovery. 

The process is called detoxification. 

Depending on the drug, detoxification can last several days or several weeks. 

The most challenging part of detox is coping with withdrawal symptoms. 

Ex-drug users experience many unpleasant side effects during detox. 

These may include:

  • Anxiety
  • Depression
  • Muscle aches
  • Nausea
  • Seizures
  • Sweating


To treat different withdrawal symptoms, different medications are used. 

Among the drugs prescribed by doctors when detoxing are:

Benzodiazepines

Drugs like these reduce anxiety and irritability. 

Many drugs, including cocaine and opiates like heroin, can cause anxiety during withdrawal. 

Benzos have a sedative effect, which eases alcohol withdrawal symptoms. 

Benzos are addictive, so doctors are cautious about prescribing them.

Antidepressants

A drug addict cannot produce natural amounts of chemicals that induce happiness in their brain. 

Because they have been dependent on drugs to induce happiness for so long, people in detox are often depressed. 

Zoloft and Prozac are antidepressants that can ease these feelings until the brain is able to produce happiness-inducing chemicals on its own again.

Clonidine

Clonidine reduces sweating, cramps, muscle aches, and anxiety caused by alcohol and opioid withdrawals. 

The medication can also stop seizures and tremors.

The severity of withdrawal symptoms varies with past drug use. 

The most severe symptoms are experienced by those who took drugs at high doses for an extended period of time.

Detoxing from Benzodiazepines (Valium, Xanax, etc.) or alcohol can be deadly, so people with these addictions should never give them up cold turkey. 

Even though withdrawals from other drugs aren’t always life-threatening, complications can still occur. 

With the help of medical professionals, detox can be a safe, successful process.

Alcohol Addiction Medications

Regularly abusing alcohol can prolong withdrawal symptoms, which can last from weeks to months. 

In medical terms, this is known as prolonged or post-acute withdrawal syndrome (PAWS). 

PAWS can be relieved with maintenance therapy, and it may also curb cravings or make a user incapable of consuming alcohol. 

The medication usually comes in the form of a tablet that is taken daily.

There are several medications available to treat alcoholism:

Naltrexone (Vivitrol)

In the brain, naltrexone blocks the receptors that produce alcohol’s pleasurable effects. 

It also suppresses the desire to drink. 

Naltrexone can bring on headaches or nausea. 

It is administered by injection every 4 weeks.

Acamprosate (Campral)

Addiction to alcohol causes emotional and physical distress, which is relieved by this medication. 

Acamprosate can be used by recovering alcoholics after they have completed detox. 

Acamprosate prevents negative emotions such as anxiety and depression from causing the desire to drink.

Disulfiram (Antabuse)

Disulfiram was the first medication approved for treating alcoholism. 

When a person taking Disulfiram drinks, it creates side effects such as nausea and vomiting. 

The idea is that those who take Disulfiram won’t drink if it makes them sick.

Heroin And Opiate Addiction Medications

Opiates include heroin, morphine, and narcotic painkillers, such as oxycontin. 

Treatment for opiate and heroin addiction eases withdrawal symptoms. 

The medication is usually taken in tablet form every day. 

Withdrawal from heroin and opiates can last up to a week for some people. 

Others may experience long-term withdrawal symptoms. 

In some cases, withdrawal symptoms can last for months or years. 

Replacement medication can reduce cravings and PAWS. 

Former users can usually continue to take medications for as long as necessary.

Heroin and painkiller addiction medications include:

Methadone

Methadone is an opiate used to treat moderate to severe opiate addictions. 

Methadone binds to the same receptors in the brain as heroin and painkillers, but it doesn’t get the user high. 

As a result, cravings and withdrawal symptoms are reduced. 

Methadone should be used with caution because some people have become addicted to it in place of heroin. 

Methadone clinics dispense the drug on a daily basis in order to prevent abuse.

Buprenorphine (Suboxone)

Buprenorphine works in a similar way to methadone, but is less closely regulated because it has a lower potential for addiction. 

Users of buprenorphine can often take the drug home with them rather than going to a clinic every day to obtain it.

Naltrexone

The effects of naltrexone on drug addiction are very similar to those that it has on alcohol addiction – it reduces the desire to use drugs. 

Because alcohol and opioids activate some of the same receptors in the brain, it works for both addictions.

Medical Detox And Rehab

Some people decide to detox themselves on their own. 

Besides being more difficult, this is also more dangerous than detoxing with a doctor. 

The best way to get sober in a safe, comfortable environment is through medical detox. 

Those addicted to alcohol or benzos should undergo medical detox.

A supervised detox is the first step in treating any type of addiction.

Taking part in a supervised detox can alleviate health issues. 

The doctor tracks the patient’s heart rate, temperature, breathing rate, and fluid levels. 

Medical professionals provide pain relief if necessary. 

They also adjust any medication dosages according to the patient’s needs and make long-term medication plans. 

Medical detox is also necessary for those with separate health issues. 

For example, withdrawal can exacerbate high blood pressure. 

You can avoid problems that may occur when you attempt to detox on your own by consulting a physician.

Inpatient rehabs often include detoxification. Inpatient rehab generally lasts 30 to 90 days. 

The first week involves close observation during the detox process. 

Other treatments, such as behavioral therapy, are provided as part of rehab. 

Get in touch with a treatment provider if you or a loved one want to explore rehab options.

Addiction Medicine Frequently Asked Questions (FAQ)

For patients with unhealthy substance use or substance-related conditions, Addiction medicine (ADM) physicians provide prevention, evaluation, diagnosis, and treatment. 

ADM physicians also help family members who are affected by the substance use or addiction of a loved one.

During detox, all traces of alcohol and drugs are removed from the body, ensuring that a person is physically stable and ready to begin therapy. 

People who are addicted to alcohol or drugs become accustomed to having these substances in their bodies.

For most users, the initial detox period lasts up to three weeks. 

The symptoms may include intense psychological cravings, anxiety, depression, hunger, fatigue, paranoia, and an abnormally low heart rate.

The liver is the largest organ in the body and plays crucial roles in maintaining homeostasis, including metabolism, glycogen storage, drug detoxification, production of various serum proteins, and bile secretion.

The most common type of substance use disorder in America is alcohol use disorder, fueled by widespread legal access and public acceptance of moderate drinking. 

Many Americans begin drinking from an early age.

Adults with substance use disorders may also have a co-occurring mental illness, like depression, anxiety, or bi-polar disorder, and use drugs or alcohol to cope with their symptoms. 

A family history of addiction may also lead to a substance use disorder.

Consuming the substance in greater amounts or for longer than recommended, having trouble cutting back or stopping use, and spending a lot of time getting, using, or recovering from a substance are all signs of a substance use disorder.