Dr. James Laurent Gagne, MD

Depends on the medication. Three are commonly used to help people quit cigarettes: Revia (bupropion), Chantix, and nicotine replacement with a patch, gum, or lozenges. You would need to take any of these medications for several months or more until the craving for tobacco is fully out of your system.

Chantix probably works best. It is a nicotine receptor blocker, which means that when you take a drag on a cigarette, the nicotine goes to your brain as usual, but the Chantix blocks your brain from receiving it, and you don't get they typical cigarette buzz. Chantix rarely has any side effects. So, when you take it, nothing happens, and when you smoke, nothing happens. Rarely, it can cause changes in mood or especially vivid dreams.

Revia is an antidepressant medication that helps you quit smoking two ways. First, sometimes people become depressed when they quit, and Revia blocks this depression. Second, often people gain weight after quitting, and Revia prevents that, too.

You can get most nicotine replacement products over-the-counter, i.e., without a prescription; nicotine patches, Commit lozenges, and Nicorette gum. All are available as generics at a lower cost. They are worth a try and do work well with the other medications, but in my experience, they often don't work as well as the other choices.

To answer this correctly, I have to make an assumption. You can put LOTS of drugs into a patch so they may be absorbed through the skin. The only patch commonly used in drug addiction is clonidine (brand name Catapres), which helps with alcohol and opiate withdrawal. I assume that's what they gave your cousin. Clonidine is sedating, cuts down on nausea and body aches, and lowers the risk for seizure. I reserve clonidine for use during the first few days of detox, because it can cause problems if continued for more than a week or so.

The FDA has approved two medications to treat alcoholism. I like naltrexone, available either in a pill you take every day or in a shot (Vivitrol) that a doctor gives you once a month. Naltrexone blocks the euphoria caused by alcohol, so it's ideal for occasional drinkers who really like the high from drinking. Nothing happens when you take naltrexone. When you drink, nothing happens either. No buzz, no high, nothing. It doesn't make you sick, it just blocks all of alcohol's effects.

Vivitrol works well for people who more or less want to get sober but aren't likely to take a pill every day. The only downsides are that it must be given by a doctor or a nurse, and without insurance, it costs over $1000 a shot. By contrast, naltrexone pills are extremely inexpensive.

The other FDA-approved drug is Campral, or acamprosate. Some physicians find it helpful, but many addiction specialists in the Untied States aren't convinced it's all that effective. See your doctor for more information about the pros, cons, and potential side effects of each medication.

Do NOT get a prescription for Antabuse, which is a decades-old drug touted to help people stop drinking. If you've taken Atabuse and have any contact with alcohol whatsoever (even applying aftershave lotion), you become violently ill. The problem is that most alcoholics stop taking Antabuse a day or so before they want a drink, and it doesn't work unless you take it regularly.

The WHOLE POINT of Suboxone and similar products with buprenorphine is that you take them for years. Difficulty stopping treatment with buprenorphine is the whole point. Addiction is the three "C"s: Craving/compulsive use, loss of Control, and ongoing use despite bad Consequences. YOU DON'T HAVE ANY OF THE THREE "C"s WITH SUBOXONE. You're not addicted, you're receiving treatment. Unless your life is 100% stable and you've taken it for years , stopping Suboxone inevitably leads to relapse. Stopping will MAKE you an addict.

The WHOLE POINT of Suboxone and similar products with buprenorphine is that you take them for years. Difficulty stopping treatment with buprenorphine is the whole point. Addiction is the three "C"s: Craving/compulsive use, loss of Control, and ongoing use despite bad Consequences. YOU DON'T HAVE ANY OF THE THREE "C"s WITH SUBOXONE. You're not addicted, you're receiving treatment. Unless your life is 100% stable and you've taken it for years , stopping Suboxone inevitably leads to relapse. Stopping will MAKE you an addict.

That said, do NOT accept treatment with other addicting drugs like benzodiazepines (Valium, Ativan, Klonopin, Xanax, etc.). Most of the other medications used in rehab are not addicting.

As long as you need them. Might be months or years, DO NOT STOP PREMATURELY out of the idea you SHOULDN'T need them.

Sure. That's what nicotine patches and lozenges are for, to prevent those symptoms.

Agreed. You're "addicted" if you have one or more of the three "C" symptoms: Craving/compulsive use, loss of Control, and ongoing use despite bad Consequences. If you're abusing opioids, sedatives, or alcohol and have withdrawal symptoms when you stop, that also usually points to addiction.

Nicotine gum does work, and many people do well with it. I often recommend using BOTH a nicotine patch and something you suck on. Nicotine lozenges often works better than the gum because they're easier to use.

Your husband has relapsed on alcohol. He needs to return to some sort of rehab.

Depends on the drug. Medication Assisted Treatment is essential for people addicted to opioids like Norco, oxycodone, or heroin. It consists of LONG-TERM MAINTENANCE with one of three medications: naltrexone (must use the injection called Vivitrol), buprenorphine (common brand is Suboxone), or methadone maintenance in a licensed methadone maintenance facility. Some people benefit from naltrexone for alcoholism. Otherwise not so much.

Most family physicians don't have the training or knowledge to prescribe accurately and wind up giving people benzodiazepines like Ativan or Valium, which just make the addiction worse. If possible work with a physician board certified in addiction medicine.