Medication Assisted Treatment For Opioid Use Disorder

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Anyone struggling with a substance use disorder like opioid addiction knows how difficult it can be to break free from its grasp. Simply deciding to stop taking opioids is rarely sufficient because you’ll likely end up with unbearable withdrawal symptoms that squash your efforts.

That’s why many rehab facilities offer medication-assisted treatment for opioid use disorder. This approach helps you cut opioids out of your system without enduring unpleasant side effects.

In this article, we’ll cover everything you need to know about medication-assisted treatment and how it can solve your opioid problem.

What Is Opioid Use Disorder (OUD)?

Opioid Use Disorder (OUD) is a medical condition characterized by a strong desire to use opioids despite their negative impact on your mind and body.

You might start by taking a few opioids prescribed by your doctor, but when you start increasing the doses or taking them for prolonged periods, it becomes an addiction.

Your regular opioid dose no longer takes effect, and you need to regularly increase your dose to get the same euphoric effects you crave. This sporadic approach to opioid dosing can lead to an opioid overdose, which is fatal without immediate medical attention.

The euphoric effect of opioids makes it difficult for patients with opioid use disorders or opioid addiction to quit without professional help. When they try to reduce or stop using opioids, they experience highly unpleasant withdrawal symptoms that often result in relapse.

Opioid treatment programs are designed to help people with substance abuse disorders overcome their addiction and, more importantly, prevent opioid overdose. These programs offer a combination of drugs (medication-assisted treatment) and counseling therapies to treat opioid addiction.

How Common is Opioid Use Disorder?

The opioid epidemic has touched millions of lives worldwide. The SAMHSA (Substance Abuse and Mental Health Services Administration)’s most recent studies show that more than 5.6 million people suffered from opioid use disorder from 2020 to 2021.

According to the WHO (World Health Organization), over 600,000 people died from drug abuse in 2019, and about 80% used opioids.

About 25% of these deaths resulted from an opioid overdose that couldn’t be treated promptly. Even if overdose-related deaths can be prevented with opioid treatment programs, less than 10% of people in need sign up for them.

How to Know if You Have Opioid Use Disorder

The sooner you identify your opioid addiction, the better your chances of recovery with minimal side effects.

Here are a few signs and symptoms of substance abuse disorder to look out for:

  • Feeling tired or lethargic
  • Changes in sleep patterns or habits
  • Unexplained weight loss
  • Recurring flu-like symptoms
  • Decreased interest in sexual activity
  • Poor personal hygiene
  • Changes in exercise routine or habits
  • Withdrawal from social interactions with family and friends
  • Engaging in secretive or dishonest behaviors, such as stealing from loved ones to procure opioids
  • Sudden or unexplained financial difficulties.

What Is Medication-assisted Treatment (MAT)?

Medication-assisted treatment (MAT) is a type of drug treatment that uses medication and behavioral therapies to treat substance use disorders.

The main goal of MAT is to help you manage withdrawal symptoms, reduce cravings, and maintain sobriety.

MAT is commonly used to treat opioid use disorder but can also be effective for other substance use disorders, such as alcohol use disorder. However, the drugs given to treat alcohol addiction are usually different.

How Does Medication-assisted Treatment Work?

Medication-assisted treatment works on two levels:

  1. Reducing your opioid dependence and cravings
  2. Managing your withdrawal symptoms.

This approach involves a combination of drugs to eliminate the opioids from your system while providing an opioid-like alternative so withdrawal symptoms aren’t too severe.

After getting through the withdrawal period, your healthcare provider might keep you on some medication for a few months to prevent relapse. For example, they might prescribe several doses of methadone for treatment, followed by smaller maintenance doses for a few months.

Medication-assisted treatment is followed by behavioral therapies such as individual counseling or group therapy sessions to ensure patients receiving treatment stay sober.

Medications for Opioid Use Disorder (MOUD)

There are three FDA-approved medications for treating opioid use disorder: methadone, buprenorphine, and naltrexone.

Methadone

Methadone is an opioid agonist that binds to opioid receptors in the central nervous system. It gives the same painkilling effects as regular opioid drugs but doesn’t cause euphoria, making it an excellent substitute for opioids.

Methadone has a long duration of action, meaning it stays in your system longer than most opioid drugs. Hence, methadone doses are less frequent than other opioids, and it can curb your cravings for more extended periods as you slowly wean off opioids.

