Dopamine Denial: New Cocaine Treatment?
By Michael Muldoon ❘
Researchers out of Oregon have found promising results when altering the way the brain manages dopamine through denial when addicted to or using cocaine.
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by Jessica Sherer | ❘
In both animal and human studies, the administration of insomnia drug Suvorexant during Opioid withdrawal resulted in improved sleep patterns, leading to lessened cravings and an overall decrease in Opioid-seeking behavior.
The National Institutes of Health found that over 75% of people who misuse Opioids or have an Opioid use disorder report having sleep problems, including waking up frequently, not sleeping well or long enough, or having irregular sleep schedules. These sleep problems can result in uncomfortable side effects like mood fluctuations and a decreased ability to cope with stressors.
During Opioid withdrawal, these conditions are compounded with other unpleasant symptoms such as abdominal cramping, nausea, vomiting, anxiety, and increased agitation. To seek relief from these withdrawal symptoms, Opioids are usually sought out and used again, leading to an ongoing cycle of abstinence, withdrawal, and relapse.
A 2023 Scripps Research study found that treating insomnia associated with Opioid withdrawal might help curb cravings and reduce relapse since a large proportion of drug use is fueled by the desire to alleviate withdrawal symptoms.
The guiding hypothesis was if people and animals could get better sleep, they would also be better equipped to resist cravings during withdrawal periods. Beneficial factors of getting good sleep include better mood and being able to properly handle stress, which are two helpful qualities when experiencing Opioid withdrawal symptoms.
Suvorexant, a Schedule IV substance, is different from other medications used to treat insomnia, as it inhibits wakefulness rather than promotes sedation. Also known by the brand name Belsomra, Suvorexant is an orexin receptor antagonist, which are drugs that inhibit the effect of orexin, the chemical messenger in the body that regulates wakefulness.
Suvorexant has a lower risk of addiction because people who take it do not experience a high or euphoria like they might while taking other insomnia medications. This is particularly beneficial when treating substance use disorders (SUD) and withdrawal, since it does not simply switch one addictive drug for another.
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In clinical studies, Suvorexant’s experimental counterpart, DORA-12, was given to Opioid-dependent rats during a 14-day period of Opioid withdrawal. The study found that all rats experienced the disrupted circadian rhythms expected of Opioid withdrawal, but the rats who were given DORA-12 showed physiological behaviors closer to that of animals who were not addicted to Opioids. In addition, when the rats were exposed to cues associated with Opioid use, they did not exhibit drug-seeking behaviors. Additionally, during and after treatment, the rats were less likely to ingest drugs again.
Similarly, a 2022 study from the Science Translational Medicine journal took 38 people who met the criteria for having an Opioid use disorder and administered Suvorexant during Opioid withdrawal. Results showed many promising outcomes, including improved sleep and REM time, reduced withdrawal symptom severity, and a heightened desire to quit Opioid use.
While more evidence is needed, these results strongly suggest that Suvorexant, and other orexin receptor antagonists, may be the key to treating adverse Opioid withdrawal symptoms, ultimately leading to better recovery outcomes.
While this is promising research for the future of Opioid addiction treatment, if you or a loved one is currently struggling with an addiction to Opioids, do not wait to get help.
Contact a treatment provider today to learn more about the resources available to you. They can help answer any rehab-related questions and discuss available treatment options.
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Jessica Sherer
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