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Opioid Use Disorder Medication

Opioid Use Disorder Medication, Signs Of Addiction & Best Treatment Options

Opioid Addiction

Misuse of prescription opioids and heroin affects more than 2 million Americans and an estimated 15 million people worldwide each year. The prevalence of opioid misuse and addiction is rapidly increasing. [1]

Opioid addiction is a long-lasting (chronic) disease that can cause major health, social, and economic problems. Opioids are a class of drugs that act in the nervous system to produce feelings of pleasure and pain relief. Some opioids are legally prescribed by healthcare providers to manage severe and chronic pain. Commonly prescribed opioids include oxycodone, fentanyl, buprenorphine, methadone, oxymorphone, hydrocodone, codeine, and morphine. Some other opioids, such as heroin, are illegal drugs of abuse.

Opioid addiction is characterized by a powerful, compulsive urge to use opioid drugs, even when they are no longer required medically. Opioids have a high potential for causing addiction in some people, even when opioid use disorder medications are prescribed appropriately and taken as directed. Many prescription opioids are misused or diverted to others. Individuals who become addicted may prioritize getting and using these drugs over other activities in their lives, often negatively impacting their professional and personal relationships. It is unknown why some people are more likely to become addicted than others.

Opioid addiction is a complex disorder, and nongenetic factors also play a critical role. Factors that have been shown to increase the risk of opioid addiction include a history of substance abuse; depression or other psychiatric disorders; childhood abuse or neglect; and certain personality traits, including impulsivity and sensation-seeking. Living in poverty and in a rural area, associating with others who abuse opioids or other substances, and having easy access to prescription or illegal opioids also contribute to a person’s risk of opioid addiction. It is likely that a combination of health, social, economic, and lifestyle factors interact with genetic factors to determine an individual’s risk.

Opioid Use Disorder Medication
Opioid use disorder medication should be combined with behavioral counseling for a “whole patient” approach, known as Medication-Assisted Treatment (MAT).

Opioid addiction can cause life-threatening health problems, including the risk of overdose. An overdose occurs when high doses of opioids cause breathing to slow or stop, leading to unconsciousness and death if the overdose is not treated immediately. Both legal and illegal opioids carry a risk of overdose if a person takes too much of the drug, or if opioids are combined with other drugs (particularly tranquilizers called benzodiazepines).

Signs Of Opioid Addiction

Opioid use disorder may be diagnosed by a doctor. Someone struggling with opioid use disorder may not display symptoms right away. However, over time, there may be some signs that they need help. [2]

  • The inability to control opioid use
  • Uncontrollable cravings
  • Drowsiness
  • Changes in sleep habits
  • Weight loss
  • Frequent flu-like symptoms
  • Decreased libido
  • Lack of hygiene
  • Changes in exercise habits
  • Isolation from family or friends
  • Stealing from family, friends or businesses
  • New financial difficulties

Opioid Addiction Symptoms

There are a number of symptoms that may be present in individuals suffering from opiate addiction. Those symptoms may include:

Mood Symptoms:

  • Lack of motivation
  • Depressed mood
  • Hyperactivity

Physical Symptoms:

  • Weight loss
  • Cramping
  • Diarrhea
  • Itchy skin
  • Joint and muscle pain
  • Nausea and vomiting
  • Headaches

Psychological Symptoms:

  • Loss of concentration or interest
  • Confusion or disorientation
  • Mood swings or extreme behavior changes
  • Depression
  • Anxiety
  • Distorted perception of reality

Behavioral Symptoms:

  • Withdrawn socially
  • Slowed or slurred speech
  • Diminished coordination
  • Loss of interest in activities once enjoyed
  • Stealing from loved ones or other illegal activities

Medication Assisted Treatment For Opioid Use Disorder

Medication-assisted treatment (MAT) is the use of opioid use disorder medications in combination with counseling and behavioral therapies, which is effective in the treatment of opioid use disorders (OUD) and can help some people to sustain recovery.

Opioid Use Disorder Medication
Opioid use disorder medication decreases drug use, opioid-related overdose deaths, criminal activity, and infectious disease transmission.

More must be done to facilitate treatment options and the development of therapies to address OUD as a chronic disease with long-lasting effects. This means helping more people secure MAT, which requires us to break the stigma often associated with some of the opioid use disorder medications. It also requires us to find new and more effective ways to advance the use of medical therapy for the treatment of OUD.

There are three drugs approved by the FDA for the treatment of opioid dependence: buprenorphine, methadone, and naltrexone. All three of these treatments have been demonstrated to be safe and effective in combination with counseling and psychosocial support. Everyone who seeks treatment for an OUD should be offered access to all three options as this allows providers to work with patients to select the treatment best suited to an individual’s needs. Due to the chronic nature of OUD, the need for continuing MAT should be re‐evaluated periodically. There is no maximum recommended duration of maintenance treatment, and for some patients, treatment may continue indefinitely. [3]

FDA-approved buprenorphine products approved for the treatment of opioid dependence include:

  • Bunavail (buprenorphine and naloxone) buccal film
  • Cassipa (buprenorphine and naloxone) sublingual film
  • Probuphine (buprenorphine) implant for subdermal administration
  • Sublocade (buprenorphine extended‐release) injection for subcutaneous use
  • Suboxone (buprenorphine and naloxone) sublingual film for sublingual or buccal use, or sublingual tablet.
  • Subutex (buprenorphine) sublingual tablet
  • Zubsolv (buprenorphine and naloxone) sublingual tablets

