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What are anti-craving drugs?
Worldwide, three compounds are widely used to treat addictive diseases and reduce craving for substances producing ���high��� effects. These are naltrexone used to treat opioid and alcohol addiction, disulfiram and acamprosate used to treat alcohol addiction.

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Is it necessary to take anti-craving drugs?
Anti-craving drug therapy is an important part of many treatment schemes. First months after detoxification is the period of special risk for the patient making first steps towards sober life and often still not strong enough to withstand the craving for substances producing ���high��� effects arising from time to time. Psychotherapeutic or other rehabilitation programmes also fail to develop sufficient resistance over such a short period of time.

We prescribe these drugs to most of our patients in order to prevent early relapse.

A new drug acamprosate should be mentioned separately. It is used in later treatment periods, longer period of time is required for its effects to show.

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What is disulfiram?
Disulfiram produces no unpleasant symptoms and does not result in addiction. Disulfiram blocks ferments which break alcohol in human body. Globally, disulfiram has been prescribed for the treatment of alcohol addiction for the longest period of time. Most widely known trade names of disulfiram are Esperal®, Lidevine®, Antabus®.

Patients taking disulfiram but not using alcohol do not feel any effects. After alcohol intake the body starts to accumulate the alcohol breaking products, which result in sudden and severe worsening of the state of health. It is considerably easier to withhold from the alcohol intake knowing that it will produce very severe symptoms. It also reduces the number of spontaneously arising thoughts about the alcohol intake. We recommend taking disulfiram at the presence of the close person. It helps to resist the temptation to discontinue treatment arising from time to time.

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What is naltrexone (���Revia���) and how it is used?
Naltrexone produces no influence on the state of health and does not result in addiction. Naltrexone blocks the effects of all opioids (heroin, morphine, tramadol, etc.). It is recognised all over the world for the treatment of opioid addiction. Naltrexone acts on opioid receptors, i.e., spinal and brain areas sensitive to narcotic substances. It displaces narcotic substances and binding to the receptors protects from the effect of narcotic substances.

Usually, naltrexone is given orally. During intensive detoxification procedure the body is saturated with naltrexone. Later on, naltrexone should be taken daily for at least twelve months. In recent years, the efforts have been made to develop and introduce the extended-release naltrexone products. Some of them are implanted subcutaneously, some are injected with the help of a special needle. The latter techniques are not finally approved or are still under studies. In rare cases they may be applied in the individual manner, if other techniques are non-effective.

Naltrexone must be taken at the presence of a close person. Sometimes we recommend especially strict conditions, e.g., we offer to crush the drug, dissolve in water and drink with a glass of liquid. Daily use of naltrexone helps to take personal responsibility for the own life, protects from unpredictable temptations and relapses. By itself, naltrexone is not sufficient for getting cured, however its therapy is a must for maintaining sobriety.

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What happens when narcotic substances are used in the background of naltrexone therapy?
Naltrexone protects from feeling ���high��� under the effect of opioids. Opioids used in first postdetoxification days may cause spastic headaches, nausea, vomiting and diarrhoea. Naltrexone therapy helps to gradually regain the usual sensitivity of nervous system to all substances having effect on mental system. We urgently ask you not to test the activity of naltrexone with any of narcotic substances.

Naltrexone 50 mg daily is a sufficient dose to block the effect of opioids and prevent relapse. Any patient abstaining from opioids for a longer period of time becomes more sensitive, i.e. after relapse, the former usual dose may cause severe, even fatal poisoning.

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Is the use of naltrexone sufficient?
Successful treatment depends not only on the therapy but on the proper care as well. There are other preconditions of successful treatment.

Self-motivation ��� desire to get rid of the dependence.

Close person able to take care of the maintenance treatment with naltrexone all year round without any breaks.

Family or other doctor who will monitor the maintenance treatment with naltrexone. Professional consultations and their attendance during the postdetoxification period.