By Megan Krause
Chris Preston is a 36-year-old former heroin addict with three years clean and sober, but he remembers the pain and misery of trying to kick dope as if it were yesterday. “God, it was terrible,” the Philadelphia native says. “There were so many times I just couldn’t make it through the kick. I’d lie on my bed, just sweating and sick and depressed… and I’d think, I know how to make this all go away. Just go get a hit.”
Not only is this level of suffering dangerous and heartbreaking, much of it is unnecessary. While some discomfort when detoxing off opiates is inevitable, a significant amount can be alleviated with medication. Known as medicated-assisted treatment (MAT), this evidence-based approach to recovery involves the use of FDA-approved medications (along with counseling and behavior therapies) to treat those addicted to heroin and other opiates.
Does it work? Yes, it does:
- MAT reduces opioid use, protects against overdoses, lowers infectious disease transmission and decreases criminal behavior, according to the National Council for Behavioral Health.
- Patients participating in MAT are more likely to stay in therapy compared to those receiving treatment that doesn’t include medication, according to a report from the National Institutes of Health.
- The World Health Organization calls one such medication, buprenorphine, an “essential medicine.”
Three common medications to treat opioid use disorder are Suboxone, the Vivitrol shot and the Naltrexone implant.
What is Suboxone?
Suboxone is the brand name of a medication that combines two active ingredients: buprenorphine and naloxone.
Buprenorphine. This drug reduces withdrawal symptoms, lowers cravings and blocks the effects of opioids. Because there is the potential for misuse and addiction to buprenorphine, Suboxone also contains naloxone.
Naloxone. This drug is an opioid antagonist that rapidly reverses opioid overdoses. It’s better known by its brand name, Narcan. It’s included in Suboxone to discourage misuse.
Important things to know about Suboxone:
- It must be prescribed by a doctor.
- It comes as a wafer that can be dissolved under the tongue or on the inside of the cheek.
- Side effects usually aren’t serious and may include lightheadedness, headache and upset stomach.
What is the naltrexone implant?
Naltrexone is a medicine that decreases cravings for opioids and blocks the effects of other opioids. The naltrexone implant is a tiny medication pellet that’s inserted under the skin and releases a steady dose of naltrexone over two to six months.
Important things to know about the naltrexone implant:
- Talk to your doctor if you think this is something that could benefit you.
- As with any surgical procedure, there is a risk of complications and infection.
- Side effects of the medicine are usually mild and include nausea, headache, dizziness
What is the Vivitrol shot?
Vivitrol is a long-acting form of naltrexone. Patients receive it as a monthly injection.
Important things to know about the Vivitrol shot:
- Doctors administer the shot in offices and clinics.
- Side effects may include nausea, headache and lightheadedness; more serious ones include liver test abnormalities, depression, and an allergic pneumonia.
- You must be off all opioids for 7-10 days and alcohol for at least 24 hours before starting naltrexone.
Help is available
The medications listed here help restore balance to the brain circuitry affected by opioid misuse. They help your brain heal, so you can continue to work toward recovery. To learn more about these medicines, talk to your doctor; to learn more about your treatment options, call SAMHSA’s National Helpline: 1-800-662-HELP (4357).