Medication-Assisted Treatment for Opioid Use Disorder

Medication-Assisted Treatment (MAT) for Opioid Use Disorder is a growing treatment option for many individuals. The research is gaining great momentum in the success rate it is having for individuals to gain long-term recovery. Here are the leading medication options with some short descriptions to assist you in understanding a little more about the options available.

Methadone- Opioid agonist-activating preceptors in the brain and changing how the brain responds to pain. Done at a clinic daily or dispensed weekly. Highly addictive, abusable, and overdose potential. Withdrawal is extreme if not tapered. There are studies showing negative long term effects on the brain in memory with prolonged use. Affordable. Longest researched treatment option with great success.

Buprenorphine- Partial opioid agonist-activates the brain’s opioid receptors but to a lesser degree than methadone. The pill is taken daily. Needs to be 24 hours after last use. You can get the feeling of euphoria if on too high of a dose, however, it plateau’s on increasing intoxication, which reduces the risk of misuse and overdose. Doctors must be trained and licensed to prescribe and pharmacies have limited scripts they can give out monthly. There are more and more being able to prescribe and it is becoming the standard for opiate abuse treatment. There is great research showing a low relapse rate and people being able to get their lives back. We have found 6mo-2years is a good amount of time on it. Many want shorter or longer times, but it is an individual decision and depends on the length of use and amount in conjunction with doctor and therapist input. Many finance options to make it quite affordable.

Suboxone- (buprenorphine/naloxone in 4:1 ratio) Daily prescription pill or dissolvable film. Need monthly doctor visits, at least. Need to be 24 hours after last use.

Sublocade- New extended-release form of buprenorphine injected monthly. $1,700 out of pocket.

Naloxone- Opiate antagonist-blocks the activating of opioid receptors, prevents euphoric high. Daily pill. Nonaddicting, noncontrolled. Must be clean for 7-14 days. Blocks opiate receptors. A great option, however many individuals do not have the willpower to take it daily as they often still haven’t closed the door on using. Also known as Narcan, commonly used to reverse an opioid overdose. Very affordable.

Vivitrol- Extextended release naloxone. The monthly shot that blocks the receptor. Wears off towards the end of the month and often cravings come back and relapse potential may be high until they get the next shot. $1400 out of pocket. 

Any and all options should also be used in conjunction with therapy and counseling for the best results.

Please check with your health care provider for what option may be best for you. There are new and improved medications coming out all the time so staying connected with an addiction professional is the best way to understand the change in treatment options.