In the second part of this series on Opioids, our blogger analyzes popular medication to treat withdrawal symptoms from opiates, and associated patented medication.
Opioids have been used for centuries as a drug for treating pain. However, despite their benefits, many opiate drugs are married to the side-effect of addiction. Since a few medical conditions demand the need for opiate administration, there has been a lot of research activity to create drugs that can counter addiction.
Detox and Medication-Assisted Treatment
Breaking free from substance addiction almost always starts with detox. Hence, detox is a key area of research focus. Medication-assisted treatment (MAT) employs developed drug(s) as part of the detox and treatment program. These drugs can support behavioral therapies— another major tool in addiction care. MAT is predominantly used to treat addiction to opiates (like heroin) and other opioids (pain pills).
There are three classes of medication commonly used to treat opiate addiction:
- Agonists(i.e. methadone), which fully activates opioid receptors. These drugs have long half-lives and remain in the blood stream for anywhere between 24 and 60 hours. Hence, while they elicit a part reaction associated with prescription opiates, they are devoid of dangerous highs and lows if ingested as prescribed. Methandone reduces cravings without the induction of a meked addictive, thus hastening recovery from withdrawal symptoms.
- Partial agonists(i.e. buprenorphine) activate opioid receptors but not to the same extent as full agonists. This means that its effect disappears after reaching a certain plateau. Its partial effect makes it less capable of eliciting euphoria or sedation found with abused opioids.
- Antagonists(i.e. naltrexone) block receptors and interfere with the rewarding effects of opiates.
These medications treat prescription opiate addiction by working on receptors in a way that is less likely to cause harm. Scientific research has shown that when administered as part of a comprehensive treatment program, these drugs can eliminate withdrawal symptoms and also prevent relapse. It comes with the added advantage of reduced risk of harmful behavior often associated with withdrawal symptoms. While MAT medication is extremely beneficial, it must be taken as prescribed by a physician to prove its positive effect on a patient. A few treatment schedules can run into months, years or even a lifetime, varying from person to person.
New upcoming Treatment options for Opioid dependence
The U.S. Food and Drug Administration (FDA) recently approved Probuphine, a first buprenorphine implant, for treating opioid dependence. Probuphine is designed to provide a constant, low-level dose of buprenorphine for six months in patients who are stable and on low-to-moderate doses of other forms of buprenorphine. This is included as part of a complete treatment program.
Earlier, buprenorphine was only approved as a pill or a film placed under the tongue or on the inside of a person’s cheek until it dissolved. However, the implant method allows for constant release in prescribed doses, making it a more effective method of administration.
In 2015, at least 33,000 people are said to have succumbed to opioids overdose in the U.S. Preliminary data for 2016 suggests there were more than 50,000 opioid overdose deaths. Taking cognizance of this, researchers are working towards developing a vaccine for de-addiction.
Like other vaccines, an opioid inoculation will cue the body to generate antibody proteins associated with fighting diseases. In this case, the vaccine will specifically target opioid molecules. Each vaccine will focus on only one type of opioid. Hence, when an opiate is ingested, a vaccinated person’s body will direct antibodies to bind themselves to the psychoactive metabolites of the drug and prevent it from reaching the brain. This ensures the person doesn’t experience a high or depress breathing. In short, an effective opioid vaccine could potentially save lives. Yet every opioid vaccine effort dating back to the 1970s have still not reached the patients.
Since the effect of a vaccine lasts for several months, the frequency of medication drops giving it an edge over other treatment forms. Besides, vaccines can negate the need for the use of one drug to remove the ill-effects of another – as in the case of methadone or buprenorphine – further reducing concerns of possible addiction to the withdrawal drug.
The most important challenge that the scientists and the regulatory authorities would be looking into these vaccines is that whether these vaccines if approved will be truly effective maintaining a high enough titer of antibodies against the illicit opioid to protect them from the drug.
(Featured image source: https://www.flickr.com/photos/yanivba/505065706)