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Detoxification can be a challenging process, as withdrawal symptoms can be very uncomfortable, and for some substances, withdrawal may even be life-threatening. Doctors in inpatient and outpatient rehab will sometimes prescribe medications to ease the process of withdrawal, reduce cravings, and support early addiction recovery efforts.
- Addiction medication often either mimics the effects of a substance or works to counteract its effects. Both types of medication can reduce cravings, but drugs that mimic the effects of a substance also tend to reduce symptoms of withdrawal.
- Medication-assisted treatment (MAT) can help manage some of the more uncomfortable effects of withdrawal.
- For people addicted to alcohol or benzodiazepines, withdrawals can be dangerous or even life-threatening.
How medications help with addiction treatment
Medication can help during the stages of alcohol and drug addiction treatment. Medication can be especially helpful to people in early recovery because it can help ease symptoms of withdrawal and reduce cravings. This can substantially lower the relapse risk for people in the first weeks and months of sobriety.
Addiction medication often either mimics the effects of a substance or works to counteract its effects. Both types of medication can reduce cravings, but drugs that mimic the effects of a substance also tend to reduce symptoms of withdrawal. Sometimes, these types of addiction medications are also addictive in some way, which can make it difficult to stop using them.
Drugs that counteract a substance can cause unpleasant symptoms if a person decides to use the substance, helping to deter use. For example, Antabuse is a medication that deters alcohol use by causing symptoms such as nausea and vomiting if alcohol is consumed. Other medications, like Naltrexone, can block the effects of a drug, such as heroin or morphine. This prevents the feeling of ‘reward’ associated with using these drugs. [1]
Medications will often be prescribed as part of an inpatient or outpatient rehab program. Doctors will review medications throughout treatment, making adjustments to the dosage if necessary.
Medications used in detox and withdrawal
The first stage of addiction recovery is to purge the body of any drugs or alcohol in the system. This process is called detox, and it can involve experiencing withdrawal symptoms that may last a week or longer. Withdrawal symptoms can be mild, moderate, or severe, depending on various factors, including the type of substance and the dosage, frequency, and duration of use.
For people addicted to alcohol or benzodiazepines, withdrawal can be dangerous or even life-threatening. Withdrawal from other types of drugs, such as cocaine or even opioids, may be less dangerous, but can still cause unpleasant and uncomfortable effects, which may include: [2]
- Anxiety, irritability, depression, or mood swings
- Nausea, vomiting, stomach cramps, diarrhea, or gastrointestinal upset
- Muscle aches, cramps, and soreness
- Insomnia, feeling tired or fatigued, and trouble focusing
- Sweating, hot and cold chills
- Strong urges and cravings to use
Medications for detox
There are a wide range of medications used to treat these withdrawal symptoms. The type of medication prescribed will depend on the individual’s symptoms and what substances they are addicted to. Commonly used medications include:
| Medication class/type | Purpose/Benefits | Comments |
|---|---|---|
| Opioid medications | Reduce withdrawal symptoms and cravings | Some types can cause or worsen withdrawal symptoms if taken alongside an opioid, so should only be used once the individual is abstinent |
| Nicotine replacement therapy | Reduces withdrawal symptoms and cravings | Different types available, patch, lozenge, inhalator |
| Alcohol antagonists | Deters alcohol consumption by causing unpleasant effects if alcohol is consumed | Can be dangerous if used with alcohol, so only to be used by people who remain abstinent |
| Benzodiazepines | Can help reduce agitation, insomnia, and other withdrawal symptoms associated with various substances | Can cause dependence and oversedation, short-term use is recommended |
| Antidepressants | Can help reduce mood changes caused by detox and withdrawal. Some types of antidepressants may be beneficial in reducing cravings. | Can cause anxiety, suicidal ideation, and insomnia, particularly at the start of treatment |
| Alpha-2 adrenergic agonists | Clonidine and lofexidine can be used to help reduce withdrawal symptoms of various substances | Shouldn’t be used by people with low blood pressure |
| Overdose reversal medications | Medications can be used to reverse the effects of a substance overdose | Can cause the onset of withdrawal symptoms |
Certain medications may not be appropriate for all people and are often recommended to be used in combination with therapy, such as cognitive-behavioral therapy, or other forms of addiction treatment. While medications can ease withdrawals and cravings and help people in recovery, medication alone cannot cure addiction. [1]
Medication by substance type
Different types of medications are used to treat substance use disorders based on the specific substance involved. These medications target withdrawal symptoms, cravings, and relapse prevention to support recovery efforts.
