Medication management is a vital tool for individuals recovering from mental health conditions and substance use disorders. Medications are meant to improve a person’s quality of life. Unfortunately, when individuals struggle with mental illness or substance abuse problems, they often find it difficult to utilize medications effectively. In many cases, they may even find their quality of life decline. Given that these individuals are often people who stand to benefit the most from medications, it is crucial to have a program in place so that clients can get the most out of medication during recovery. That is where medication management comes in.
What is Medication Management?
Medications are prescribed for many reasons. In all cases, however, they are designed to make a person healthier and feel better. Unfortunately, when medications are misused or taken incorrectly, they can be ineffective. In some cases, misusing medications or abusing them can even be harmful.
Medication management is a service offered by outpatient treatment programs. It helps clients avoid the dangers of administering medication improperly. A medication management service will ensure that clients take the right dosage of their medication. Staff members also keep track of clients’ medication schedules and guarantee that they take their dosage at the right frequency and at consistent times of the day. In many cases, staff members also provide supervision while clients take their medications. This helps prevent both accidental misuse and deliberate abuse.
Moreover, rehabs like NuView Treatment Center employ physicians and psychiatrists who can prescribe medications to clients. Part of a medication management program involves getting prescribed the right medications. Medical professionals can observe clients to see how they handle certain medications. As clients make progress, it is common for their pharmaceutical needs to change. Quality medication management programs work to ensure that the medicine a client is taking is appropriate given their current needs and circumstances.
Why Use Medication Management?
Individuals who suffer from substance addictions or mental health disorders often struggle to manage their everyday tasks. They may find it difficult to hold down a job or meet commitments to family members. Substance addiction and mental illness lead to poor impulse control, poor time management, and cognitive problems. Medications can often help — but taking medication properly requires these very same skills!
Individuals who take medication improperly not only fail to obtain the benefits, but they often suffer significant consequences, which can range from health problems to relapse. Research studies have shown that failure to adhere to proper medication administration protocols results in a variety of harms:
- Roughly 50% of patients in the United States regularly fail to take their medications correctly.
- 33% of patients in the United States never even fill out their first prescription
- Every year, approximately 700,000 people in the United States end up in the emergency room after an adverse reaction to a prescribed medication
- Improper use of medication is costly, damaging the economy to the tune of $290 billion each year
Medication management reduces these risks, and it also has several other benefits, including:
- Reduced medical costs, as a result of fewer emergency room visits and hospitalizations
- Lowered risk of dangerous drug interactions or side effects
- Higher likelihood that a client will reach their healthcare goals
- Reduced risk of relapse
Medication for Addiction Recovery
Individuals who suffer from substance use disorders often benefit from taking medications. This is especially true when it comes to opioid use disorder and alcohol use disorder. Several medications exist that can help a person recover from these two substance addictions. Medication-assisted treatment, also known as MAT, is a treatment modality that combines behavioral therapy with pharmaceutical medication. While behavioral therapy offers the most long-term benefits, medications can help clients adhere to their rehab programs by reducing withdrawal symptoms and decreasing cravings.
Medications for Opioid Withdrawal
Methadone, which is often sold as Methadose or Dolophine, is in fact an opioid drug. It is often used as part of an opioid replacement therapy program. Methadone is a long-acting opioid that does not provide a high. As such, people who are addicted to shorter-acting opioids like heroin can switch to methadone and still satisfy their intense cravings for opioids. Rehab programs supervise clients as they slowly taper off of methadone. It is generally dispensed once per day in the form of an oral liquid concentrate, a tablet, or a diskette.
It should be noted, however, that methadone is an opioid agonist. This means that it affects opioid receptors in the brain no differently than most recreational opioids. As such, it does have a very high potential for abuse when used incorrectly. In fact, individuals who misuse or abuse methadone can become severely physically dependent. While methadone can be helpful for people working to taper down their dosage of opioids, clients must take this medication under the careful supervision of staff members.
Buprenorphine, which is often sold as Subutex or Buprenex, is a more recent alternative to methadone. The drug is a partial opioid agonist. This means that it activates the same opioid receptors as recreational opioids do, but not to the same extent. As such, taking buprenorphine can mitigate cravings and reduce withdrawal symptoms. Taking buprenorphine as prescribed does not lead to a high. Clients can engage in opioid replacement therapy by switching from their recreational opioid to buprenorphine, after which they can slowly taper their dosage.
When taken as prescribed, buprenorphine is quite safe. In fact, even increasing the dosage is okay, since buprenorphine actually has a “ceiling” after which effects stop increasing. It is generally taken in the form of a tablet or sublingual film, though some people take it via a buprenorphine patch. However, when people take buprenorphine without supervision, it is possible to alter the medication. By injecting buprenorphine, a would-be abuser can achieve a high from the medication. Proper medication management can ensure that individuals in recovery obtain the benefits of buprenorphine without abusing it.
