Could a blood pressure drug, already FDA approved, be a solution to maintaining recovery after inpatient addiction treatment?
At the University of Texas, researchers are hopeful about new findings that could offer drug and alcohol addicts the opportunity to stay sober with the use of a prescription medication already approved to treat high blood pressure.
It was formerly believed that people with addictions struggled with purely physical cravings for the substances they were addicted to. We now know that environmental cues such as people, places, and things that addicts associate with their drug or alcohol use can also trigger overwhelming cravings and make it extremely difficult to stay sober. The new drug may work to prevent relapse by targeting these unconscious environmental associations that are known relapse triggers.
In their preliminary study, the researchers first trained rats to associate either a white or black room with a drug they were addicted to. The rats would then almost always choose to enter the colour of room that was tied to either alcohol or cocaine in their memory, whether or not the drug was actually present in the room.
Once the rats strongly associated one colour of room with a drug, the researchers then gave them a high dose of the blood pressure medicine, isradipine. On the first day after taking isradipine, the rats still went to their associated room when given the choice. However, after one or two days the rats given isradipine no longer exhibited a preference for either room. Researchers concluded that the isradipine had actually erased the rat’s memory of associating external cues with their addiction.
The blood pressure medication targets particular ion channels in the heart and blood vessels, as well as certain brain cells. The blocking of the ion channels in blood vessels reduces blood pressure. The blocking of the ion channels in certain brain cells appears to reverse the rewiring of the brain which makes addiction-associated memories so powerful.
Because isradipine has already been FDA approved for human consumption as a high blood pressure medication, clinical trials using the drug to treat addiction in humans could take place relatively quickly.
Researchers believe this drug could be more effective than other prescription medications used to help people stay sober as it actually addresses the unconscious memories that can so often trigger relapse. One challenge with the medication is that at high doses it can cause alarmingly low blood pressure and may need to be taken with other medications to stabilise blood pressure.
Prescription Medications Already Being Used to Help Addicts Stay Sober
With nearly 23.5 million people suffering from addiction in the U.S. alone, the search for prescription medications to stop drug addiction is not new. Isradipine is only in the early stages of testing to determine whether or not it is effective at treating drug addiction in humans, but if it does get approved it will be the first prescription medication of this kind used in drug addiction treatment. However, there are currently three major addiction medication approaches: replacement therapy, aversion therapy, and craving reduction therapy used in the following ways:
- Replacement Therapy.
Replacement therapy is likely the most controversial of all addiction treatment approaches. This is where legal substances are used to replace more harmful drugs. Methadone and suboxone are the most common and are both opioid replacements used to treat heroin or prescription opiate addiction.Suboxone is a newer and presumably safer alternative to methadone as its potential for abuse and overdose is lower. However, using either drug replacement medication without also actively participating in addiction counselling (with the eventual goal of abstinence) is criticised as being a sub-par harm reduction technique when compared to complete abstinence and recovery from opiate addiction.
- Aversion Therapy.
Disulfiram, sold under the brand name Antabuse, is one of three medications approved to treat alcoholism. Antabuse is an aversion therapy medication that inhibits the body’s ability to process alcohol and causes extreme nausea and vomiting if someone taking it drinks even a small amount of alcohol.The effectiveness of Antabuse is mediocre, as once people stop taking the drug they can easily go back to drinking alcohol. However, some people do attribute their ability to stay sober to antabuse as it gave them time to change their thinking about alcohol use whilst knowing that they could not physically drink it.
- Craving Reduction Therapy.
If the new drug isradipine is approved it would likely fit into this category as it may eliminate cravings due to environmental triggers by reversing unconscious memories associated with addiction – a different approach than other craving reduction medications.Naltrexone is currently the most popular medication in this category. Naltrexone can be used to treat opiate overdose, but when taken orally it has been shown to reduce alcohol cravings. Essentialy, this drug blocks the effects of alcohol or opiates, which makes taking them less appealing and cravings subside over time.
Vivitrol is a new injectable version of naltrexone that is long-acting for 28 days and prevents the need to take a daily pill. One young man attributes his ability to stay sober from heroin to vivitrol. He says the drug reduced the amount of time he spent craving and thinking about taking heroin because he knew if taken it would not have the effect he wanted. This allowed him to focus on working with his psychiatrist to learn how to self-manage and develop coping skills necessary to stay sober in the long run.
Campral is another drug approved by the FDA to treat alcoholism, and works similarly to naltrexone to reduce cravings for alcohol.
Therapy is Essential for Long-Term Addiction Recovery
Even with the latest discoveries about using prescription drugs to treat addiction, it is important to remember alone they are not sufficient to achieve long term recovery from addiction. While prescription medications can be a temporary tool to help people stay sober, addiction is a complex disease that requires evidence-based psychological, behavioural and social treatments in order to be effective and afford people the highest quality of life.
Recovery is not defined solely by abstinence from drugs and alcohol, but rather requires more holistic lifestyle changes as well. Attending an addiction treatment centre will allow you to make the changes necessary to stay sober and live life to the fullest.