Substitution therapy may be necessary in some cases to ensure the functioning of the body with all its organs. This involves supplying the body with missing substances that it needs to function properly. In such cases, it is called substitution therapy.
What is substitution therapy?
Substitution therapy is defined by supplying the body with substances from outside that it normally makes itself. Substitution therapy is defined by giving the body substances from the outside that it normally makes itself. However, a functional weakness or failure of the organ in question may mean that this is no longer possible. A special form of substitution therapy is the treatment of opioid addicts, who are administered methadone or similar substances to curb withdrawal symptoms and thus remove them from the haze of addiction. This is intended to address the side effects of drug addiction.
Function, effect and goals
There are different areas of application and application procedures for substitution therapy. A classic area of application is the addition of insulin in diabetes mellitus, when the pancreas is no longer able to provide sufficient insulin for sugar regulation in the body. In this case, insulin is injected into the abdomen by the affected person himself. Other forms of substitution therapy include levothyroxine administration in hypothyroidism (hormone supplementation after thyroid surgery), enzyme replacement therapy in certain metabolic disorders, blood transfusion in anemia, or volume replacement in dehydration. Substitution therapy is often indicated, especially after surgery. Along with insulin replacement therapy, levothyroxine administration for hypothyroidism is one of the most commonly indicated substitution therapies in practice. In this context, substitution therapy for drug addiction is one of the best-known substitution therapies, which also has a social function. In methadone substitution, the addict is administered a daily dose of methadone corresponding to the degree of addiction in order to avoid withdrawal symptoms. The methadone is slowly phased out until there is no longer any dependence, because methadone also has a high addiction potential. The aim of all substitution procedures is to enable the body or the damaged organs to resume their normal function. When administered, the added substitute docks onto the responsible receptors and thus ensures normal functioning. In the case of heroin addicts, for example, the aim is to free them from the addictive substance, thus eliminating possible psychosocial and health consequences. Ideally, the aim is to restore the patient’s ability to work and to avoid acquisitive crime. One of the goals is also to prevent infection with the diseases typically associated with drug use, such as hepatitis C. Particularly in the case of substitution therapy for addictive disorders, experience has shown that the principle works and addicts can actually be taken out of the cycle of dependence, acquisitive crime and decline in health. Moreover, since the “stuff” from the street is too often too impure or else too pure, methadone substitution can also prevent sufferers from overdosing or poisoning themselves.
Risks, side effects, and dangers
However, substitution therapy also carries risks. When injecting insulin, for example, close attention must be paid to ensuring that the adequate dose is injected, because otherwise dangerous hypoglycemia can result, for example. If the dose of insulin injected is too low, in turn, too much sugar will remain, which can also lead to massive symptoms. In the case of levothyroxine administration in hypothyroidism, it is also important that the necessary hormones are added to the thyroid and parathyroid glands in a professional manner and in the correct dosage to avoid complications. Similar considerations apply to blood transfusions, enzyme replacement therapy, and volume replacement for dehydration. It is important to hit the exact right dose and deliver it in a professional manner. Failure to do so may result in severe side effects. Substitution therapy should therefore always be carried out by specialists and under observation of the patient.Complications also often arise during the transition between inpatient care and outpatient follow-up. Another stumbling block is when different medical disciplines (surgery, general medicine and internal medicine) are involved, because smooth interaction must then be ensured. In the case of drug substitution, there is also the need for psychosocial care to counter any risks of relapse psychotherapeutically.