As an opioid agonist, methadone also helps reduce withdrawal symptoms with its opioid-like action.

Methadone is only prescribed for patients with a confirmed diagnosis of opioid use disorder and is strictly monitored by the SAMHSA and the United States DEA (Drug Enforcement Agency).

Although safer than opioid drugs, there’s still a chance you can get addicted to methadone if taken in larger doses or for a more extended period than prescribed. That’s why methadone can only be given at SAMHSA-certified treatment facilities that offer opioid treatment programs.

Methadone can be found in oral tablets and liquid dosage forms.

Common Side Effects of Methadone

Some patients taking methadone may experience any of the following side effects:

  • Feeling restless or agitated
  • Nausea or vomiting
  • Breathing slowly or irregularly
  • Itchy skin
  • Excessive sweating
  • Difficulty passing stools (constipation)
  • Problems with sexual function or desire

Methadone & Pregnancy

Methadone is one of the few medications for opioid use that is considered safe during pregnancy and breastfeeding.

It doesn’t cause congenital disabilities and can even help both the mother and the baby avoid some health risks and complications due to opioids.

The baby may still experience withdrawal symptoms after delivery, known as neonatal abstinence syndrome, but the symptoms are much milder if the mother is on methadone.

Buprenorphine

Buprenorphine is a partial opioid agonist that binds to opioid receptors but doesn’t fully activate them like methadone or other opioid drugs. It causes very little euphoria or respiratory depression (slowed breathing) while providing a moderate painkilling effect.

Healthcare providers prescribe buprenorphine to minimize withdrawal symptoms during opioid treatment services.

Buprenorphine has a smaller chance of addiction than methadone because of its partial agonist activity. You can find buprenorphine in doctor’s clinics and other healthcare settings besides rehab centers since it’s not as strictly regulated as methadone.

Buprenorphine is rarely given alone but as part of a comprehensive medication-assisted treatment program that includes other drugs and counseling therapy.

Several dosage forms of buprenorphine are FDA-approved to treat OUD, including:

  • Sublingual tablets (Subutex)
  • Sublingual films (Suboxone)
  • Buccal films (Bunavail)
  • Buprenorphine implants (Probuphine)
  • Extended-release injectable suspension (Sublocade)

Many of these formulations contain a mixture of buprenorphine and naloxone, an opioid antagonist that blocks opioid receptors.

Together, these two drugs work synergistically. Buprenorphine activates the opioid receptors, while naloxone prevents it from activating them too much. Hence, the combination makes it even less likely for you to get addicted to buprenorphine.

The presence of naloxone also helps prevent physical dependence and withdrawal symptoms. This duo is usually prescribed in MAT programs for people with a high risk of relapse.

Common Side Effects of Buprenorphine

Some patients taking buprenorphine may experience any of the following side effects:

  • Nausea and vomiting
  • Lightheadedness
  • Exhaustion
  • Sweating
  • Dry mouth
  • Dental problems
  • Muscle pain
  • Insomnia
  • Fever
  • Vision problems
  • Tremors and irregular heartbeats

Naltrexone

Naltrexone is another opioid antagonist that blocks opioid receptors in the central nervous system. It prevents the euphoric and rewarding sensations you feel when taking opioid drugs.

Unlike methadone and buprenorphine, naltrexone has no effect when it comes to withdrawal symptoms because it doesn’t activate the opioid receptors whatsoever. Instead, naltrexone helps reduce opioid cravings and prevent relapse.

However, naltrexone should only be given in case of complete opioid abstinence or after withdrawal symptoms have resolved. Otherwise, it can cause severe withdrawal symptoms or make them worse.

The SAMHSA recommends waiting at least seven days after a patient’s last dose of short-acting opioids before starting naltrexone. In case of long-acting opioids, 10-14 days is recommended.

Naltrexone can be found in the form of oral tablets and extended-release injections.

Common Side Effects of Naltrexone

Some patients taking naltrexone may experience any of the following side effects:

  • Nausea and vomiting
  • Insomnia
  • Headache
  • Lightheadedness
  • Reduced appetite
  • Muscle and joint pains
  • Dental problems

Conclusion

Medication-assisted treatment is one of the best ways to overcome opioid use disorder. This practical treatment approach handles your withdrawal symptoms so you can focus on staying sober and taking charge of your life.

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