Alcohol use disorder medications
Medications for alcohol use disorder help individuals reduce cravings, manage withdrawal symptoms, and maintain abstinence. Some drugs work by deterring alcohol consumption, while others reduce the rewarding effects of drinking. [4][5]
| Medication | Brand names | Classification | Benefits | Uses | Side effects |
|---|---|---|---|---|---|
| Acamprosate | Campral | Other | Reduces withdrawal symptoms and cravings. Improves abstinence | People with alcohol dependence and liver damage | Dry mouth, dizziness, anxiety, stomach upset |
| Disulfiram | Antabuse | Alcohol antagonist | Helps maintain abstinence by causing unpleasant effects when alcohol is consumed | People who have already stopped drinking alcohol and are committed to abstaining | With alcohol consumption – headache, nausea, vomiting, anxiety, shortness of breath |
| Naltrexone | Revia, Vivitrol | Opioid antagonist | Decreases feeling of pleasure associated with consuming alcohol, reducing cravings | People with alcohol use disorder who need help to stop drinking | Nausea, headache, fatigue, vomiting, anxiety, dizziness |
| Topiramate (off-label) | Topamax, Trokendi XR, Qudexy XR | Antiepileptic | Can help reduce desire to drink alcohol | People who want to reduce alcohol consumption, may help with weight loss | Decreased appetite, trouble with speech, nausea, dizziness, issues with memory and sight, stomach pain |
| Gabapentin (off-label) | Neurontin, Horizant, Gralise | Antiepileptic | Reduces alcohol consumption, and cravings, and improves alcohol-related sleep and mood issues | People with heavy alcohol consumption who want to reduce or stop drinking | Drowsiness, headache, shaking, vision problems, nausea, dry mouth, changes in appetite and weight |
| Varenicline (off-label) | Chantix | Nicotine receptor agonist | Nicotine addiction medication, which can help reduce alcohol consumption; use is controversial | People with alcohol and nicotine addiction | Nausea, stomach issues and pain, dry mouth, appetite changes, insomnia, headaches |
Opioid use disorder medications
Opioid use disorder medications aim to reduce withdrawal symptoms, curb cravings, and prevent relapse. These treatments can be short-term for detox or long-term to support ongoing recovery. [1][2]
| Medication | Brand names | Classification | Benefits | Uses | Side effects |
|---|---|---|---|---|---|
| Naltrexone | Vivitrol | Opioid antagonist | Blocks euphoric effects of opioids, reduces cravings | Short-term and long-term treatment for opioid use disorder, should only be administered after at least 7 days of abstinence from opioids | Drowsiness, headache, nausea, changes in appetite, aches and pains |
| Buprenorphine | Brixadi, Subutex | Opioid antagonist and partial opioid agonist | Blocks euphoric effects of opioids, reduces cravings and withdrawal symptoms | People who have stopped using opioids at least 8 hours prior, short-term and long-term treatment | Stomach issues, drowsiness, dry mouth, aches and pains, insomnia, fever |
| Methadone | Dolophine, Methadose | Opioid agonist | Reduces cravings and withdrawal symptoms | People who can attend a clinic daily for administration, short-term and long-term treatment | Insomnia, anxiety, nausea, dry mouth, sweating, restlessness |
| Naloxone and Nalmefene | Narcan and Revex | Opioid antagonist | Reverses opioid overdose | People who have overdosed on opioids | Opioid withdrawal symptoms |
Stimulant use disorder medications
While no FDA-approved medications currently exist for stimulant addiction, off-label treatments can help reduce cravings, manage withdrawal symptoms, and improve cognitive functioning during recovery. [6]
| Medication | Brand names | Classification | Benefits | Uses | Side effects |
|---|---|---|---|---|---|
| Modafinil (off-label) | Provigil | Stimulant | Reduces cravings and withdrawal symptoms, improves cognitive functioning | People needing help to stop stimulant use and remain abstinent | Headache, insomnia, nausea, stomach issues, dizziness, loss of appetite |
| Bupropion (off-label) | Aplenzin, Wellbutrin | Antidepressant | Reduces the reinforcing effects of stimulants, help reduce use and maintain abstinence | People with low to moderate addiction to methamphetamine | Anxiety, insomnia, drowsiness, dry mouth, headache, nausea, stomach pain, change in appetite and weight |
