In recent years, it’s become much more common to use medications as part of treating an addiction. For some people and organizations, this decision to pursue medication-assisted treatment can be controversial. Some models of recovery, like 12-step programs, advocate for an exclusively abstinence-based recovery. For many who struggle with drug and alcohol dependency, those programs are still a great option or a component of their treatments.
However, with the rise of addiction as a public health crisis, people are becoming ever more open to the idea of medications as both replacement therapies as well as a way to mitigate symptoms. This can make treatment more accessible through general practitioners rather than specialists.
In 2015, for example, research showed that one-tenth of Americans would struggle with addiction at some point in their lives. And of those, most would not receive formal treatment. This is a huge gap, and everyone involved in public health acknowledged that it needed to be closed.
Developing or repurposing medications for use in addiction treatment is just one avenue of exploration. Finding any new, evidence-based and widely available treatment options for people struggling with alcohol and drug dependencies has become a big focus in medicine, government and other areas of American life. Recently, a drug called vigabatrin has been studied for use in patients with a dependency on cocaine.
The Basics of Vigabatrin
Vigabatrin is also known by the trade name Sabril. Technically, it’s classified as an anticonvulsant. In the United States, this drug was initially approved in 2009 for use in infants and children with seizure disorders. Vigabatrin has been used in Europe since the late 1980s, but the approval process stateside took longer. Part of this is because vigabatrin use is not without serious side effects: for example, it can damage your vision. If you are taking vigabatrin, you will need to have your eyes examined about a month after starting treatment and continue to do so periodically after that. It has also been linked to suicidal ideation. However, at the time of its approval, the FDA determined that the benefits of this drug could outweigh the risks for some patients. People with epilepsy are among those who benefit from vigabatrin.
People who take vigabatrin need to stay in close contact with their medical providers and communicate any negative symptoms they’re experiencing clearly. Because of the challenges posed by a medication like Sabril, doctors who prescribe it must hold a special designation. This is known as a REMS certification. In this way, it’s similar to some other medications used to treat substance dependency, like suboxone and methadone. While not every doctor can prescribe vigabatrin, many who treat addicts are likely to hold this certification. Patients who are transitioning from inpatient settings can call doctors’ offices and inquire about whether they are REMS certified and use medications in their practices.
Vigabatrin for Drug Dependency
Vigabatrin isn’t just used for seizure disorders, though. It has been studied for use in drug addicts for years, now. In April of 2011, doctors at the National Institute on Drug Abuse and the University of Pennsylvania began studying the use of vigabatrin for substance dependencies together. Specifically, they wanted to see if it could be effective in treating people with alcohol and cocaine dependency. The study had 32 participants, half on Sabril and half on a placebo. When it ended in 2013, this study showed that people with addictions could benefit from vigabatrin.
Vigabatrin has been demonstrated to have at least two desirable effects in its use with substance-dependent people. The first is that it helped to reduce people’s actual use. Participants in the NIDA/Pennsylvania study had fewer heavy drinking days and fewer instances of cocaine use. The second is that it helped to drive down their cravings and withdrawal symptoms. Being able to tackle both of these big issues with one treatment makes vigabatrin a formidable option for cocaine addiction treatment. It’s able to eliminate some of the most serious issues associated with cocaine dependency.
Overall, patients taking vigabatrin were less likely to have shakes and cravings that might lead them to use again. In general, it can be said to reduce their feelings of anxiety. Since then, it’s been studied further. For example, one study tracked Mexican cocaine users who had recently been released from prison. Sabril helped to reduce their cocaine use and cravings, too. This is exciting because it seems to demonstrate that this medication may really be able to help recovering people make better decisions. The mechanism by which vigabatrin works is by inhibiting GABA transaminase, a neurotransmitter that seems to be involved in addiction and other disorders. Vigabatrin use is still being studied for its applications in addiction medicine. There is speculation that it can help people who are dependent on methamphetamines, too.
Sabril is increasingly being prescribed in the US, especially for people with cocaine dependency issues. Some studies have put its effectiveness at treating addiction as high as 28%. That means that between a quarter and a third of addicts who use Sabril are finding healing. This could mean a huge improvement in reaching that big cohort of addicted adults who need help. So far, there are no drugs specifically approved to be used with cocaine addicts. That means that any prescriptions for Sabril are technically off-label use. Off-label might sound somewhat scary, but qualified physicians are able to use their judgement in prescribing the medication. Many medications are used off-label, and it’s really nothing to worry about.
