Methadone has been used to treat heroin users for a long time, basically from the 1960s, and was accepted as a satisfactory treatment for heroin users by the FDA in 1973. There are several outcomes of methadone usage in public health for pharmacotherapies ranging from short-term to long-term maintenances. For instance, illicit drugs have reduced, increased employment rate, reduced crime rate, few family-related cases, low crime rate, and fewer psychiatric symptoms. Methadone is an opiate agonist that acts long-term to withdraw, reduce and prevent the victim from craving the other types of opiates (Blanco-Gandía & Rodríguez-Arias, 2018). According to recent statistical estimates, more than 179,000 Americans are predominantly in authorized clinics funded by grants from the federal government to offer methadone maintenance (Paul et al., 2021).
Levo-alpha acetylmethadol (LAAM) is an analog opioid that agonizes the effects of other opiates. FDA approved LAAM in 1993 for long-term maintenance of disorders that rely on the use of other opiates. LAAM is effective in withdrawing, preventing, and blocking the effects associated with the use of heroines (Paul et al., 2021). The potential of LAAM abuse is low though rarely consumed because its impact on the cardiovascular system is detrimental. In addition, very few clinics accept the use of Levo-alpha acetylmethadol because of regulatory and insurance problems. LAAM has several merits over the use of methadone, particularly regarding its use of three doses per week, which can reduce the potential of contracting HIV/AIDS, improve the relationship between the patients and the clinicians, and save the cost of treatment. In implementing treatment of opioids addiction using LAAM to save the cost of treatment and obtain the best results, one must pay attention to several issues like:
- HIV measures related to LAAM use
- The effect of LAAM on the operations of clinical activities
- The cost of adopting LAAM activities
- Roles of victims in the long-term treatments.
Buprenorphine hydrochloride serves as both an agonist and analgesic opioid. Recently, buprenorphine hydrochloride was availed to all trained and approved medical practitioners, including pharmacies (Kohan et al., 2021). It has proved to have the same wavelength as the receptor of mu-opioid. The potential of getting addicted to the drug wimpy and its use is safe acting on a long-term basis. The use of the drug three times at intervals advised by a medical practitioner has shown outcomes of reduced use of heroin. There is another drug called naloxone that can be combined with buprenorphine hydrochloride. The combination is known to counterpole accouterments of opioids and treats acute states resulting from opioid use. Naloxone has reduced the potential to abuse buprenorphine (Heo & Scott, 2018). FDA licensed the combination of buprenorphine hydrochloride and buprenorphine-naxolone in 2002, and its use still kicks effectively.
Naltrexone is a receptor antagonist. It blocks the activity of the opiate directly from the receptors. At first, it was used in treating disorders related to opiates but was later approved to treat conditions related to alcohol consumption back in the 1990s. Naltrexone is known for its effects of reducing gratifying impacts arising from the use of opiates (Wiese & Wilson-Poe, 2018). In the case of RTCs, the drug has proved to lower the rate of substance use and the quantity equivalent to illicit drug dependence in a single episode. The main issue with this drug is retention, where fifteen percent of patients remain on naltrexone every year.
References
Blanco-Gandía, M. C., & Rodríguez-Arias, M. (2018). Pharmacological treatments for opiate and alcohol addiction: A historical perspective of the last 50 years. European Journal of Pharmacology, 836, 89-101.
Heo, Y. A., & Scott, L. J. (2018). Buprenorphine/Naloxone (Zubsolv®): A review in opioid dependence. CNS Drugs, 32(9), 875-882.
Kohan, L., Potru, S., Barreveld, A. M., Sprintz, M., Lane, O., Aryal, A., & Viscusi, E. (2021). Buprenorphine management in the perioperative period: educational review and recommendations from a multi-society expert panel. Regional Anesthesia & Pain Medicine, 46(10), 840-859.
Paul, A. K., Smith, C. M., Rahmatullah, M., Nissapatorn, V., Wilairatana, P., Spetea, M., & Dietis, N. (2021). Opioid analgesia and opioid-induced adverse effects: A review. Pharmaceuticals, 14(11), 1091.
Wiese, B., & Wilson-Poe, A. R. (2018). Emerging evidence for cannabis’ role in opioid use disorder. Cannabis and Cannabinoid Research, 3(1), 179-189.