As opioid-related overdoses continue to surge nationally, federal and professional healthcare authorities are calling for more aggressive use of medications such as buprenorphine (alone or in combination with naloxone), methadone, and naltrexone.
According to the National Institute on Drug Abuse, these medications are not used widely enough in privately-funded substance use disorder treatment programs, and most states have insufficient capacity to provide medication-assisted treatment (MAT) to all patients with opioid use disorder. The agency notes that these medications are “safe, effective, and save lives…and can be used alone or as part of a larger treatment plan when countering the effects of opioids such as heroin, fentanyl, oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, or morphine.
Both the Food and Drug Administration and the Substance Abuse and Mental Health Services Administration have also endorsed more MAT involvement in substance abuse treatment programs and have recommended that where counselling services are not immediately available, patients should still be able to benefit from buprenorphine treatment and should not be denied such opportunities.
The FDA admits that there is still some stigma associated with using medications to treat OUD, but It’s necessary to “find new and more effective ways to advance the use of medical therapy for the treatment of OUD,” and all three of these medications have been demonstrated to be safe and effective in combination with counseling and psychosocial support. Everyone who seeks treatment for OUD should be offered access to all three options as this allows providers to work with patients to select the treatment best suited to an individual’s needs.”
Buprenorphine attaches to opioid receptors in the brain and helps reduce cravings and withdrawal symptoms without causing euphoria or dangerous side effects. It’s available under various trade names and in different forms (injectable, implant, sublingual) and when combined with naloxone (an over-the-counter medication used to reverse the effects of opioid overdose emergencies) it’s available as Suboxone® one of the main medications used to treat opioid addiction. According to a report from Harvard Medical School, Suboxone has been shown to lower the risk of fatal overdoses by approximately 50 percent. Used by itself, buprenorphine (also known as Sebutex®), is available in various tablet, sublingual and injectable forms.
Methadone, which has been available for over 40 years, is an opioid medication with slower and more subtle effects that don’t produce a high in people with OUD, and it eases their withdrawal symptoms, curbs cravings and supports recovery.
Naltrexone (Vivitrol®) is an opioid antagonist, used in the form of a monthly injection to block the effects of opioids as well as of alcohol, by preventing the “high” associated with these drugs and reducing cravings. It’s used over the long term and only after the drugs have cleared the body.
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