Controversy in Psychopharmacological Intervention to Treat Substance Abuse Disorders

Controversy in Psychopharmacological Intervention to Treat Substance Abuse Disorders

Consumption of opiates such as heroin together with cocaine is one of the addictions that the U.S. government has to deal with. According to Preston, O’Nela and Talaga (2010), heroin is one among the substances that are most abused, reason being the powerful effect it has on users. Besides being addictive and leading to dependency, heroin and opiates in general may cause respiratory depression and lead to death in some instances. On the other hand, withdrawal from these substances is commonly followed by anxiety, agitation, and gastrointestinal upset (Preston et al., 2010).

To reduce dependence on opiates, several drugs- one of them being methadone- are used. Methadone is a synthetic opiate that works by reducing a person’s craving for heroin and other opiates (Preston et al., 2010). It is effective in managing opiate addiction-related disorders due its long half-life; in addition, it is less abused compared to other opiates and generates a relatively lesser ‘high’ than other opiate. Nevertheless, use of methadone and its effectiveness in treating substance addiction is still one of the issues that have been met with a considerable degree of controversy. For example, critics argue that being an opiate itself, use of methadone can increase or create new addiction among users. This is a valid concern considering the increasing cases of deaths caused by prescription opioid overdose. In fact, it is reported that in 1999-2010, deaths caused by overdose of prescription opioids increased by more than four times, exceeding the total number of deaths caused by excessive consumption of cocaine together with heroin (Volkow et al., 2014). More worrying is the report that 8%-18% of those deaths were intentional (Volkow et al., 2014). This suggests that methadone may not be safe for treating substance addiction because it can be used by people with suicidal thoughts, besides causing death due to overdosing.

Much as the above concern is valid, methadone works effectively in reducing opiate addiction as long as its use is controlled. As reported by Volkow et al. (2014), the Department of Health and Human Services is working towards addressing the risks of prescription-drug abuse. More importantly, evidence shows that with proper prescription and monitoring, methadone is an effective medication-assisted therapy that not helps patients to recover but is also cost-effective and safe (Volkow et al., 2014).

References

Preston, J. D., O’Neal, J. H., & Talaga, M. C. (2010). Handbook of clinical psychopharmacology for therapists (8th ed.). Oakland, CA: New Harbinger.

Volkow, N. D., Frieden, T. R., Hyde, P. S., & Cha, S. S. (2014). Medication-assisted therapies—tackling the opioid-overdose epidemic. New England Journal of Medicine, 370(22), 2063-2066.

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