Treatment for Narcotic Abuse

Intoxication is treated in cases of overdose, when severe respiratory depression occurs. Naltrexone, an opiate agonist drug, may be used to revive a person who has overdosed. It binds to opioid receptors in the brain and counteracts the effects of drugs like heroin, morphine, and codeine. Its side effects include nausea and headache and it may be associated with liver toxicity.

Detoxification is the first step in treatment. Withdrawal may last from a couple of days to 2 weeks. Two drugs, methadone and clonidine, are used to treat it.

Methadone (a synthetic narcotic) can reduce the discomfort of withdrawal and is given in tapering doses until withdrawal ends. Because methadone is a narcotic, side effects are similar to the effects of heroin or morphine, but they have a slower onset, last longer, and are less severe. Also, respiratory depression can occur in high doses.

Clonidine, an antihypertension medication, affects the nervous system and can block the physical manifestations of withdrawal, like anxiety and irritability. Its most common side effects are dry mouth, dizziness, and drowsiness.

Dependence must be overcome by abstinence. Drug counseling, self-help groups, half-way houses, and narcotics anonymous (similar to alcoholics anonymous) may instill in a user the behavioral and psychological changes necessary to break a drug habit.

Methadone maintenance is helpful when combined with these strategies. Tapering initially large doses of methadone can help people gradually overcome dependence. Methadone is abused and its use remains controversial. Still, long-term treatment plans (30 days to more than a year) can keep people away from street drugs, needles, and disease. They improve the quality of life for most people who attempt to recover.

Over 11,000 drug treatment centers in the United States provide treatment for intoxication, withdrawal symptoms, and dependence. The aim in detoxification is abstinence. Staff is trained in substance dependence, and most centers employ physicians. Patients choose an inpatient or an outpatient treatment program, depending on the severity of dependence, availability of facilities, insurance coverage, and other considerations. Some facilities specialize only in detoxification or long-term treatment; others provide both.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 05 May 2001

Last Modified: 28 Sep 2015