| Topiramate (off-label) | Topamax | Antiepileptic | Decreases stimulant use, reduces withdrawal symptoms | People stopping stimulant use | Nausea, headache, fatigue, vomiting, anxiety, dizziness |
| Disulfiram (off-label) | Antabuse | Alcohol antagonist | Alcohol use disorder medication found to help decrease cocaine use | People with cocaine use disorder, wishing to reduce use | Headache, drowsiness, impotence, rash |
| Dextroamphetamine/amphetamine, others (off-label) | Dexedrine, Adzenys ER, others | Long-acting amphetamine | Increases abstinence | People with cocaine use disorder, wishing to reduce use, topiramate not effective | Anxiety, fast heart rate, loss of appetite |
Benzodiazepine use disorder medications
Medications for benzodiazepine use disorder focus on safely managing withdrawal symptoms and reducing dependency. Long-acting benzodiazepines or other supportive treatments can be used to taper use gradually. [7][8]
| Medication | Brand names | Classification | Benefits | Uses | Side effects |
|---|---|---|---|---|---|
| Diazepam | Valium | Benzodiazepine | Long-acting benzodiazepine can be used as a replacement to reduce use gradually, with fewer withdrawal symptoms | People addicted to benzodiazepines and using short-acting drugs | Sedation, dizziness, weakness, headache |
| Carbamazepine (off-label) | Carbatrol, Equetro, Epitol | Antiepileptic | Help reduce benzodiazepine use | People tapering off benzodiazepines | Shaking, dizziness, abnormal thinking and speech, dry mouth |
| Flumazenil | Romazicon | GABA receptor antagonist and benzodiazepine antagonist | Prevents withdrawal symptoms, reverses benzodiazepine overdose | For rapid reduction in benzodiazepine use to abstinence or low dose | Sedation, impaired cognition, seizure |
Medications for nicotine dependence
Medications for nicotine dependence help reduce cravings and withdrawal symptoms, supporting individuals who wish to quit smoking. These include nicotine replacement therapies, antidepressants, and other FDA-approved treatments.[9][10]
| Medication | Brand names | Classification | Benefits | Uses | Side effects |
|---|---|---|---|---|---|
| Nicotine replacement therapy (NRT) | NRT | Reduce withdrawal symptoms | To help reduce and stop smoking | Irritation on skin with patch | |
| Bupropion | Wellbutrin | Antidepressant | Reduces cravings and withdrawal symptoms | People wanting to stop smoking | Anxiety, insomnia, drowsiness, dry mouth, headache, nausea, stomach pain, change in appetite and weight |
| Varenicline | Chantix | Nicotine receptor partial agonist | Reduces withdrawal symptoms and cravings and blocks rewarding effects of smoking | People requiring help to reduce and stop smoking | Nausea, stomach issues and pain, dry mouth, appetite changes, insomnia, headaches |
Medical detox and rehab treatment
Some people benefit from an inpatient stay, where they can safely detox from a substance. Medication-assisted treatment (MAT) in a rehab facility is provided as a structured, drug-free program to help detox from drugs or alcohol while managing some of the more uncomfortable effects of withdrawal. For those addicted to alcohol or benzodiazepines, a medically supervised detox is particularly important as withdrawal symptoms can be fatal. [2]
During medical detox, trained physicians will monitor the individual’s heart rate, temperature, fluid level, and respiration. People with co-occurring disorders or underlying physical or mental health issues will receive the appropriate medication to manage these conditions alongside addiction medications, often in conjunction with behavioral therapy. [11]
A medical detox or inpatient rehab stay should be followed up with a long-term outpatient treatment program for addiction. Most inpatient rehab programs last 30 to 90 days, although research shows that a longer treatment duration can provide more benefits. [11]Â
If you or someone you know is suffering from alcohol or drug addiction, contact a treatment center today to find the best options for medical detox.
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