What you need to know
- Medication for opioid use disorder can help people stop or reduce opioid use.
- These medications work by limiting or blocking the effects of opioids, reducing cravings, and preventing withdrawal symptoms.
- If you’re seeking treatment for OUD, talk to your health care provider or contact SAMHSA’s National Helpline (1-800-662-HELP).
Anyone can become dependent on opioids, a class of drugs that includes some prescription pain medications like oxycodone and illegal substances like heroin. If you continue using opioids even when you want to stop, you may have opioid use disorder, a chronic medical condition that changes how your brain works. OUD may cause mental and physical distress or even overdose and death, but treatment can save lives and help people manage symptoms.
OUD treatment varies depending on a person’s needs. It may include counseling, peer support, or in-patient rehabilitation. It may also include medication, which research shows can help people stop or reduce opioid use.
Medication for OUD, also called MOUD, “really gives people a chance to make different decisions,” Dr. Michelle Lofwall, a psychiatrist, addiction medicine specialist, and professor at the University of Kentucky, tells Public Good News.
Read on to learn how these medications work and where to find treatment for OUD.
Which medications are approved to treat opioid use disorder?
The Food and Drug Administration has approved three medications to help stop or reduce opioid use: methadone, buprenorphine, and naltrexone.
Methadone
Methadone is an opioid that binds to the same receptors as stronger opioids like fentanyl and heroin. However, methadone activates those receptors more slowly, so it doesn’t produce the same feeling of euphoria. This medication helps reduce cravings and prevent withdrawal symptoms.
“If someone has a return to use of heroin or fentanyl, it’s more difficult for the heroin and the fentanyl to bind to the receptor if there’s medication there,” Lofwall explains.
Most people who take methadone receive a daily dose under the supervision of a health care provider. Some people may take home doses after a period of stability.
Buprenorphine
Buprenorphine is an opioid medication that partially binds to opioid receptors. Because it’s not as strong as methadone, most people can safely take their daily dose at home.
Some people may benefit from Suboxone, a combination of buprenorphine and naloxone, which helps prevent opioid misuse.
Naltrexone
Naltrexone is a non-opioid medication that blocks opioids from attaching to receptors. People who take naltrexone won’t experience the “high” associated with opioid use, and the medication may reduce opioid cravings. To start naltrexone, a person must stop taking opioids completely for seven to 10 days.
What are the risks?
When taken as prescribed, MOUD is very safe. Like any medication, it may cause side effects like dizziness, nausea, or fatigue.
For most people, the benefits of MOUD far outweigh the risks of resuming frequent opioid use. That’s why it’s important to take these medications as directed.
“We know that the brain is changed in addiction, and the risks are quite high if a patient tries to stop medications,” Dr. Gail D’Onofrio, a professor of emergency and addiction medicine at Yale’s School of Medicine, tells PGN.
Before starting MOUD, talk to your health care provider about any other medications or supplements you take.
How long do people take MOUD?
Some people take MOUD for a few months, while others may take it for years or even indefinitely.
“Just like diabetes, in most cases, patients need medications for life,” D’Onofrio says. “Any return to use is a possibility that overdose may occur.”
Where can I get it?
If you think you may be dependent on opioids, talk to your health care provider about which treatment options might be right for you.
“It’s a collaborative patient-clinician process, just like we would hope it would be for people going for treatment of type II diabetes or high blood pressure or cancer,” Lofwall says.
Any health care provider who is licensed to prescribe medication can prescribe naltrexone. To receive methadone or buprenorphine, you’ll need to see a provider licensed by the Drug Enforcement Administration. You can also call SAMHSA’s National Helpline (1-800-662-HELP) to find treatment resources near you.
If you start one type of medication and don’t see results right away, other options are available.
“There’s always hope,” Lofwall says. “If one medicine doesn’t work, that doesn’t mean that they’re all not going to work. You can switch medicines. You can try different things. It’s important to seek out treatment and get help because [OUD is] a deadly disorder, and we’re just losing too many really great people.”
For more information, talk to your health care provider.
This article was supported by Life Unites Us, a health campaign that receives funding from the Pennsylvania Department of Drug and Alcohol Programs. Public Good News retains full editorial control over its reporting.