Psychopharmacology Week6 : Compare and contrast Methadone and Buprenorphine for substance abuse treatment

Psychopharmacology Week6 : Compare and contrast Methadone and Buprenorphine for substance abuse treatment

1. Naltrexone is often used in psychiatric mental health care for many reasons related to addiction and/or impulse control. It is also occasionally used to help patients with self-harm behaviors or weight loss. Considering the mechanism of action of naltrexone, how does it aid in addiction treatment?
2. Compare and contrast methadone and buprenorphine for substance abuse treatment. For this discussion, addiction use (what substances) include the mechanism of action, contraindications, and the pros or cons of each option.

Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.

Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.

Please review the rubric to ensure that your response meets the criteria.

Estimated time to complete: 2 hours

Sample Solution

1. Considering the mechanism of action of Naltrexone, how does it aid in addiction treatment?

Naltrexone is a narcotic antagonist used to manage alcohol and opioid dependence. Naltrexone has a high affinity for μ receptor and antagonist activity against mc, κ, and δ receptors (DRUGBANK, 2021a). Naltrexone binds to these receptors, completely blocking or attenuating the effects of endogenous opioids, resulting in antagonistic activity against the objective and subjective effects of opiates such as miosis, drug craving, euphoria, and respiratory depression (Singh & Saadabadi, 2021).

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In addition, Naltrexone suppresses ethanol consumption by modifying the hypothalamic-pituitary-adrenal. It has a long-lasting effect and is effective when administered orally compared to other antagonists.

2. Compare and contrast Methadone and Buprenorphine for substance abuse treatment. For this discussion, addiction use (what substances) includes the mechanism of action, contraindications, and the pros or cons of each option.

Methadone and Buprenorphine are opioid agonists and antagonists approved to manage the opioid disorder and severe pain with inadequate alternative treatments. However, Methadone is a synthetic opioid with a total agonist activity against the µ-, κ- and σ-opioid receptors (DRUGBANK, 2021b).

In addition, Methadone has a non-competitive antagonistic activity at the N-methyl-d-aspartate receptor. Conversely, Buprenorphine has a partial agonistic activity at the mu-opioid (DRUGBANK, 2021c). Besides, Buprenorphine has antagonistic activity at the kappa-opioid receptor.

Methadone acts by activating μ-receptors to induce a downstream effect of the G-protein, inhibiting pain transmission from the spinal cord (Durrani & Bansal, 2021). Methadone’s action cause analgesic effects, receptor internalization, and recycling, suppressing sedation, withdrawal symptoms, miosis, nausea, vomiting, hypotension, sweating, constipation, and bradycardia. However, Methadone is also associated with side effects such as respiratory depression, severe hypotension, decreased bowel motility, constipation, and decreased reproductive function in males.

Conversely, Buprenorphine act by partially binding to the mu-opioid receptor, partially exciting the receptors before reaching a ceiling effect (Kumar, Viswanath, & Saadabadi, 2017). Buprenorphine’s therapeutic values include analgesia, sedation, euphoria and dysphoria, and drowsiness. However, Buprenorphine has lower intrinsic activity and bioavailability. Side effects include depression of cough reflex, and respiratory centers, orthostatic hypotension, hepatic events, and adrenal insufficiency.

References

DRUGBANK. (2021a, August 16). Naltrexone. Retrieved August 18, 2021, from https://go.drugbank.com/drugs/DB00704

DRUGBANK. (2021b, August 16). Methadone. Retrieved August 18, 2021, from https://go.drugbank.com/drugs/DB00333

DRUGBANK. (2021c, August 16). Buprenorphine. Retrieved August 18, 2021, from https://go.drugbank.com/drugs/DB00921

Durrani, M., & Bansal, K. (2021, April 15). Methadone. StatPearls [Internet]. Retrieved August 18, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK562216/

Kumar, R., Viswanath, O., & Saadabadi, A. (2017, May 25). Buprenorphine. Retrieved August 18, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK459126/

Singh, D., & Saadabadi, A. (2021, February 1). Naltrexone. StatPearls [Internet]. Retrieved August 18, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK534811/