Rehab staff members who are concerned that a client may try to abuse their medication may recommend Suboxone instead. Suboxone, which is also sold as Bunavail and Zubsolv, is a combination medication that includes both buprenorphine and naloxone. Naloxone, an opioid antagonist, reduces the risk of abuse. Attempting to abuse Suboxone will actually send a person into painful opioid withdrawal!
Naltrexone, an opioid antagonist that is often sold under the named Depade and ReVia, is generally administered once a month. It is most effective after a person has been abstinent for a significant period. Naltrexone works by blocking opioid receptors. It makes it impossible for a person to experience the high associated with recreational opioids. It thereby reduces the risk of relapse and increases the likelihood that a person will remain committed to their rehab program.
However, it should be noted that naltrexone is most commonly administered via injection. Given the risks of improper injection, medication management is crucial for the proper administration of naltrexone.
Medications for Alcohol Withdrawal
Disulfiram, which is often sold as Antabuse, is a deterrent medication for alcohol abuse. It can significantly reduce cravings for alcohol among people with alcohol use disorder. Moreover, if a person does choose to drink alcohol while taking disulfiram, they will experience several painful side effects. These include headache, nausea, and vertigo.
Disulfiram is most commonly administered in a tablet form 12 hours after a person’s last drink. When used as part of a medication management program, it can reduce the risk of relapse and enhance sobriety.
Naltrexone, which is also prescribed often for opioid use disorder, can also have similar benefits for alcohol use disorder. Not only does it block the effects of recreational opioids, but it also can reduce the pleasurable feelings associated with alcohol intake. As such, it functions as an effective deterrent for abuse and reduces the risk of relapse.
Acamprosate, which is often sold under the brand name Campral, is another drug that is often prescribed as an abstinence maintenance medication. Since it does not reduce the symptoms of alcohol withdrawal, it is generally prescribed after a person has already quit, often at least a week afterward. When taken as prescribed, acamprosate can mitigate cravings and reduce the likelihood of relapse. During a medication management program, staff members will generally administer it three times a day.
Medications for Physical and Mental Health Conditions
In many cases, individuals with substance use disorders suffer from comorbid health conditions. In fact, research shows that 50% of people with drug or alcohol addictions also experience mental illness and vice versa. The term “comorbid” is used because it implies that the conditions interact with each other. Individuals with mental health disorders, such as depression, attention-deficit/hyperactivity disorder (ADHD, anxiety disorder, or bipolar disorder, may be driven to abuse drugs and alcohol because these substances provide temporary relief from the painful symptoms of their mental illness. Over time, not only do they develop a physical dependence on these substances, but their substance abuse can exacerbate their mental health conditions and make them even more debilitating.
Physical health problems are also a driving force behind addiction. In fact, chronic pain is one of the foremost reasons why doctors prescribe opioid painkillers. It may come as a surprise to discover that these legal prescription painkillers, which include fentanyl, oxycodone, and hydrocodone, are the driving force behind the opioid epidemic in the United States. Most people who abuse recreational opioids like heroin actually began by developing a dependence on prescription opioids — which are often just as addictive, if not more so.
Treating dual diagnosis clients who suffer from comorbid addictions and physical or mental health problems is complex. Quality rehabs work to address both the addiction and the underlying health problem that is driving a person to abuse drugs. This is known as an integrated treatment.
In many cases, medications like antidepressants, anti-anxiety medications, or even painkillers are necessary. In fact, taking these medications can make clients less driven to self-medicate. However, medication management is crucial to ensure that these helpful medications do not contribute to the problem.
When is Medication Management Useful?
Medications are often essential for people who are recovering from mental health disorders and substance use disorders. Factors that make medication management especially useful include:
- When a person suffers from poly-drug addiction
- To reduce drug abuse via injection, and to reduce health risks associated with injection
- During outpatient detox services
- When mental health issues and/or other medical issues are co-occurring
- In cases of alcohol dependence or opioid dependence, to help with withdrawal and prevent relapse
Goals of Medication Management
Over the long term, the purpose of medication management is to help a person struggling with drug or alcohol addiction. By improving their quality of life and reducing the risk of relapse, medication management can help them progress in their recovery journeys. Ultimately, it may even help them stay sober without the use of medications. However, when it comes to legitimate physical or mental health disorders, there is no shame in getting proper pharmacological treatment. Over time, medication management can either help patients taper off or learn how to take their medications autonomously and effectively.
All clients are unique. The amount of time for which a client needs medication management depends on physical, environmental, and emotional factors, as well as the presence of comorbid disorders and the severity of substance dependence. Outpatient medication management programs offer regular evaluations and check-ins. This ensures the clients take the right medications at all times and that their dosage is effective. As individuals move forward in their recovery journeys, it is common for their dosages to be adjusted slowly. Quality rehabs ensure that clients take part in counseling and behavioral therapy while they receive mediation management.