Treating Opioid Use Disorder

Addiction sneaks up on someone when they least expect it. It occurs gradually. By the time they seek help for opioid addiction, they are more than likely taking a higher dose than when they first started. This isn’t a concern for someone who’s taking the drug for short-term use. It doesn’t become a problem until opioids are taken for long periods of time and a person who has become tolerant to them has to take higher doses for the drug to remain effective. 

A person might find out that they are dependent on opioids when they start to feel withdrawal symptoms after they stop taking them. It’s important to note that someone can become dependent on a drug without being addicted to it. Dependence is bound to happen with chronic use of any drug or substance; it only becomes a problem when taking it interferes with daily life. If someone can’t stop taking opioids no matter how hard they try to, they are likely addicted.1

Fortunately, programs are available to help people struggling with addiction. The most common treatment program for opioid abuse disorder is Medicated Assisted Treatment (MAT), which uses both pharmacological and behavioral therapies to slowly wean a patient off of opioids. MAT programs typically use opioids to combat withdrawal symptoms so patients can focus on behavioral therapies. Currently, there are three drugs that have been approved by the Food and Drug Administration (FDA): methadone, buprenorphine (Probuphine®, Suboxone®), and naltrexone (Vivitrol®). Each drug has its pros and cons.

Naltrexone is the only FDA-approved drug that isn’t an opioid.
Having been recently approved, there are less studies about its effectiveness compared to methadone or buprenorphine.2
Methadone has been successfully treating opioid addiction for decades and numerous studies back it up as an effective treatment.Unlike buprenorphine, methadone has a higher risk of abuse.3
Buprenorphine is less likely to be abused.4Studies show more success rates with methadone as opposed to buprenorphine.5

Here are some important things to know about MAT programs:

They work. MAT programs have been used for decades and studies back up these programs as an effective treatment for opioid use disorder. 

You are not substituting one addiction for another. Because opioids are often involved in MAT programs, a common misconception is that patients will get addicted to the drugs during treatment. While addiction may be possible, MAT has shown to be highly effective in patient retention after treatment has been completed.6

Treatment drugs can be taken with or without behavioral therapy. Addiction patients may not have access to MAT programs due to location or the costs involved, but that should not deter anyone from starting treatment. Drugs are available with or without behavioral therapy, and studies show no discernible differences in the method of treatment.7

The drugs have similar side effects. Methadone and Buprenorphine are both opioids, and taking them to combat addiction doesn’t come without side effects. Expect general side effects such as dizziness and nausea, drowsiness, sweats, or constipation.

1 Tolerance, Dependence, Addiction: What’s the Difference? | NIDA Archives
2How effective are medications to treat opioid use disorder? 
3 What is the treatment need versus the diversion risk for opioid use disorder treatment? 
4 Buprenorphine Treatment for Opioid Use Disorder: An Overview 
5 Buprenorphine vs methadone treatment: A review of evidence in both developed and developing worlds
6 Effective Treatments for Opioid Addiction 
7 Evaluating comparative effectiveness of psychosocial interventions adjunctive to opioid agonist therapy for opioid use disorder: A systematic review with network meta-analyses