FDA-approved methadone products approved for the treatment of opioid dependence include:

  • Dolophine (methadone hydrochloride) tablets
  • Methadose (methadone hydrochloride) oral concentrate

FDA-approved naltrexone products approved for the treatment of opioid dependence include:

  • Vivitrol (naltrexone for extended-release injectable suspension) intramuscular

Methadone For Opioid Addiction

Methadone is an opioid use disorder medication approved by the Food and Drug Administration (FDA) to treat opioid addiction as medication-assisted treatment (MAT), as well as for pain management. When taken as prescribed, methadone is safe and effective. Methadone helps individuals achieve and sustain recovery and to reclaim active and meaningful lives.

Methadone treatment is one component of a comprehensive treatment plan, which includes counseling and other behavioral health therapies to provide patients with a whole-person approach.

Buprenorphine Treatment For Opioid Addiction

Buprenorphine is a medication approved by the Food and Drug Administration (FDA) to treat opioid use disorder (OUD) as medication-assisted treatment (MAT). As with all opioid use disorder medications used in MAT, buprenorphine should be prescribed as part of a comprehensive treatment plan that includes counseling and other behavioral therapies to provide patients with a whole-person approach.

  • To begin treatment, an OUD patient must abstain from using opioids for at least 12 to 24 hours and be in the early stages of opioid withdrawal. Patents with opioids in their bloodstream or who are not in the early stages of withdrawal, may experience acute withdrawal.
  • After a patient has discontinued or greatly reduced their opioid use, no longer has cravings, and is experiencing few, if any, side effects, if needed, the dose of buprenorphine may be adjusted. Due to the long-acting agent of buprenorphine, once patients are stabilized, it may be possible to switch from every day to alternate-day dosing.
  • The length of time a patient receives buprenorphine is tailored to meet the needs of each patient, and in some cases, treatment can be indefinite. To prevent possible relapse, individuals can engage in on-going treatment—with or without MAT.

Naltrexone For Opioid Abuse Treatment

Intramuscular extended-release Naltrexone is a medication approved by the Food and Drug Administration (FDA) to treat both opioid use disorder (OUD) and alcohol use disorder (AUD) as a medication-assisted treatment (MAT) option. Naltrexone can be prescribed and administered by any practitioner licensed to prescribe opioid use disorder medications and is available in a pill form for Alcohol Use disorder or as an extended-release intramuscular injectable for either Alcohol or Opioid Use disorder.

A Risk Evaluation and Mitigation Strategy (REMS) is required for the long-acting injectable formulation to ensure that the benefits of the drug outweigh its risks. The pill form can be taken daily for alcohol use disorder, but the extended-release injectable formulation is approved for the treatment of OUD. The pill form is taken daily and the extended-release injectable is administered every four weeks, or once a month, by a practitioner. Naltrexone is one component of a comprehensive treatment plan, which includes counseling and other behavioral health therapies to provide patients with a whole-person approach. Naltrexone is not a recommended MAT option for anyone younger than 18 years of age, or for patients experiencing other health conditions.

Opioid Use Disorder Medication
Opioid use disorder medication increases social functioning and retention in treatment.

Naltrexone is not an opioid, is not addictive, and does not cause withdrawal symptoms with the stop of use. Naltrexone blocks the euphoric and sedative effects of opioids such as heroin, morphine, and codeine. Naltrexone binds and blocks opioid receptors, and reduces and suppresses opioid cravings. There is no abuse and diversion potential with naltrexone.

Opioid Addiction Treatment

It is important to provide treatment for people struggling with opioid use disorder to prevent overdose or even death. To treat those with opioid use disorder, it is crucial to expand access to evidence-based treatments, including medication-assisted therapy (MAT). MAT is a comprehensive way to address the needs of individuals that combines the use of opioid use disorder medication (methadone, buprenorphine, or naltrexone) with counseling and behavioral therapies.

MAT has proved to be clinically effective and significantly reduce the need for inpatient detoxification services for these individuals. MAT provides a more comprehensive, individually tailored program of medication and behavioral therapy that addresses the needs of most patients.

The ultimate goal of MAT is full recovery, including the ability to live a self-directed life. This treatment approach has been shown to:

  • Improve patient survival
  • Increase retention in treatment
  • Decrease illicit opiate use and other criminal activity among people with substance use disorders
  • Increase patients’ ability to gain and maintain employment
  • Improve birth outcomes among women who have substance use disorders and are pregnant

Research also shows that these opioid use disorder medications and therapies can contribute to lowering a person’s risk of contracting HIV or hepatitis C by reducing the potential for relapse. [4]

If you or someone you love is struggling with substance use disorder and have concerns with opioid use disorder medication, contact We Level Up addiction rehab center.

We Level Up is an opioid addiction treatment center. Our clinical team can help individuals successfully complete the opioid detox process while managing the psychological, physical, and spiritual issues connected to drug abuse. Qualified doctors, nurses, therapists, and addiction cases managers will be with you throughout the recovery process to ensure you have the support you need. Call to learn more.