Medications that can prevent or reduce withdrawal symptoms from stopping opioids are buprenorphine, methadone, and extended-release naltrexone.
Medications for alcohol use disorder are acamprosate, disulfiram, and naltrexone.
Some medications may cause side effects and pose other risks. Talk with a medical provider to create the treatment plan that’s right for you.
There are several medications that can help if you or a loved one is recovering from opioid or alcohol use disorder. Medication treatment for substance use disorders, combined with behavioral therapies and counseling, can reduce your withdrawal symptoms and cravings to sustain your recovery.
Recovery is possible, and medication treatment can help.
For many people diagnosed with opioid use disorder (OUD), it’s hard to stop using opioids and stay in treatment. These are highly addictive substances; when you try to quit, you may still crave them or experience painful withdrawal symptoms. Medication treatment for opioid use disorder, formerly called medication-assisted treatment (MAT), combines prescription drugs and behavioral therapies to aid in your recovery from OUD. The Food and Drug Administration (FDA)-approved medications for OUD are buprenorphine, methadone, and extended-release naltrexone. These medications are safe and effective when taken as prescribed.
Uses and benefits of medication for OUD (MOUD). In a MOUD program, a medication is prescribed to prevent or reduce withdrawal symptoms from stopping use of opioids such as codeine, fentanyl, heroin, hydrocodone, morphine, and oxycodone. The medication can also reduce your cravings for opioids, block their effects, and prevent an opioid overdose.
MOUD programs also incorporate counseling or behavioral therapies to assist in your recovery and motivate you to stay in treatment, follow prescribed therapies, and, if needed, address other physical and mental health issues. The type of MOUD and the length of treatment are tailored for you by your medical provider, although some treatments are more effective over certain minimum lengths of time. For instance, statistics show that methadone may be most effective in treating OUD if taken for at least 14 months.
Buprenorphine, a synthetic opioid, helps people with OUD manage symptoms and cravings in part by safely simulating some of the euphoric effects of opioids such as morphine and fentanyl. Buprenorphine is most often taken as a film or tablet that must be dissolved under the tongue; it can also be delivered by injection or implant. Buprenorphine is given out or prescribed at the doctor’s office, with ongoing dosing and treatment compliance overseen by a pharmacist. The availability of buprenorphine has improved access to OUD treatment, especially for patients not near certified methadone clinics, which are the only entities legally allowed to dispense methadone. Buprenorphine also is sometimes recommended for those who experience side effects with methadone.
The following are examples of brand-name drugs approved for MAT that rely on buprenorphine alone or in combination with naloxone, an opioid antagonist that reduces the potential for buprenorphine abuse:
Methadone, a synthetic opioid, helps people manage OUD treatment and remain in recovery by targeting opioid receptors. Compared with commonly misused opioids, it lasts longer and acts more slowly, not generating a “high.” Marketed under the brand names Dolophine and Methadose, methadone is available only through certified opioid treatment programs or methadone maintenance programs (often referred to as methadone clinics). It is typically taken daily by mouth in tablet or syrup form.
Extended-release naltrexone, an opioid antagonist medication, assists in OUD treatment by blocking the euphoric and relaxed feelings that people get from opioids such as codeine and morphine, thereby reducing cravings. Sold under the brand name Vivitrol, extended-release naltrexone is administered monthly through an intramuscular injection given by any licensed health care provider with the ability to prescribe medicines. Naltrexone is also used to treat alcohol use disorder.
Naloxone can safely reverse the toxic effects of an overdose and save a life. If you or someone you know is using opioids, carry naloxone as a precaution to protect against an overdose. You can get naloxone in a product named Narcan, which is sold over the counter. Learn more.
Medication treatment for alcohol use disorder (AUD) works similarly to medication treatment for OUD. Approved medications help you manage the effects of reduced or no alcohol use, and counseling or behavioral therapies assist you in sustaining your recovery. The FDA has approved acamprosate, disulfiram, and naltrexone (oral and extended-release) for use in medication treatment for AUD, formerly known as MAT for AUD.
Uses and benefits of medication for AUD (MAUD). In a MAUD program, a medication can be prescribed that can help you cut back on drinking — or stay alcohol-free if you’ve stopped drinking. Certain drugs work by lessening the painful withdrawal symptoms that can occur right after you stop using alcohol. Another drug causes you to become physically ill if you drink. Effective MAUD treatment plans also incorporate counseling or behavioral therapies to help you stay in recovery, adhere to therapy, and attend to other physical and mental health issues.
Types of medications for AUD. Three drugs are approved for use in MAUD:
Acamprosate, marketed under the brand name Campral, can ease alcohol withdrawal symptoms such as sleeping problems and mood issues, helping prevent a relapse. Two-pill doses are taken three times a day starting on the fifth day of abstinence from alcohol. This medication is for people who are alcohol-free and want to remain that way.
Disulfiram, marketed under the brand name Antabuse, deters drinking because people who consume a small amount of alcohol while on the drug feel ill almost immediately. These side effects — which include an upset stomach, nausea, and other symptoms — may go away after 30 minutes or last up to two hours. The once-a-day pill can be taken by mouth or crushed into water or juice. Experts caution that this drug should never be given to someone who is intoxicated.
Oral naltrexone, marketed under the brand names ReVia and Depade, and extended-release naltrexone, marketed under the brand name Vivitrol, both block the euphoric effects of alcohol and reduce cravings for it. The oral version is a pill taken once a day; the extended-release version is an injection that a patient gets every four weeks.
Medications for OUD or AUD can be regularly prescribed to treat common conditions such as hypertension. There is evidence showing that integration of counseling or behavioral therapies makes the treatment more effective. In addition, federal law requires you to receive counseling or behavioral therapy if you’re in a certified opioid treatment program.
Talk to your medical provider about your health history and life situation, which can help them develop a medication treatment plan that meets your goals. If you take any medication home, lock it away so children can’t get to it. And before taking any medication, consider the side effects and precautions, listed below.
Most medications for substance use disorder are considered safe when taken as prescribed. However, some can cause side effects and, especially if misused, pose other health risks, including serious harm or death by overdose.
Consult a licensed medical provider before taking any medication, tapering off a prescribed therapy, or switching to a different medication.
Dependence and overdosing. You can become dependent or overdose on some medications, especially if they are misused. Start and stop this therapy under the care of a trained medical provider and take any medication exactly as prescribed. Work with your medical provider to develop a treatment plan that meets your needs.
Pregnancy and breastfeeding. Both opioid and alcohol use can harm mothers, fetuses, and the babies of moms who are breastfeeding. If you have OUD or AUD and are planning a pregnancy, are pregnant, or are breastfeeding, talk to your medical provider about the relative benefits and risks of medications for addiction treatment.
Interactions. Most medications for substance use disorders have adverse interactions when taken with certain other medications, so be sure to tell your medical provider about any other medications and supplements you’re taking.
Cost. Some medications and treatments may be covered by private insurance, state Medicaid programs, or Medicare. If you are uninsured, underinsured, or otherwise have trouble paying for treatment, check whether your treatment program offers financial assistance that would help you pay for care or allow you to get it for free.
Recovery is possible, and medication treatment can help. Find a program near you.
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Medications to Treat Opioid Use Disorder Research Report, How do medications to treat opioid use disorder work? Opioid Agonists and Partial Agonists (Maintenance Medications), National Institute on Drug Abuse, Aug. 10, 2022