Analyzing the Treatment of Heroin Addiction

Abstract
The research question was assessing substance abuse treatment effectiveness. This is an important topic because substance abuse is a chronic disorder that many patients are unable to get rid of and this causes social strife and increases criminal activity in the country. Heroin addiction is currently the most abused drug in the country and this trend not only affects the poor but also the will to do individuals in society. It is therefore vital that we address the treatment methods currently being used. We have assessed the various treatment options that are currently available for the treatment of heroin addiction. Methadone, naltrexone, and buprenorphine have been assessed and described in detail offering information on the effectiveness of each drug. We have established that methadone is still the most effective drug for the treatment of heroin addiction. The other two drugs are also effective in their own way, but when compared to methadone there are inferior. The results show that relapse rates are lower with patients who use methadone. Buprenorphine is also effective provided the patient is able to follow the prescribed dosage. The drug also has less potential for abuse as compared to methadone. Therefore, patients who do not have the appropriate social support, and diligence to follow doses should be prescribed for methadone.
Evaluating the Effectiveness of Substance Abuse Treatment
Introduction
The dependence on drugs is a chronic and relapsing disorder that requires specialized treatment. It is difficult to break the dependency cycle, and hardcore drug users will often suffer extreme psychological, economic, physical, emotional, and social pain (Livingston, Milne, Fang, & Amari, 2012). Hardcore drug users are isolated from the society in many ways, and their addiction affects not only them but their families and friends as well. According to Dunn et al. (2010) treatment of drug abuse is considered to be the process of breaking an individual's dependence on illicit drugs like heroin and cocaine or licit drugs like alcohol and prescription medications. Drug abuse treatment is a complex and variable network of services that are tailored to meet the needs of an individual. The underlying understanding in a majority of research is that drug abuse treatment does work. However, identifying how effective a treatment is and for whom is the most difficult task. This is because individuals will react differently to different forms of treatment.
Evaluating the effectiveness of drug abuse treatment begins with an understanding of the hardcore drugs like heroin and cocaine. Heroin is defined as an opioid (a substance that acts upon the opioid receptors) that is mostly used as a recreational drug because of its euphoric effects. Heroin is also medically used in several countries to relieve pain or in opioid replacement surgery. The drug is normally injected into a vein, but it can also be snorted, smoked, or inhaled. The onset of its result is typically rapid and the effects will last for a few hours.
The purpose of this paper is to analyze the effectiveness of the available treatment options for heroin. This will assist in determining if the treatment options being used are working or there is a need for change. The paper is structured in a systematic manner and it begins with the pharmacological treatment options that are available for heroin. Each treatment option is critically analyzed and its effectiveness is presented backed by available research. We will then discuss the most effective treatment option for heroin. Finally, we will end the paper with a conclusion the reiterates the information we have presented in the paper briefly.
Effective Drug Abuse Treatment
It is vital to understand what it means when we say that a treatment option is effective. This is based on the primary goals of any drug abuse treatment. Reducing the use of the primary drug. In order for a treatment to be considered effective, it should be able to reduce relapse time, increase abstinence, reduce the frequency of drug usage, and reduce the amount of drug used in total (Messina, Grella, Cartier, & Torres, 2010). Improving the functioning of drug users in terms of employment refers to increasing the number of days individual works, and improving their performance at work. Improving education status denotes the individual being able to attend school and increasing the individual's attendance in school. This also refers to improving grades and overall performance in school. Improving medical status is determined by a decrease in the number of hospitalizations, emergency room visits, and doctor visits. Improving interpersonal relationships with family, friends, and employers. Improving mental health status, and improving the legal status of the individual.
Pharmacological Treatment of Heroin
There are two main approaches that are employed in the pharmacological treatment for opioid dependence. The first approach is short-term treatment where the addict is detoxified to a drug-free state. The second approach is long-term treatment where the addict is maintained in a legally sanctioned narcotic like methadone. The majority of pharmacological treatment programs make use of the long-term treatment approach, which requires the administration of a medication that is either aimed at replacing the illicit drug or blocking the effects of the drug. In most cases, the medication is administered for at least 1 month, but it can also be administered for several years. This is mostly dependent on individual cases. The medications used in pharmacological treatment are methadone, naltrexone, and buprenorphine.
