DBs Unit 6

DB 6.1: Obstacles in the Use of Medications for Alcoholism Treatment and Importance of Psychopharmacology for Counselors

Obstacles to Medication Use in Alcoholism Treatment

Individuals with alcoholism may encounter several obstacles when using medications like naltrexone, acamprosate, or disulfiram. These may include physical side effects like nausea and headaches, not to mention psychological resistance, where the patient does not feel the need to take the medication. In addition, these patients can also be faced with barriers such as stigma toward the use of medication for addiction within their culture or family setting. Concordance can also be problematic in that people might forget or decide not to take doses, which will reduce the efficacy of the medication (Mason, 2021).

One great concern is the possibility of pharmacokinology or pharmacodynamics interaction with other compounds that the individual may be using, including illicit drugs or prescribed medications that the patient may have a psychiatric disorder. The functions of dual diagnosis—where an individual has both substance dependency and mental illness—can pose challenges to clients with regard to treatment planning (Witkiewitz et al., 2019).

Importance of Familiarity with Psychopharmacology for Counselors

Counselors must be knowledgeable about medications used in treating alcoholism and other substance use disorders to provide holistic care. Knowledge of drugs such as naltrexone or disulfiram enables the counselor to collaborate with physicians to track a client’s progress, the side effects, and nonresponse. Such counselors are also more knowledgeable in explaining and counseling their clients, thus enabling them to make decisions on the pharmacological management of their conditions (Stone et al., 2019). Furthermore, awareness of medication interactions and side effects benefits the counselor in order to help minimize dangers when the patient is in the recovery process.

Use of Psychedelics in Addiction Treatment

Recent research has shown promising results in using psychedelics like psilocybin and MDMA in treating addiction. Notably, psychedelics rewire the neural pathways that are related to substance dependence, and this is an innovative strategy when other measures have not proven to be effective (Stone et al., 2019). Although the research is rather limited, there is growing evidence that individuals using psychedelics have enhanced emotional regulation, and cravings have been reported to decrease.

I agree with the cautious and monitored use of psychedelics in treatment, but only when conducted under strict clinical supervision. The controlled administration of psychedelic drugs along with psychotherapy has proved to be a way of achieving life-changing recovery for individuals suffering from chronic cases of addiction. However, the risks related to abuse, misuse, and lack of controls need to be handled properly before widespread adoption.

References

Mason, B. (2021). Alcohol use disorder: The role of medication in recovery. Alcohol Research: Current Reviews, 41(1). https://doi.org/10.35946/arcr.v41.1.07

Stone, J., Marsh, A., Dale, A., Willis, L., O’Toole, S., Helfgott, S., Bennetts, A., Cleary, L., Ditchburn, S., Jacobson, H., Rea, R., Aitken, D., Lowery, M., Oh, G., Stark, R., & Stevens, C. (2019). Counseling guidelines: Alcohol and other drug issues (4th ed.). Perth, Western Australia: Mental Health Commission.

Witkiewitz, K., Litten, R. Z., & Leggio, L. (2019). Advances in the science and treatment of alcohol use disorder. Science Advances, 5(9). https://doi.org/10.1126/sciadv.aax4043

DB 6.2: Medications for Opioid Addiction and the Importance of Medication Intake Process

Rationale for Medication Intake in Addiction Treatment

Including a medication intake process as part of addiction treatment is crucial for ensuring that the client’s physical and mental health is properly managed. In this process, it would be useful to collect comprehensive information about a patient’s medical history, including the medications taken for addiction and mental disorders treatments in the past and at the moment. This aids in establishing possible adversative effects and other prospective harms or inaptitudes beneficial to deliberate medications such as methadone, buprenorphine, or naltrexone in the individual (Medline Plus, 2019).

Clients’ tolerance levels, previous relapses, and any co-occurring disorders also need to be assessed, as these factors can impact the effectiveness of treatment. Moreover, adherence to the medications allows the medical professionals to fine-tune the dosages or recommend other complementary drugs if needed – antidepressants included. Knowing whether a client has been on medications like Suboxone, which combines buprenorphine and naloxone, can inform treatment planning and address potential challenges in tapering or transitioning away from opioid use (Dydyk et al., 2024).

Key Information in Medication Intake

During the intake process, the counselor should seek details such as:

1. History of opioid use, including types of opioids used (heroin, prescription painkillers)
2. Duration and frequency of use
3. Previous treatments, including any medications used and their effectiveness
4. Physical health status, including liver and kidney function, as these organs process the medications
5. Co-occurring mental health conditions and other medications taken
6. Potential contraindications, such as allergies to specific drugs

Other Medications to Be Aware Of

Counselors should also be aware of medications that could interact with opioid treatment, such as antidepressants, antipsychotics, or benzodiazepines, which are often prescribed for mental health conditions. Moreover, over-the-counter drugs, nutritional products, and alcohol may also interfere with the treatment process, making it even harder to get well (Bui et al., 2022). Perceived relationships can provide counselors with knowledge of the client’s interactions and, thus, help the client manage their recovery process.

