It’s the use of medications, in combination with counseling and behavioral therapies, to provide a whole-patient approach to the treatment of substance use disorders. Research shows that when treating such disorders, or disease, the most successful approach for many people includes both medication and behavioral therapies.
It’s a clinically driven approach with a focus on individualized patient care.
--Substance Abuse and Mental Health Services Administration; Center for Substance Abuse Treatment (SAMHSA CSAT) Division of Pharmacologic Therapies
Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Harm Reduction is also a movement for social justice built on a belief in, and respect for, the rights of people who use drugs.
Harm reduction incorporates a spectrum of strategies—from safer use to managed use to abstinence—to meet drug users “where they’re at” and address conditions of use, along with the use itself. Because harm reduction demands that interventions and policies designed to serve drug users reflect specific individual and community needs, there is no universal definition of or formula for implementing harm reduction.
Opioid drugs include heroin, opium, morphine, codeine, oxycodone, Lortab, Vicodin, Percocet, methadone and buprenorphine and similar drugs. Opium is produced from the resin in poppy flower seed pods. Opiates are drugs manufactured from opium. “Opioids” includes opiates as well as synthetic painkilling drugs like Vicodin, Lortab and others. All opioid drugs are classed as depressants. They slow down activity in the brain and central nervous system. Alone, or combined with other depressants like alcohol or benzodiazapines (Valium, Librium, Xanax etc.) they can stop breathing and cause overdose death.
As with all illegal drugs, the purity and potency can be unpredictable, depending on the manufacturing process, ingredients and what additives the final product has been cut with. Opiates are usually used intravenously, though some forms of opiate drugs can be smoked (opium) or snorted (white heroin). Heroin is a highly addictive drug and there is significant risk of overdose. However, synthetic opioids are just as addictive and just as deadly when misused or combined with other depressants.
When a person with an addiction stops using opioids (such as heroin or pain killers) on their own, they will most likely develop a range of serious physical symptoms such as nausea, vomiting, muscle pain, headaches, anxiety and sleeplessness.
Subutex and Suboxone® are medications approved for the treatment of opiate (including heroin and pain killers) dependence. Both medicines contain the active ingredient, buprenorphine hydrochloride, which works to reduce the symptoms of opiate dependence.
Suboxone acts as a medical intervention to alleviate the painful symptoms of prescription medication withdrawal, in order to allow successful recovery and encourage a smooth continuance of day-to-day life for the patient. Once Suboxone treatment begins, a patient will experience a dramatic reduction in withdrawal symptoms and also a suppression of harmful drug cravings.
Buprenorphine is available in different generic and trade formulations from different manufacturers. Like methadone, it is used both to treat withdrawal symptoms and to block the cravings associated with opioid dependence. The blocking effect of these medications, when taken as prescribed, can help reduce the risk of relapse and therefore, overdose.
In order to prescribe this medication, physicians must be specially credentialed and receive a waiver granted by the DEA. Buprenorphine can be dispensed at an outpatient opioid treatment program, prescribed by physicians in OASAS licensed treatment programs or in properly credentialed physicians’ office settings.
Naltrexone (or naloxone) is a non-narcotic medication used to block opioid receptors so they cannot be activated. If a patient who has been administered naltrexone attempts to continue taking opioids, he or she is unable to feel any of the opioid’s effects due to naltrexone’s blocking action. Some research shows, and some patients report, that naltrexone can also relieve cravings.
Naltrexone is administered in an orally prescribed pill or in an injectable long-acting formulation (marketed under the brand name Vivitrol®), which is designed for once-monthly dosing. The FDA approved this medication for use in people with opioid use disorders to prevent relapse. Naltrexone should be used only in patients who have been detoxified from opioids and have been opioid free for 7-10 days. Naltrexone is available in outpatient opioid treatment programs, OASAS licensed treatment programs, and in many physicians’ offices.