Medical Services

Sometimes abstinence alone isn’t enough to overcome addiction. That’s why Fresh Start Recovery Programme offers medical and allied health treatments to addiction.

Naltrexone

Naltrexone blocks the effects of opiates (eg heroin). Naltrexone stops opiates being able to bind to the opioid receptors in the brain and so the ‘high’ is eliminated.

Naltrexone is currently registered as an oral tablet (Revia® 50mg) for the treatment of opiate and alcohol dependence and is used off-label for amphetamine dependence. When appropriate, Fresh Start also uses a sustained release implantable naltrexone formulation known as the O’Neil Long Acting Naltrexone Implant. It is in the process of registration.

Opiates

Opiates, including heroin, opium, morphine and codeine work by binding to the opioid receptors in the brain. The opioid receptors also detect the body’s own naturally-occurring chemicals such as endorphins. Opiate users may be treated with naltrexone tablets or implants to block the effects of the high and reduce or eliminate cravings.

Amphetamines

Amphetamine type stimulants (ATS) which include amphetamines, methamphetamines, MDMA (ecstasy) and dexamphetamine work by increasing levels of serotonin, dopamine and norepinephrine in the brain.

While the effects of ATS are not directly related to the opiate system, the opiate system and the dopamine system are linked, so that increases in dopamine can be limited by blocking the opioid receptors using naltrexone. This reduces cravings for amphetamines (although it does not eliminate the high if stimulants are used).

Alcohol

People who become addicted to alcohol feel cravings for it, and when they satisfy the craving to drink, they get a dopamine rush. Blocking the opioid receptors using naltrexone reduces cravings for alcohol (although it does not eliminate the feeling of drunkenness if alcohol is used).

Benzodiazepines

Benzodiazepines are prescription drugs and many people who have become addicted to them did so after a doctor prescribed them. Benzodiazepines include diazepam (Valium), alprazolam (Xanax), midazolam, oxazepam (Serepax), temazepam and nitrazepam (Mogadon).

Flumazenil

Flumazenil is commonly used as an injection with patients to reverse the affects of sedation after surgery and to treat benzodiazepine overdose. However Fresh Start Recovery Programme is currently using Flumazenil as a low dose infusion over a period of 4 days or more to help with the withdrawal of patients from a range of benzodiazepines. Flumazenil clears the benzo molecules from the GABA-A receptors in the brain.

Hepatitis C

Hepatitis C is an infectious liver disease caused by a virus. The hepatitis C virus is spread by blood-to-blood contact. This means that intravenous drug users who share needles or other equipment are in danger of getting it.

Hepatitis C virus can be treated with the anti-viral drugs interferon and ribavirin. Treating hepatitis C is straightforward in theory but a lot of intravenous drug users don’t get offered treatment for it. However, Fresh Start has a highly successful treatment programme for hepatitis C and welcomes all drug users who are being treated with naltrexone to join it.