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Disulfiram (Antabuse) is a medication that inhibits metabolism of acetaldehyde, a toxic breakdown product of alcohol, and produces unpleasant symptoms (flushing, headache, nausea, vomiting, dizziness, light-headedness, tachycardia) if a person consumes alcohol. The patient who stops taking disulfiram can experience the Disulfiram alcohol reaction for up to 14 days (and generally for at least 4 to 5 days) after discontinuing ingestion of disulfiram. The rationale for disulfiram in treating alcoholism is that most alcoholics taking disulfiram will not drink for fear of getting sick. Disulfiram thus prevents impulsive drinking in response to acute craving or stressors
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The intensity of the reaction may vary with each individual but is generally proportional to the amount of disulfiram and alcohol ingested. The duration of the reaction is variable, from 30 to 60 minutes in mild cases, up to several hours in more severe cases or as long as there is alcohol remaining in the blood. Disulfiram is slowly absorbed from the gastrointestinal tract and is slowly eliminated from the body. Prolonged administration of disulfiram does not produce tolerance. The longer a patient remains on therapy the more sensitive he becomes to alcohol.
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Used alone, without proper motivation and without supportive therapy, disulfiram is not a cure for alcoholism, and it is unlikely that it will have more than a brief effect on the drinking pattern of the chronic alcoholic.
Disulfiram Implant
Disulfiram implant appears to give effective blood levels for twelve weeks on an average. It is usually inserted under local anaesthetic after detoxification is over and 2 – 3 doses of the oral Disulfiram have been given. It is inserted through a small (1 cm) incision in the lower abdomen or at the back of the upper Arm., which is inserted 3-4 mm of the skin.
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| Advantages of Implants: |
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Almost impossibility of relapse while the implant is effective. |
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Avoids the need to supervise
Disulfiram. |
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Regular administration to take
Disulfiram
is reduced. |
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Reduces craving even more than
Disulfiram
because there is no point in craving for what you can't have |
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Long term cost effective. |
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| Disadvantages of Implants: |
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Requires minor surgery and a small scar with temporary tenderness and bruising |
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Risk of turning to other drugs as a substitute. |
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Costly then oral Disulfiram at early stage. |
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Naltrexone Implant |
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This is a special formulation of Naltrexone, which is designed to release slowly over a 8weeks to 1 year period. It is placed under the patient's skin and so it is effective and does not allow the patient to forget or skip their medicine. There are some potential side effects with the Naltrexone Implant including infection, irritation or inflammation and sometimes even some skin breakdown over the implant site. It does not directly stop a person wanting to use heroin, although it may reduce or prevent cravings in.The implant is usually inserted under local anesthesia after detoxification is over and 2 – 3 doses of the oral Naltrexone have been given. It is inserted through a 1 cm incision in the lower abdomen or at the back of the upper arm. The implant is inserted 3-4mm under the skin
Naltrexone Therapy & It’s Importance
The ultimate goal of any detoxification program is to have patients on Naltrexone. Naltrexone is a pure narcotic antagonist. That is, it attaches to the endorphin or opiate receptors in the brain and completely blocks them. This means that if someone tries to use any kind of opiate while they are on Naltrexone, they feel no effect because all of the receptors are completely blocked. While Naltrexone is in the body, it is virtually impossible to relapse. Naltrexone has been available as an oral tablet since the late 1970s. However, it only has duration of action of around 24 to 48 hours and in practice, it has been found that most patients either forget or purposefully choose not to take their medicine. Then in a short period of time they go back to using Heroin. For this reason, we strongly recommend the Naltrexone implant. We believe that Naltrexone therapy should be given for 12 months. This gives the patient a chance to have their brain physically recover from the damage from the narcotics. It also gives the patient an excellent chance to begin on the road to recovery.
Naltrexone implant
This is a special formulation of Naltrexone, which is designed to release slowly over a 6-10 week period. It is placed under the patient's skin and so it is effective and does not allow the patient to forget or skip their medicine.
Risks and side effects
There are some risks associated with the Naltrexone pellet as mentioned above. There is some risk of taking the Naltrexone Therapy before the detoxification is complete. If taken too early, Naltrexone will push people into a complete withdrawal state and if the detoxification is not completely over, then there will be some withdrawal symptoms. If done too early, these can be severe.
Life after Naltrexone Implantation
We believe strongly that detoxification without appropriate follow-up and treatment is almost always unsuccessful. We insist that all of our patients be willing to participate in an appropriate treatment program as part of their after- care. This should include 12-step programs and professional therapy.
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Almost impossibility of relapse while the implant is effective. |
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Avoids the need to supervise Naltrexone Implantation. |
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Regular administration to take Naltrexone Implantation is reduced. |
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Reduces craving even more than Naltrexone Implantation because there is no point in craving for what you can't have |
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Long term cost effective. |
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Disadvantages of Implants: |
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Requires minor surgery and a small scar with temporary tenderness and bruising |
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Risk of turning to other drugs as a substitute. |
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Costly then oral Naltrexone Implantation at early stage. |
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