Methadone
Methadone is considered to be a slow-acting opioid agonist that is taken orally in order for it to reach the brain slowly, which dampens the high that would occur with other routes of administration. Methadone is an effective substitute for heroin, codeine, morphine, and other opiate derivatives. All opiates act quickly and they wear off within a few hours of administration, which result in withdrawal symptoms like sleep disturbance, mild depression, and agitation (Ball & Ross, 2012). Methadone doses are substituted for the illicit opiates in order to suppress the withdrawal symptoms. It can also be prescribed in detoxification or to reduce the usage of illicit drugs. Methadone is the oldest pharmacological treatment method for heroin. It has been in use since the 1960s and it is still considered to be an excellent treatment option for heroin. This is especially true for a patient who does not respond well to other medications.
There are numerous studies that have been carried out to determine the effectiveness of methadone and all the studies have had similar results. Methadone is an effective medication for the treatment of opioid addictions. However, there are many controversies surrounding the use of methadone. One of the main controversies is that one is trading one addiction for another. This is a false fact because methadone is only taken under medical advice and it does not have the same effects as heroin. It has also been noted that there are addicts who are unable to get off methadone usage. However, this does not indicate that the medication is not effective in the treatment of heroin addiction. when compared to other pharmacological treatments, methadone has been shown to have a high rate of reducing heroin usage and relapse (Devi, Ab Rahman Azriani, Ariff, & Hashimah, 2012). It should be noted that the individual needs to complete the treatment program in order for the drug to be effective. It has been established that 82 percent of individuals who leave the treatment program rapidly are more likely to relapse within one year.
Naltrexone
Naltrexone is an opioid antagonist. The medication is used to block the actions of heroin. The drug blocks the ability of heroin to affect the receptors in the brain. Naltrexone is beneficial in preventing relapse although it has no effect on withdrawal symptoms, which means it can only be used after the withdrawal process is completed. Naltrexone is not addictive or sedating and it does not result in physical dependency by the patient. The drug is administered in small daily doses or larger doses three times a week. It has been noted that patients have trouble complying with this treatment and this reduces its effectiveness.
It is assumed that naltrexone works best when the patient is highly motivated especially the ones who have social support. As a result, it has been established that the retention rate for this treatment is high for individuals with high economic and social status. Patients who have the appropriate external motivation like fear of losing their job or return to prison have been shown to find success in the treatment. The treatment has been found to have minimal effects on patients who are less motivated and have a lower economic status. It is for this reason that it is deemed to be less effective in treating heroin addiction. Another factor that makes the treatment less effective is the fact that one can only use it after they have been fully detoxified because it does not have an effect on the withdrawal symptoms. With proper monitoring, the treatment has been shown to be effective, which means that the patient should have the proper support systems for them not to relapse and complete the treatment program.
Buprenorphine
Buprenorphine is a partial opioid agonist, which means it has the ability to block the receptors in the brain that could be normally triggered by using heroin. This makes it effective in reducing and eradicating the withdrawal symptoms because the brain receptors would be lied to believe there has been an encounter with the opiate. This medication has gained popularity against methadone because it has less potential for abuse as compared to methadone. The drug can be prescribed by certified physicians, which eliminates the need for the patient to visit the clinic every day to receive their daily dose (Whelan & Remski, 2012). It has also resulted in increased access to the drug.
The drug has been shown to be effective in the treatment of opioid addictions and has been shown to retain more people within the program as compared to other drugs apart from methadone (Fareed et al., 2010). In comparison to methadone, the drug has been shown to retain fewer individuals and this is mainly attributed to the flexible nature of taking the drug. Patients taking buprenorphine have flexible doses, which means the patient does not have to take the medication daily. This flexibility results in patients not taking the drug and this increases their rate of relapse.
Conclusion
Drug addiction and abuse have been shown to be a chronic disorder and it is vital that the available treatments be analyzed in order to establish the most effective treatment strategy. Making use of pharmacological treatment has been shown to be quite effective in the treatment of heroin addiction and this is the preferred method for preventing and reducing the rate of relapse. However, the three main pharmacological treatments being used have positive and negative effects and it is vital that we understand how these affect the patient outcomes. Methadone has been shown to be the most effective pharmacological treatment and has lower rates of relapse when compared to the other treatment options. The drug has its own disadvantages, but this cannot water down its effect in treating heroin addiction. Buprenorphine is also effective if the patient is disciplined enough to follow through with the flexible doses prescribed.

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