Opioid use disorder remains an epidemic in the United States. Research shows that three million Americans have had or are currently suffering from substance abuse. Drug addiction ensnares people from almost all socioeconomic and educational backgrounds. Medication-assisted addiction treatment (MAT) can be used to curb substance cravings and thereby reduce substance abuse. Medication combined with behavioral health services increases recovery rates and saves lives, thus making people healthy in the communities they live.
What Are Opioids?
Opioids are a form of drugs that includes prescribed pain relievers as well as illicit medications like heroin and synthetics such as Fentanyl. Prescribed opioids have a lower risk of addiction among patients. It can convert into a high risk of misuse, overuse, or addiction among patients having psychological, sociological, and genetic factors. Opioid medication-assisted treatment with medications like Naltrexone, Buprenorphine, or Methadone can effectively cure substance use disorder. They help decrease the withdrawal symptoms and reduce cravings. According to research, these medications are the most effective way to treat drug addiction and maintain long-term recovery.
Who Is More Prone to Its Use?
Many patients are initially exposed to opioids through their healthcare providers for various reasons, such as after wisdom tooth removal, during recovering from injury or surgery, etc. Later, some individuals begin to self-medicate with opioids because they feel more normal or experience a positive reward when they use the opioid.
Teens and young adults are especially prone to drug overuse as their forming brains are searching for novel experiences, and they may initially access medications stored in the home. They may use it to cope with academic, social, or emotional stress or even to party and get high, often not recognizing the dangerous potential of addiction or overdose. The overuse of these drugs becomes harmful when a habit develops. Opioid pain medication should be used under the supervision or consultation of a medical practitioner.
MAT for Opioid use disorder
It consists of adding medications to prevent cravings, in combination with counseling and behavioral therapies to treat substance use disorders on a ‘whole-patient’ basis. The Food and Drug Administration (FDA) in the United States has approved MAT-specific medicines. They can help a person stop constantly thinking about the drug and reduce cravings. This addiction treatment program allows the person to focus on returning to a healthy lifestyle. We will discuss the four most common medications used in opioid addiction treatment.
Suboxone is a medication that clinicians commonly use to treat drug overuse disorders. It is a combination of two medications: buprenorphine and naloxone. Buprenorphine alleviates opioid withdrawal symptoms, suppresses cravings, and lowers the risk of overdose. Naloxone prevents injection or misuse of the medication. Suboxone generics have also been approved by the FDA.
2. Buprenorphine (Sublocade)
Buprenorphine is also a prescribed tablet and a patient can take it orally. It functions as a partial agonist and activates opioid receptors in the brain toward biological response. Extended-release injectable Buprenorphine, or Sublocade, indents for those who have initiated treatment with the oral tablet or film (Suboxone), followed by an adjusted dose for at least seven days. No detox is required before starting Suboxone and then moving on to Sublocade. It also removes the need for patients to remember to take their medication daily. It should be noted that Sublocade is only available through a restricted program, as it can be hazardous to self-administer.
3. Naltrexone for extended-release injectable suspension (Vivitrol)
Extended-release injectable Naltrexone, also known as Vivitrol, is administered by a doctor monthly through an injection in the buttocks. Licensed healthcare providers are the ideal persons to prescribe it unless no other special training is required. Patients must abstain from opioids for some time before starting on Naltrexone, which can be difficult for some to achieve. Naltrexone is an opioid antagonist and prevents the patient from feeling” high” when they use medications.
Methadone is a mu-opioid receptor agonist, typically used as replacement therapy for heroin or other substance dependence. Methadone’s slow onset of action when taken orally and prolonged elimination half-life (24–36 hours) allows it to be used as either a maintenance therapy or detoxification agent. Methadone has been used as a substitution for heroin or other opiates through tolerance and cross-tolerance mechanisms. It also prevents substance withdrawal symptoms and cravings. Methadone dose reduction schedules have ranged from 2–3 weeks to 180 days. More extended periods are generally associated with better outcomes.
The Bottom Line
In the United States, addiction treatment programs to curb substance abuse are tremendously beneficial, whether the medication-assisted treatment is done virtually by telemedicine or physically in the clinic. Consultation with a specialist in a medication-assisted treatment program is an ideal deal to fix problems related to opioid addiction.
By Gurpreet Singh Padda, MD, MBA