Los Angeles Medical Director Recommends Detox Medication

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Some medications have proven successful in addiction and detox treatments, while others exacerbate the problem, but they should always be taken with comprehensive treatment, says the Los Angeles Medical Director for substance abuse.

Various medications offer benefits for someone who is going through addiction detox, but often people who hear about this notion shutter in irony. “Solving a drug addiction with more drugs?” they might say, but that often leaves out the context. While some drugs will indeed make the problem worse, there are many medications that can facilitate the process and mitigate symptoms.

“The benefits of adding medication to addiction treatment are that we multiply our approaches for a very difficult and chronic condition,” says Gary Tsai, Medical Director and Science Officer of Substance Abuse Prevention and Control for the County of Los Angeles Department of Public Health.

Diabetics rely on insulin, for example, he says, but medications can also be an effective supplement for what insulin cannot fully control.

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“For any chronic conditions such as diabetes,” says Tsai, “we generally want to treat it both from a behavioral perspective, like losing weight and controlling your diet, as well as a medical perspective in instances where it is necessary.” 

“[It’s the] same thing for addiction. Where some people’s addiction is severe enough to the point where individuals [who have] opioid or alcohol use disorder would benefit from medications in addition to their treatment to help achieve recovery,” he says.

While the best medication depends on the comprehensive condition that includes mental health and severity, the most commonly effective medications for opioid use disorder are methadone and suboxone, which contains buprenorphine and naloxone. Nalaxone prevents overdose, while buprenorphine can be used to maintain treatment and provide pain relief in a safe manner

Similar medications can be used for detox treatment, director Tsai says. “What’s important is that the use of these medications can be maintained for what we call maintenance treatment or it can be used for detox.”

A new study on the effectiveness of publicly funded treatments in California, published by the journal Annals of Internal Medicine, determined that more immediate access to opioid agonist treatment (OAT), otherwise known as medication-assisted treatment, benefits patients by adding 0.42 more quality-adjusted years (QALYs) than the observed standard of care over their lifetime.

The study concluded that more immediate access to OAT would be economically viable while providing greater health benefits for all patients suffering with opioid use disorder.

Director Tsai says some people feel strongly about taking medication during a detox program, but that it can help a patient with withdrawal and therefore establish a foundation for lifelong treatment and sobriety. In treatment, some people use medications for a short period while others take them for years.

“If your outcomes are better, then you have savings in terms of all the cost associated with relapse,” Tsai says.