References

Bui, T. N. T., Hotham, E., Loughhead, M., McMillan, S. S., Procter, N., Poole, K., & Suppiah, V. (2022). Exploring mental health clients’ current medication knowledge, beliefs, and experience with healthcare providers in the community in South Australia. Health & Social Care in the Community, 30(6). https://doi.org/10.1111/hsc.14029

Dydyk, A. M., Jain, N. K., & Gupta, M. (2024, January 17). Opioid use disorder. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK553166/

Medline Plus. (2019). Drug use and addiction. Medlineplus.gov; National Library of Medicine. https://medlineplus.gov/druguseandaddiction.html

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DB 6.1

• In consideration of the readings regarding medications used in the treat alcoholism, what are some might be some obstacles that an alcoholic might encounter in regard to the use, etc. of this medication? Discuss the importance of the professional counselor being familiar with these medications or any psychopharmacology.
• Additionally, share your knowlege about the use of psychodelics in the treatment of drug addictions. Do you agree or disagree with it’s use. Why or Why not?

NOTE : You must make at least 1 substantial posting answering the topic above in addition to 2 substantial replies. In order to qualify for a grade over a 85 for this discussion topic, you should have at least 1 contribution by Wed. at midnight for this specific topic. You must participate in this discussion board forum (making postings/replies on all of the discussion boards for this unit) at least 3 days per unit. You also must use APA style in your postings and replies so please use in-text references and provide a reference to give proper credit to the authors.

DBs Unit 6

DB 6.2

• In thinking about these medications methadone, buprenorphine, naltrexone, and suboxone in the treatment of addictions/ abuse discuss how the rationale for including a medication intake as part of the intake process. Discuss what information you should seek when conducting a medication intake. Are there additional medications you might need to be aware of as well.

NOTE : You must make at least 1 substantial posting answering the topic above in addition to 2 substantial replies. In order to qualify for a grade over a 85 for this discussion topic, you should have at least 1 contribution by Wed. at midnight for this specific topic. You must participate in this discussion board forum (making postings/replies on all of the discussion boards for this unit) at least 3 days per unit. You also must use APA style in your postings and replies so please use in-text references and provide a reference to give proper credit to the authors.
authors.

Readings:

• Read the information on pgs 37-45 in NIDA’s (2009) “Principles of Drug Addiction Treatment” about psychopharmacology and drugs/alcohol
• Read the information by NIH (2008) in regard to medications to assistant with alcoholism 
• Read the information by NIH (2016) in regard to resistance to alcoholism medication
• Read the information by SAMSHA’s TIP #43 related to Pharmacology of Medications Used to Treat Opiod Addiction.
• View the video in regard to Opiod Replacement Therapy by clicking HERE and HERE.
• Medication for Alcoholism:Medication for Alcoholism:
  • Naltrexone (Depade or ReVia), Extended-Release Injectable Naltrexone (Vivitrol), Acamprosate (Campral), and Disulfiram (Antabuse) are all currently approved medications to help in the treatment of alcoholism.  Please view the linked material.
    • Medication for alcohol use disorders
  • Additionally, new drugs, such as Topiramate, are being manufactured and tested to treat alcoholism. Please view the video links below.
    • Topiramate Video
• Medication for Opioid Addiction:Medication for Opioid Addiction:
  • Methadone, buprenorphine and, for some individuals, naltrexone are effective medications for the treatment of opiate addiction. Additionally, the use of Suboxone is being widely studied to examine if this medication can also be effective in monitored use. Please be sure to view the linked material and video that explains this process in greater detail.
    • Suboxone
• Medication for Nicotine Addiction:Medication for Nicotine Addiction:
  • Every year, millions of dollars are spent in America surrounding tobacco. While just as many millions are spend in development, marketing, and sales of this addictive substances, much more is spent working to prevent or treat the damaging effects of this substance. Please be sure to view the link below for additional information.
    • Treatment Options for Nicotine
• Psychopharmacology for Other Drugs of Abuse:Psychopharmacology for Other Drugs of Abuse:
  • Presently, there are no FDA-approved medications to treat cocaine or other illicit drugs other than what we have previously discussed. Consequently, NIDA is aggressively working to identify and test new medications to treat cocaine addiction safely and effectively. Several medications marketed for other diseases (e.g., baclofen, modafinil, tiagabine, disulfiram, and topiramate) show promise and have been reported to reduce cocaine use in controlled clinical trials. Additionally, a cocaine vaccine that prevents entry of cocaine into the brain holds great promise for reducing the risk of relapse. But the FDA is far from approving any such medications.
  • Please be sure to view the link below for additional information.
    • The Magic Pill