Substance Use Disorder
Medication Treatment Options

Toward Recovery.

The use of medications, in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders. Medications used are approved by the Food and Drug Administration (FDA) and are clinically driven and tailored to meet each patient’s needs.

Research shows that a combination of medication and therapy can successfully treat substance use disorders, and for some medications can help sustain recovery. Medications are also used to prevent or reduce opioid overdose.

The ultimate goal is full recovery, including the ability to live a self-directed life. This treatment approach has been shown to:

  • Improve patient survival

  • Increase retention in treatment

  • Decrease illicit opiate use and other criminal activity among people with substance use disorders

  • Increase patients’ ability to gain and maintain employment

  • Improve birth outcomes among women who have substance use disorders and are pregnant

Research also shows that these medications and therapies can contribute to lowering a person’s risk of contracting HIV or hepatitis C by reducing the potential for relapse. Learn more about substance misuse and how it relates to HIV, AIDS, and Viral Hepatitis. The FDA approved several medications to treat alcohol use disorders (AUD) and opioid use disorders (OUD). These medications relieve the withdrawal symptoms and psychological cravings that cause chemical imbalances in the body. Medications used are evidence-based treatment options and do not just substitute one drug for another.

Medications for Alcohol Use Disorder (MAUD)

Acamprosate, disulfiram, and naltrexone are the most common medications used to treat alcohol use disorder. They do not provide a cure for the disorder but are most effective for people who participate in a treatment program.  I prescribe these medications.

I administer Vivitrol injections( intramuscular extended release naltrexone)  monthly on site.  Visit the Vivitrol website for more information. 

Medications for Opioid Use Disorder (MOUD)

Buprenorphine, methadone, and naltrexone are the most common medications used to treat opioid use disorder (OUD). These medications help normalize brain chemistry, block the euphoric effects of alcohol and opioids, relieve physiological cravings, and restore normal body functions without the harmful effects of the substances. They are effective in treating OUD related to short-acting opioids such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone.

I prescribe Buprenorphine and Naltrexone to treat OUD.  I also administer Sublocade injections.

Benzodiazepine Tapers

Benzodiazepines (Xanax, Valium, Klonopin, Ativan, etc.) are used in psychiatry for alcohol withdrawal and panic disorder, where they are used appropriately in an evidence-based fashion.

These drugs can play a role in psychiatry but should always be in a “supportive” and “emergency” role in care and should not become the everyday “workhorse” in someone’s treatment regimen.  However, these medications, when used REGULARLY AND FOR LONGER PERIODS OF TIME, can cause the user to develop a psychological and physical dependence.

There are many adverse effects to your mind/mood by taking these medications consistently and long-term.  If you have become dependent on high-dose benzodiazepines, I will help you slowly taper off of them (over years and not months).  I use the Ashton Method to taper. 

Signs of Dependency

1. They have taken benzodiazepines in prescribed "therapeutic" (usually low) doses for months or years.

2. They have gradually become to "need" benzodiazepines to carry out normal, day-to-day activities.

3. They have continued to take benzodiazepines, although the original indication for prescription has disappeared.

4. They have difficulty in stopping the drug, or reducing dosage, because of withdrawal symptoms.

 5. If on short-acting benzodiazepines, they develop anxiety symptoms between doses, or get cravings for the next dose.

6. They contact their doctor regularly to obtain repeat prescriptions.

7. They become anxious if the next prescription is not readily available; they may carry their tablets around with them and may take an extra dose before an anticipated stressful event or a night in a strange bed.

8. They may have increased the dosage since the original prescription.

9. They may have anxiety symptoms, panics, agoraphobia, insomnia, depression and increasing physical symptoms despite continuing to take benzodiazepines.