Medications help with different aspects of the treatment process. Withdrawal Medications can suppress withdrawal symptoms during detoxification. However, medically assisted detoxification is not in itself "treatment." Detoxification is only the first step in the treatment process. Patients who go through medically assisted withdrawal but do not receive any further treatment show drug abuse patterns similar to those who were never treated. Treatment Medications can help reestablish normal brain functioning and prevent relapse by diminishing cravings an addict may have. Currently, doctors prescribe detox medications for opioid additions like heroin, morphine, tobacco (nicotine) and alcohol addiction, and are developing others for treating stimulant addictions to cocaine, methamphetamine and cannabis (marijuana) addictions. Most people with severe addiction problems use and abuse more than one drug and require treatment for multiple substance abuses. Opioids Methadone, buprenorphine and, for some individuals, naltrexone are effective medications for treating opiate addictions. Acting on the same targets in the brain as heroin and morphine, methadone and buprenorphine suppress withdrawal symptoms and relieve cravings. Naltrexone works by blocking the effects of heroin or other opioids at their receptor sites and doctors only prescribe these drugs for certain patients who underwent detoxification. Because of compliance issues, naltrexone is not as widely used as other medications. All medication helps patients disengage from seeking out drugs and other criminal behavior, and aid addicts in being more receptive to behavioral treatments. Tobacco Drug companies make many kinds of nicotine replacement therapies including the patch, a spray, gum and lozenges, which are available over the counter. In addition, the Federal Drug Administration approves two prescription medications for tobacco addiction: bupropion and varenicline. These drugs have different act on the brain differently, but both help to prevent relapse in people trying to quit smoking. Doctors recommend each medication for use in combination with behavioral treatments, including group and individual therapies, as well as telephone-quit lines. Alcohol The Federal Drug Administration approves three medications for treating alcohol dependence: naltrexone, acamprosate and disulfiram. A fourth drug called topiramate exhibits encouraging results in clinical trials. Naltrexone blocks opioid receptors that are involved in the rewarding effects of drinking and in the craving for alcohol. Naltrexone reduces relapsing to heavy drinking and is highly effective in some patients, likely due to genetic differences. Doctors believe that acamprosate reduces symptoms of protracted withdrawal, such as insomnia, anxiety, restlessness and dysphoria, which is an unpleasant or uncomfortable emotional state, similar to depression, anxiety or irritability. Acamprosate may be more effective in patients with severe dependence. Disulfiram interferes with the degradation of alcohol, resulting in the accumulation of acetaldehyde, which, in turn, produces a very unpleasant reaction that includes flushing, nausea and heart palpitations when a patient drinks alcohol. Compliance can be a problem, but among patients who are highly motivated, disulfiram can be very effective.

Institute on Alcohol Abuse and Alcoholism

National Institute on Alcohol Abuse and Alcoholism provides leadership in a national effort to reduce problems related to alcohol. The National Institute on Alcohol Abuse and Alcoholism conducts research in a range of scientific areas, including genetics, neuroscience, epidemiology, and studies the health risks and benefits of alcohol consumption, prevention and treatment. The National Institute on Alcohol Abuse and Alcoholism coordinates and collaborates with other research institutes and Federal programs on issues related to alcohol. The National Institute on Alcohol Abuse and Alcoholism collaborates with international, national, state and local institutions, organizations, agencies and programs to translate and disseminate research findings to health care providers, researchers, policymakers and the public.

Lap Band

A lap band is an inflatable silicone device that a surgeon places around the top portion of the stomach, via laparoscopic surgery, in order to treat obesity. Lap band surgery is an example of bariatric surgery designed for obese patients with a body mass index (BMI) of 40 or greater, or between 35 to 40 in cases of patients with certain co-morbidities that are known to improve with weight loss, such as sleep apnea, diabetes, osteoarthritis, high blood pressure or metabolic syndrome, among others. Lap banding is the least invasive surgery of all bariatric surgeries. Lap banding using laparoscopic surgery usually results in a shorter hospital stay, faster recovery, smaller scars, and less pain than open surgical procedures. The patient can continue to absorb nutrients from food normally. Lap bands are made entirely of biocompatible materials, so they can stay in the body without causing harm. However, not all patients are eligible for laparoscopy. Patients who are extremely obese, who have had previous abdominal surgery or have complicating medical problems may require a more open surgery approach. The surgeon creates a small incision near the belly button and pumps carbon dioxide into the abdomen to create a workspace. Then the surgeon inserts a small laparoscopic camera through the incision into the abdomen. The camera sends a picture of the stomach and abdominal cavity to a video monitor. It gives the surgeon a good view of the key structures in the abdominal cavity. The surgeon makes more small incisions in the abdomen. The surgeon watches the video monitor and works through these small incisions using instruments with long handles to complete the procedure. The surgeon creates a small, circular tunnel behind the stomach, inserts the lap band through the tunnel and locks the band around the stomach. Clinical studies of lap band surgery patients found that they felt better, spent more time doing recreational and physical activities, benefited from enhanced productivity and economic opportunities and had more self-confidence than they did before surgery. The placement of the band creates a small pouch, or stoma, at the top of the stomach. This pouch holds approximately one half cup of food. A typical stomach holds about six cups of food. The pouch fills with food quickly, and the band slows the passage of food from the pouch to the lower part of the stomach, causing the sensation of being full. As the upper part of the stomach registers as full, the message to the brain is that the entire stomach is full, and this sensation helps a person to be hungry less often, feel full more quickly and for a longer period, eat smaller portions, and lose weight over time. As patients lose weight, their bands will need adjustments, or "fills," to ensure comfort and effectiveness. The surgeon can adjust the lap band by introducing a saline solution into a small access port just under the skin. There are many port designs and a surgeon may place them in varying positions, but they always connect to the muscle wall in and around the diaphragm via sutures or staples.