the use of drug therapy for addiction

drug therapies to treat nicotine addiction

• Addiction to nicotine is treated using an agonist substitution method, where a safer alternative is provided to patients (nicotine replacement therapy)

  • Varencline - prescription medication acts as an agonist on nicotinic receptors and stimulates dopamine release in the same way as nicotine

    • Used for those who don’t want to use nicotine replacement therapy in chewing gum or skin patches

• Nicotine replacement therapy delivers nicotine in mouth sprays, chewing gum or small pouches that rest between the cheek and the gums or skin patches

• The nicotine in these products, which is usually less than what the regular smokers is inhaling, is released into the bloodstream more slowly and doesn’t contain the harmful chemicals that are found in cigarettes

• The amount of nicotine is gradually reduced over time, with the withdrawal symptoms managed over 2-3 months until the person can give up nicotine completely

drug therapies to treat gambling addiction

• There isn’t a specific drug that can target gambling addiction directly, but drugs that are used to reduce symptoms of other addictions, such as heroin and alcohol, have been shown to work, taking an antagonist approach

• The main drug therapy for gambling addiction is the opioid antagonist naltrexone, which works by blocking the reward system in the brain where the person engages in their addictive behaviour

  • Naltrexone reduces the release of dopamine in the nucleus accumbens, therefore decreasing the feeling of pleasure and increasing the release of GABA in the mesolimbic system, which is a neurotransmitter that decreases cravings

research which investigates the use of drug therapy for addiction

• Stead et al. (2012)

  • Reviewed 150 nicotine replacement therapy trials and found that the chances of stopping smoking were increased by 50-70% with the use of nicotine replacement therapy compared to placebo and to no treatment groups, supporting the effectiveness of the nicotine replacement

• Ward et al. (2018)

  • Investigated the use of naltrexone therapy for gambling addiction and found that after 6 weeks of treatment, all 10 participants showed a decrease in cravings, with 6 patients giving up gambling completely

strengths of drug therapy for addiction

• Drug treatment is cheaper and easier to engage with than other forms of treatment, such as CBT, as it requires only a prescription and medical supervision

• Drug therapy for addiction removes stigma as it encourages people to view addiction as a medical issue, rather than a moral or psychological weakness, and so makes those addicted more likely to seek help

weaknesses of drug therapy for addiction

• Drug therapies can have side effects, such as sleep disturbances, gastrointestinal problems and headaches, which may result in people not taking their medication leading to relapse

• Drugs do not work in the same way for everyone, as small genetic variations between people can have a significant effect on the outcome of drug treatments, such as naltrexone, the effectiveness of which depends on a variation in a single gene - the µ-opioid receptor gene (genes in the nucleus accumbens that release dopamine when stimulated)

link of drug therapies for addiction to issues & debates

• Drug therapies are biologically reductionist, focusing solely on treating addiction through chemical means

• Framing addiction as a medical issues via drug treatment can help reduce stigma, promoting more socially sensitive and ethical support

  • However, drug side effects and varied responses across individuals raise ethical concerns about informed consent and personalised care