Controversy surrounding the treatment of substance abuse disorders with other substances extends from the most basic to the philosophical. Some health care providers focus on the removal of all substances to address the addiction and argue that total abstinence is the only real option. They believe that no medications should be given (except to save one's life) during treatment for substance abuse. Many mental health professionals, particularly in America, hold these views. In contrast to removing all substances, others focus on the ability of the client to function. Many programs support the belief that addicts can live normal lives with controlled use of substances.

 

Question

select a medication used in treating substance abuse disorders explain the major actions, intended effects, and side effects of this medication. Explain controversy surrounding the use of this medication in treating substance abuse disorders. Give an explanation defending the effective use of this medication and support your defense with evidence from a Learning Resources or research.

'Substance Abuse Disorder' or SUD can be defined as a chronic and relapsing medical illness with a strong root and repeated remission and relapse. Researchers consider that the risk of relapse cannot revert to normal after the use of alcohol or any drug after years and years of abuse, even after the detoxification process. Clinical psychologists claim that no drug can eradicate the possibility of relapse even after intensive pharmacological treatment because drugs can only help individuals to maintain abstinence but cannot guarantee that relapse can never occur in the future. Hence with pharmacological therapy, behavioral and psychological therapies are very much considered to be effective.  

Disulfiram is a medication very prominently used while treating alcohol abuse, which is sold by the trade-name 'Antabuse'. This medication cannot be used with all kinds of alcohol addicted patients, although this drug has the longest use of history in terms of treating alcoholics since 1940. 

Step-by-step explanation

Antabuse treatment can be regarded as a form of aversion therapy, as the drug produces unpleasant physical reactions because of drinking, which leads to the discouragement of drug use. Hence, it is widely used to prevent relapse and encourage abstinence in chronic alcohol drinkers. 

The side effects of taking Antabuse are-

• Life-threatening reaction: Consumption of alcohol while on Antabuse treatment can lead to life-threatening fatalities- death, coma, heart attack, and convulsions. 

• Serious interactions- Even without drinking the individual undergoing the treatment can suffer serious complications such as liver damage, acne, impotency, and skin rashes. 

• Noncompliance- Some addicts do not respond to the treatment well because they can have intense cravings and may have severe denials regarding the side-effects of the illness. 

The most common controversy related to this drug is that even though it has been in the market since the 1940s but it is indicated that to have an uneven efficacy while treating patients with severe alcohol abuse and also because of lack of appropriate ways of providing this medicine is another reason for the increase in adverse effects of this drug. That is, this drug should be prescribed to be taken in appropriate quantity, as high dosage can be risky and another fact is that, the patients should provide their consent for the aversion treatment and without consent, it should not be administered, such nuances are ignored by the clinicians very often. Another very important point is that this drug is low in cost when compared to other drugs such as 'Naltrexone' and due to this Disulfiram is most commonly used. 

For the effective use of Disulfiram, it becomes essential for the clinician to build a complete treatment program by adding in psychotherapy, counseling, group therapy, and family therapy with pharmacological therapy because Antabuse treatment is not enough to keep the individual away from relapse and the adverse effects of alcoholism.

Research conducted by C Wright and R D Moore in 1991 on the use of Disulfiram to treat alcohol addiction, concluded that it is important for the clinician to consider it only as an adjunctive therapy and the patient undergoing this treatment still requires consistent attention and supervision with other forms of therapy to expect complete abstinence and relapse prevention. Prescribing 'Disulfiram' without counseling and consent therapy won't be helpful and note that antabuse does not have a proven long term effect on chronic alcoholism.