Opiod Replacement Therapy
PSY F370 Drugs and Behavior
Fall 2013
November 9, 2013
Opioid Replacement Therapy
Medications used for opiate addiction work as agonists, antagonists or utilize a combination of both actions. By definition, agonists cause a chemical action by binding to cell receptors and mimicking the action of naturally occurring substances such as neurochemicals. Antagonists also attach to cell receptor sites but instead of causing an action, they block the receptor from being stimulated by a target substance such as an opiate. For example, as a paramedic I have used naloxone (Narcan) for my narcotic overdose patients. Naloxone is classified as a narcotic antagonist which means that it occupies opiate receptor sites in the brain, knocking off the opiate drug and reversing, or effectively blocking the drug’s effects. While naloxone is used for opiate overdose, naltrexone is a medication used for addition that works by the same antagonistic action.
Medications used in opioid replacement therapy utilize another opioid (i.e. methadone) in place of the problem drug to create a “more controllable form of addiction” (Hall) through agonist action. Methadone is a longer acting opioid replacement drug that when used reduces cravings for the problem substance, alleviates withdraw symptoms, and has the overall effect of allowing patients to function normally
One of the newer opioid replacement drugs buprenorphine works as an agonist-antagonist, partially blocking the opiate receptor site from and at the same time acting on the site to reduce craving and withdraw symptoms as the pure agonist does.
Some critics of replacement therapy believe that all opiate use is wrong, this includes therapeutic use in the surgical setting and long term opiate use for chronic pain. (Hall)
A more common criticism of replacement medication use is that the approach replaces one drug with another; actually replacing one addiction with another. While the objective of replacement medication is to
Fall 2013
November 9, 2013
Opioid Replacement Therapy
Medications used for opiate addiction work as agonists, antagonists or utilize a combination of both actions. By definition, agonists cause a chemical action by binding to cell receptors and mimicking the action of naturally occurring substances such as neurochemicals. Antagonists also attach to cell receptor sites but instead of causing an action, they block the receptor from being stimulated by a target substance such as an opiate. For example, as a paramedic I have used naloxone (Narcan) for my narcotic overdose patients. Naloxone is classified as a narcotic antagonist which means that it occupies opiate receptor sites in the brain, knocking off the opiate drug and reversing, or effectively blocking the drug’s effects. While naloxone is used for opiate overdose, naltrexone is a medication used for addition that works by the same antagonistic action.
Medications used in opioid replacement therapy utilize another opioid (i.e. methadone) in place of the problem drug to create a “more controllable form of addiction” (Hall) through agonist action. Methadone is a longer acting opioid replacement drug that when used reduces cravings for the problem substance, alleviates withdraw symptoms, and has the overall effect of allowing patients to function normally
One of the newer opioid replacement drugs buprenorphine works as an agonist-antagonist, partially blocking the opiate receptor site from and at the same time acting on the site to reduce craving and withdraw symptoms as the pure agonist does.
Some critics of replacement therapy believe that all opiate use is wrong, this includes therapeutic use in the surgical setting and long term opiate use for chronic pain. (Hall)
A more common criticism of replacement medication use is that the approach replaces one drug with another; actually replacing one addiction with another. While the objective of replacement medication is to