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Dr. Jerman
Medications for substance use are prescribed to control cravings and relieve severe symptoms of withdrawal. Dr. Mansfield, can you tell us how some medications for substance use work?

Dr. Mansfield
Of course, Dr. Jerman. Currently, medications are available to directly treat opioid, tobacco, and alcohol addictions. Depending on the individual's needs, medications may also be prescribed to treat co-occurring problems with mood, sleep, or anxiety.

Opiates, such as oxycodone or heroin, bind to opioid receptors in the brain, which control feelings of pain and pleasure. This means that they can be very effective at relieving pain, but they are also highly addictive. For people addicted to opiates, medications include:

  • Methadone
  • Buprenorphine, and
  • Naltrexone

These medications are opioid medications that can reduce withdrawal symptoms without causing the same "high" that other opiates do.

Nicotine is the addictive agent in tobacco products. Nicotine patches, gum, lozenges, and nose sprays can be used to reduce withdrawal symptoms for someone trying to quit using tobacco. Other medications prescribed for tobacco addiction include:

  • Varenicline, and
  • Bupropion

An alcohol addiction can also be treated with medications, including:

  • Disulfiram
  • Acamprosate
  • Naltrexone, and
  • Topiramate

Disulfiram blocks an enzyme that is involved in metabolizing alcohol intake, which produces very unpleasant side effects when combined with alcohol. For this reason, it effectively discourages a person from drinking alcohol.

Acamprosate, naltrexone, and topiramate work in different ways to reduce or relieve withdrawal symptoms. Acamprosate does this by restoring the chemical balance in the brain of an alcohol-dependent person who has recently quit drinking. Naltrexone is an opioid pain reliever, and topiramate is an anti-seizure medication.