Methadone – treatment in heroin dependence (Biological Approach)
- Synthetic opiate – similar in chemical structure to heroin – has a similar effect at the synapse – replaces heroin at synapse
- Taken orally as a liquid
- Addicts assessed and level of methadone is determined
- Given in local pharmacy or clinic
- Given daily to get rid of symptoms
- Steady release into blood stream – constant
- Don’t get a rush – function reasonably normal – less desirable
- Supresses withdrawal symptoms
- If a dose is missed, the body is less able to break it down
- Dose decreased over a period of time
- Therapeutic dose – 60 – 90 mg a day
- NHS recommends medical checks are undertaken at least once every 3 months – monitoring level and stability of addiction – urine checks for drugs
- Supervised until seen as trustworthy to take doses away
Evaluation
- Very expensive – comes from tax
- Can be seen as unethical
- Doesn’t treat psychological dependence
- Breaks link with drug dealers and needles
- It isn’t mixed with other drugs
- Hard to overdose on methadone – unless mixed in a cocktail of other drugs where it would become dangerous
- Many addicts never try to detox
- Withdrawal takes longer than heroin (about a month)
Aversion Therapy – treatment for alcohol dependence (Learning Approach)
- Psychological treatment based on classical conditioning
- Alcohol when consumed normally – metabolises into a toxic compound, acetaldehyde
- If acetaldehyde builds up in the body it causes unpleasant symptoms associated with excessive drinking e.g. nausea, vomiting, dizziness, headaches, and palpitations
- Acetaldehyde is normally oxidised very rapidly into acetic acid which is completely harmless
- Aversion therapy gives patient disulfiram before consuming alcohol – blocks the oxidising of acetaldehyde so the individual experiences the unpleasant effects
- Daily dosage of disulfiram is given orally
- Pairing of alcohol with unpleasant symptoms is used to classically condition an aversion to alcohol
- Association of taste and smell of alcohol with unpleasant effects creates learning by association and should put the alcoholic off drinking in the future
- Given in hospital/specialised clinics
- Could take months/years depending on reaction and motivation of clients
Evaluation
- Very effective in short term due to unpleasant effects
- Works well if linked to social support – continued abstinence needs to be reinforced
- Deals effectively with physiological addiction – allows psychological reasons to be addressed separately
- Relapse rates are high – when disulfiram is no longer being used the level of nausea experienced relies entirely on the conditioned response, which will gradually become extinguished
- If nothing is done to resolve the psychological reasons why addiction started, relapse is almost inevitable
- Only effective if drinker abstains completely from alcohol in the future – alcohol consumption without disulfiram would immediately activate reward system
- Stimulus generalisation – may avoid all drinks, not just alcohol
- Kraft & Kraft – looked at a case study; fingernail biter, cannabis smoker, obese, etc. – aversion therapy was most cost effective and rapid treatment
- Some clients may be more motivated than others
- Relatively successful method – 9 year study, 50% remained abstinent