Medications Provide Hope for Opioid Use Disorders

Introduction

Opioid use disorders (OUD) have been a pressing issue in modern society, leading to a significant rise in morbidity and mortality rates. As healthcare professionals work to combat this crisis, medications that help treat OUD have proven to be indispensable tools providing hope for these stubborn addictions.

Overview of Opioid Use Disorders

Opioid use disorders are characterized by the chronic misuse of opioid substances, such as prescription pain relievers, heroin, and synthetic opioids like fentanyl. This misuse can lead to addiction, wherein individuals experience cravings, compulsive drug-seeking behaviors, and an inability to cease use despite negative consequences. Unfortunately opioid problems come with a high risk of death and disability, which makes it even more important to seek treatment as soon as possible.

Medications for Opioid Use Disorders

There are currently three primary medications approved by the FDA for the ongoing treatment of opioid use disorders: methadone, buprenorphine, and naltrexone. These medications work in distinct ways to help individuals achieve and maintain recovery from OUD.

Suboxone (buprenorphine/naloxone) film 8 mg

Buprenorphine

Buprenorphine is a partial opioid agonist, meaning it activates opioid receptors in the brain but to a lesser extent than full agonists. This medication provides enough activation to alleviate cravings and withdrawal symptoms without producing the full effects of opioids, thus reducing the risk of abuse and dependence.

Buprenorphine can be prescribed by qualified physicians in various settings, such as clinics and private practices, offering more accessible treatment options. The medication is often combined with naloxone (as in the formulation Suboxone) to discourage misuse via injection.

Possible side effects of buprenorphine may include headache, nausea, constipation, and drowsiness. As with methadone, it is crucial to follow the prescribed dosing regimen.

METHADONE IS USUALLY GIVEN IN LIQUID FORM AT OTP CLINICS

Methadone

Methadone is a long-acting, full opioid agonist, meaning that it activates opioid receptors in the brain, producing similar effects to other opioids. However, its slow onset and long duration of action help to prevent euphoria, cravings, and withdrawal symptoms, making it a safer and more effective option for opioid maintenance treatment.

Methadone is administered daily under the supervision of a healthcare professional in specialized treatment programs called opioid treatment programs (OTPs). This medication has a proven track record of reducing illicit opioid use, criminal activity, and the risk of infectious diseases associated with drug use. It is given as a liquid (as shown above) to prevent diversion.

Possible side effects of methadone may include constipation, dizziness, drowsiness, and respiratory depression. It is essential to follow the prescribed dosing regimen, as misuse of methadone can be life-threatening.

Vivitrol is a monthly injection that is administered into the gluteal muscle

Naltrexone

Naltrexone is an opioid antagonist, meaning it blocks opioid receptors in the brain, preventing the effects of opioids. This medication can help prevent relapse in individuals who have already detoxified from opioids. Unlike methadone and buprenorphine, naltrexone does not produce any opioid effects, reducing the risk of abuse and dependence.

Naltrexone is available in oral form (Revia) or as a long-acting injectable (Vivitrol). The long-acting injectable formulation is administered monthly, offering a more convenient option for individuals who may struggle with daily adherence.

Possible side effects of naltrexone may include nausea, headache, dizziness, and injection site reactions (for the injectable form).

Medications like methadone, buprenorphine, and naltrexone are valuable tools in the fight against opioid use disorders. By understanding their mechanisms, benefits, and potential side effects, healthcare providers and patients can work together to choose the most appropriate treatment plan for each individual's needs. It is essential to remember that medication-assisted treatment (MAT) is most effective when combined with behavioral therapies, counseling, and support services, creating a comprehensive approach to recovery.

NARCAN COMES AIS A NASAL SPRAY FOR THE REVERSAL OF OPIOID OVERDOSES

Naloxone

Often marketed under the brand name Narcan, naloxone is a life-saving medication that rapidly reverses the effects of an opioid overdose. Unlike the medications above, it is not an ongoing treatment for the chronic disease of addiction, but an emergency tool to reverse a life-threatening overdose. As an opioid antagonist (or “blocker”), naloxone binds to the opioid receptors in the brain, effectively displacing opioids and reversing their effects, such as respiratory depression (the slowing of one’s breathing rate), a primary cause of overdose fatalities. Naloxone is typically administered through intranasal spray or intramuscular injection and can be used by first responders, healthcare professionals, and even trained laypersons. This medication recently became available over-the-counter, so it may be available at your local pharmacy. Due to rapid action, naloxone has become an essential tool in combating the opioid crisis, preventing countless overdose-related deaths. Public health initiatives have worked to increase the availability of naloxone and with over-the-counter availability, more lives will certainly be saved.

It should be noted that once naloxone is administered, it is important to call 911 to bring emergency services. Naloxone is short-acting and may wear off before the effects of the opioid causing the overdose. For that reason, people experiencing an overdose are usually monitoring in a hospital setting.

When considering medication for opioid use disorders, it is vital to involve a healthcare professional experienced in addiction medicine to ensure appropriate selection, monitoring, and adjustment of treatment. Open communication between patients, their families, and healthcare providers is key to achieving the best possible outcomes in the management of opioid use disorders.

Ultimately, the goal of using these medications is to improve the quality of life for those affected by opioid use disorders, reduce the risk of relapse, and decrease the negative consequences associated with drug use. By promoting a better understanding of the available treatment options, we can make significant strides in addressing the opioid crisis and supporting those on their journey to recovery.