Vigabatrin With Other Treatments
One of the most important aspects of any drug dependency treatment is working with others. Behavioral therapies are an important component of any addiction treatment program. At Granite Recovery Centers, we understand that only too well. One of our most closely held values is teamwork. Giving our clients medication can help them recover from addiction, but pills are not cure-alls when it comes to dependencies. Addiction affects all areas of an individual’s life. Because of that, a multi-faceted approach to treatment tends to work best.
Paying attention to diet, exercise, one-on-one and group therapies are all important parts of effective addiction treatment. Vigabatrin users benefit strongly from individual and group therapies. The support can be very important, especially given some of the side effects of the drug. While Sabril has wonderful positive effects in some drug users, the side effects associated with its use are also quite serious. Staying connected with therapists and other recovering people is very important for patients on vigabatrin.
Treating Cocaine Use Disorder Is Challenging
Cocaine addicts can be among the most challenging clients to work with in treatment settings. By the time those with this issue are ready to ask for help, it’s likely that they’ve moved on to smoking crack, instead of just using powder. Almost two-thirds of cocaine addicts in treatment have crossed that threshold. Often, they’re also using additional substances in addition to coke.
If we stop to think about the nature of cocaine addiction and how it develops, this makes sense. People in demanding careers often start using cocaine to have more energy or stay awake longer. Later in the day or night, they find they need something else to help them come down. Because of this, they may also be dependent on alcohol, marijuana or other substances. Detoxing from everything can be a challenge. The body is making a huge adjustment, and it’s not often pleasant. It’s easy to see why something like an anticonvulsant can be useful in these cases.
Some but not all residential treatment centers are able to provide a medically supervised detox. At other times, patients will detox in a separate facility or even a hospital. During detox, vital signs will be monitored regularly and tracked. It’s very important that those with a drug or alcohol dependency issue are in a medical setting as they come off the drug. Going cold-turkey when it comes to alcohol can actually be deadly: there are times when a medication must be administered if the patient is to get through the experience safely. Rehab can’t really progress until the physical part of detox is over with.
Rehab at Granite Recovery Centers
At Granite Recovery Centers, we offer several rehab options for our patients. We have a medication-assisted treatment program. There’s also one tailored specifically for people who have worked in uniformed professions. Soldiers, police officers and firefighters often experience trauma in their work settings. Trauma, PTSD and C-PTSD are strongly correlated with the development of drug and alcohol dependencies. The uniformed program is built specifically to reach these individuals and make it easier for them to get healthy. About 6% of veterans in substance use disorder programs are users of cocaine and could potentially benefit from the use of Sabril.
In terms of the practical aspects of treatment, we offer two major types. There is standard inpatient therapy, but we also have outpatient services. Usually, inpatient treatment is the best first step. It provides plenty of structure for people as they transition to life without substances. Being in the facility also means that various types of therapy are easily accessible throughout the day. Outpatient treatment is a good fit for people coming from a residential inpatient program. Outpatient services make it easier for people to implement structure and new practices into their own lives at home. Granite Recovery Centers’ outpatient programs are based on the 12-step program, and they incorporate strategies from other modalities as well.
Finally, we offer treatment to dual-diagnosis patients, too. Dual diagnosis means that, in addition to a substance-use issue, the patient also deals with mental illness. Examples of mental illness can include eating disorders, depression, anxiety and other problems. Dual-diagnosis patients have other pressing needs, along with their dependencies, that must be addressed specifically if their recovery is going to be successful. Dual-diagnosis patients generally see professionals like psych nurses during their inpatient experience in addition to participating in 12-step groups, activities and therapy sessions.
If you or a loved one is struggling with a substance use disorder, contact us today. Our staff is up to date on all the best and most effective treatments. Vigabatrin, replacement therapies like suboxone and abstinence-based approaches are all on the table at Granite Recovery Centers. We know that everyone’s experience with substance use disorder is different and that everyone’s road to recovery will be unique to them, too. Our job is to put people on the right path and help them as needed along the way. We are committed to offering all the tools people may need on their journey.