More Effective Treatment Options for Addiction on Horizon
Ever more effective therapies for drug addiction – a life-threatening brain disorder – may be on the horizon as scientists, physicians and commercial enterprises partner to respond to the national crisis involving abuse of pain-relieving medications, called opiates.
In fact, one particularly potent weapon – a new approach to delivering the effective treatment drug, naltrexone, in an implantable, longer-lasting format – is already in the clinical study queue and could be given the FDA’s go-ahead soon for widespread use by physicians, says Dr. Russell Surasky, FAAN, ABPM.
He calls this innovative, implantable drug therapy a potential “game-changer” for any patient addicted to opiates or alcohol.
Dr. Surasky is a noted brain specialist, who holds rare, double-board certifications in neurology and addiction medicine and serves as medical director of Bridge Back to Life, a multi-center outpatient addiction treatment program. He also founded the Surasky Neurological Center for Addiction in Great Neck, New York and is a national speaker, educating physicians and the New York criminal justice system about addiction and its treatment.
“Statistics show that, each day, some-4,000 people in the United States begin abusing opiates; another 400 individuals start using heroin. Their brain disorder – addiction – results in an estimated 120 drug-overdose deaths daily,” states Dr. Surasky.
Dr. Surasky provides an overview of the opioid-abuse problem and resulting addiction and shares his knowledge of currently available and future treatments.
Q. What does the most recent research tell us about addiction?
A. Each of us has two brain centers: the rational brain and the limbic system. The limbic system is the most powerful driver of human behavior, controlling basic survival needs like eating, drinking and mating and functioning outside conscious control. No messages from our rational brain can restrain it. The use of opioids hijacks the limbic system. Opiates bind directly to brain receptors, thereby rewiring the brain and reordering its survival priorities so that opioid drugs become the primary motivator in life.
Q. What treatments are currently in use to manage addiction disorders?
A. Suboxone and methadone are drugs commonly used to treat opiate addiction. They reduce overdoses, but, unfortunately, both also are extremely addictive. With suboxone and methadone, the brain does not have a chance to return to its normal number of opiate receptors, thus forcing the patient to remain reliant on addictive substances. The emotional centers of the brain are not allowed to reset; the mind continues to create memories in presence of an opiate. This process continues the craving and obsession that fuel relapses and perpetuate the addictive cycle. Essentially, suboxone and methadone are a trade-off, offering short-term benefits with long-term consequences. Without newer treatments to replace them, we soon will be left with countless patients physically dependent on these drugs.
Q. Thanks to some innovative approaches, you have achieved success in treating addictions. Can you tell us more?
A. At our addiction center, we have developed a treatment program centered on the medication naltrexone. Unlike suboxone and methadone, naltrexone is not an opiate, is not addictive, and does not cause physical dependence. It attaches to opiate receptors in the patient’s brain and immediately and dramatically reduces cravings for opiates. Even if patients abuse opiates while on naltrexone therapy, they neither experience a “high” nor do they become sick. Additionally, naltrexone does not require a life of unending medication. Treatment length varies, but typically continues for approximately one year.
As part of our program, we have developed a new protocol that involves use of neurologic-based medications just prior to the start of naltrexone treatment. These neurologic medications completely eliminate opiate withdrawal symptoms, allowing the patient to start naltrexone treatment (Vivitrol or implantable) within just a couple of days without having to go first through difficult opiate withdrawal symptoms.
Currently, naltrexone is given in an injectable form, called Vivitrol. The effectiveness of each injection lasts only about one month, requiring the patient to follow up with a doctor on a regular basis. The first few months of sobriety are the most critical and challenging for patients. Having a drug delivery mechanism that can prolong the benefits of Vivitrol well beyond a month would be ideal.
Q. Do you see something better on the horizon?
A. The addiction treatment company, BioCorRx, is developing a sustained-release naltrexone implant. The implant BICX102 would be embedded under the skin, allowing release of naltrexone continuously for approximately three months. A product like this could make a huge difference in the lives of patients undergoing treatment for opiate or alcohol addiction,
Q. For sake of disclosure, do you invest in, or work for, Alkermes, BioCorRx or other enterprises related to your work as an addiction specialist?
A. The pharmaceutical company, Alkermes, recently sponsored my efforts to teach other physicians in the country about addiction and Vivitrol therapy – an opportunity for which I am truly grateful. I do invest in many companies that have goals aligning with the values and principles of serving humanity including BICX. I believe Vivitrol and the development of the naltrexone implant, BICX 102, could prove a significant leap forward in our work as physicians to relieve the suffering of addiction.
Noted brain specialist Dr. Russell Surasky serves as medical director of Bridge Back to Life, a multi-center outpatient addiction treatment, and is founder of the Surasky Neurological Center for Addiction in Great Neck, N.Y. He holds rare, double-board certifications in neurology and addiction medicine and is well known for his innovative approaches to the treatment of addiction and mental illness. His memberships in professional organizations include the American Academy of Neurology and the American Society of Addiction Medicine. https://www.drsurasky.com/