Symptoms Associated with Opioid Dependence
What is Rapastinel? It was originally developed by Naurex as an alternative to the antidepressant drug Ketamine which has a number of adverse side-effects and a potential for abuse. Unfortunately, soon after acquiring Naurex in 2016, Allergan was soon met with a disappointment as the drug failed in its clinical trials. SMART offers substance abuse EHR software that helps streamline opioid dependance clinics.
While it failed as an antidepressant, there is renewed interest in it as a potential treatment for withdrawal symptoms associated with opioid use disorder, as described in this Duke University research abstract:
Pharmacotherapies, such as buprenorphine and methadone, are used to treat those dependent on opioids. However, these commonly used pharmacotherapies are opioid partial agonists and agonists, so the patient remains in an opioid-dependent state throughout treatment.
Treatment requires long-term tapering with buprenorphine or methadone, during which withdrawal symptoms can occur. These limitations show a clear need for a non-opioid pharmacotherapy. SMART can help your treatment center streamline efforts with substance abuse EHR software.
Drugs that target the NMDA receptor have been proposed as alternatives to opioid-targeted pharmacotherapies. The NMDA receptor is involved in the maintenance of opioid dependence and its blockade may reverse the neuroadaptive changes induced by opioid dependence.
Regulation of the NMDA receptor could accelerate treatment of opioid dependency (Glass, 2011).
Ketamine, an NMDA antagonist, has potential as a treatment, but has associated side effects and potential for abuse. Rapastinel is a novel drug marketed as an antidepressant, and it acts as a partial agonist of the NMDA receptor complex. The negative side effects reported with ketamine have not been reported with rapastinel (Moskal et al., 2016). Since rapastinel acts as a partial agonist and has no reported side effects, it may be a more tolerable treatment option for those dependent on opioids.
Current research is limited only to rodents, but the Duke study is hopeful that the continued success of their research will earn the drug clearance for human trials. Those who provide outpatient medication-assisted treatment with methadone and buprenorphine know the efficacy of the treatment. We also know that only a fraction of those who have opioid use disorders actually receive specialty treatment for it. Why is that? Stigma plays a big part. Others simply “don’t want to be in treatment for life” or, at the very least, are concerned about withdrawal symptoms that come with short-term non-medication-assisted therapies.
AddictionCenter.com, an informational web guide for those who are struggling with substance use disorders, states that “A supervised detox is the first step to treating any type of addiction”. According to NIDA, “When people addicted to opioids like heroin first quit, they undergo withdrawal symptoms (pain, diarrhea, nausea,and vomiting), which may be severe. Medications can be helpful in this detoxification stage”; and “While not a treatment for addiction itself, detoxification is a useful first step when it is followed by some form of evidence-based treatment”.
Medication-assisted detox treatment is not a new concept. It's widely available, relying mostly upon methadone, buprenorphine and naltrexone. Consider a new drug that is effective, non-addictive, has no risk of abuse and no reported side effects. That could be a game-changer in terms of bringing people who need opioid use disorder treatment into treatment. Might Rapastinel might be that drug? Contact SMART today to learn more about how our substance abuse EHR software offers the leading technology and research to help bring hope back for those suffering from the grips of this disorder, and the facilities dedicated to saving lives during this ongoing epidemic.