Blocking agents
Blockade therapy refers to the usage of naltrexone, which, pharmacologically speaking, is an opiate antagonist (inhibitor of opiate receptors).
Thanks to this pharmacological characteristic, naltrexone is efficiently used in treating opiate addiction, alcoholism, and nicotine addiction.
Naltrexone blocks ("covers") opiate receptors in the brain, so that opiates cannot provoke their stimulation. With time, this blockade reduces the active potency of heroin and other opiates, as the conditioned (learned) expectation of a positive drug effect is gradually being lost, the motivational importance of addiction is dying out, and the vicious circle of the disease is being stopped.
Naltrex Zone Hospital uses naltrexone depot forms (implants), in agreement with the results of numerous worldwide studies. A doctor specialising in surgery inserts the implant into fat tissue under the skin by carrying out a minimally invasive surgical operation. The implants we use last 3-6 months on average.
Active hepatitis (a significantly high titre of liver enzymes and a low number of leukocytes) is an absolute contraindication, whereas cases positive for hepatitis C and B are a relative contraindication for naltrexone usage. The relative contraindication means that the usage of this medicine poses no danger if other parameters of the overall health status are favourable.
Considering that alcohol and nicotine realise one part of their active potential through endogenous opiate receptors, the naltrexone blockade of these receptors helps and is used in treating alcoholism and nicotine addiction.
Substitution therapy
Substitution therapy is used in treating opiate and opioid addiction. Opiates are natural alkaloids of opium (codeine, morphine, thebaine). Opioids are semi-synthetic and synthetic substances producing an opiate-like effect (heroin, methadone, tramadol, etc.).
Our hospital uses buprenorphine in substitution therapy. We do not use methadone because the side-effect profile of buprenorphine is significantly lower than the profile of methadone. As a result, patients eagerly accept buprenorphine as a long-term therapy.
In practice, opiate addicts are shifted to substitution therapy, which is the continuation of pharmacotherapy by using buprenorphine (Suboxone). The period of using substitution therapy varies from several months to several years, depending on addiction chronicity, family situation, the person's psychological maturity, and many other social factors (employment possibility, financial situation, other people's support, etc.).
The aim of substitution therapy is to substitute (replace) street opiates (heroin) with the pharmacological preparation buprenorphine (Suboxone). Buprenorphine does not provoke the feeling of euphoria, crucial for heroin and opiate potency.
The addictive potential of buprenorphine (the possibility of creating addiction) is many times lower when compared to heroin and other opiates. This is why it is recommended as a substitution. Most patients treated with buprenorphine say that this medicine has helped them eliminate an abstinence crisis and control heroin cravings much better. Most importantly, they claim that they have been given back the feeling of living a normal life again.
Given that buprenorphine (Suboxone, Subutex) does not cause an artificial euphoric effect and a feeling of satisfaction, the person can now search for satisfaction and composure in the so-called natural rewards (food, sex, friendships, success, hobbies, sport). In this way, a ground for further work on developing a new, healthy motivational system of personality has been established.
Aversion therapy and other forms of pharmacotherapy
In treating alcoholism, aversion therapy (repulsion therapy) is introduced by using disulfiram (Esperal, Tetidis). This medicine blocks alcohol metabolism, so that metabolites provoking a strong feeling of discomfort and repulsion (throbbing headache, skin redness, tachycardia, nausea, vomiting, confusion) accumulate in tissues.
By taking this medicine, the patient voluntarily places a barrier to alcohol taking thus additionally increasing the strength of his/her will not to consume alcohol. With time, abstinence assumes the characteristics of an everyday habit, which increases the chance of successful healing.
Naltrex Zone Hospital also uses other types of pharmacotherapy in treating a series of clinical addiction forms. More specifically, we use baclofen in treating alcoholism and cocaine addiction, aripiprazole (Azolar) and olanzapine (Sizap) in treating cocaine addiction, topiramate (Topamax) in treating eating disorders, each of which is individually prescribed upon the teamwork making of each individual patient's treatment plan.