Effective Treatments for Opioid Addiction

Fighting the opioid addiction crisis will take a multi-pronged approach. That means providing treatment options that people can easily access, developing drugs that are effective, etc. to help those in recovery from opioid use disorder (OUD) return and remain on the path to independence.

OUD has more recently come into focus for the medical community; as a result, significant improvements in how it is diagnosed and cared for have progressed. By seeking a medication-assisted treatment (MAT) program with additional behavioral modalities, recovery is achievable.

The CDC recently reported over 107,000 overdose deaths from drugs in the U.S. in 2022. Going by statistics, we now know that opioids were responsible for almost three-quarters of those fatalities. That figure does not include the 73,838 deaths caused by fentanyl overdose.

Similarly, the increasing prevalence of opioid use disorder (OUD) is mirrored in higher numbers looking for treatment. Only 1 in 5 people received treatment for OUD in 2021, out of the about 2.5 million individuals who sought help in treating opioid addiction that same year. A trend toward greater numbers of Americans needing services and yet not being able to get them safely remains problematic.

The geographic differences in opioid prescribing are still prominent, with states like Alabama at frequencies as high as 74.5 per 100 persons, compared to Hawaii's statewide rate of 24.3. This variation represents some of the vast differences, many a result of regional inequalities in employment opportunities or support for addiction treatment.

The following table below presents opioid death and prescription rates for three selected states:

The prescription rate between Alabama and Hawaii varies wildly—same as death rates. This signifies the need for targeted interventions.

Medications save lives for those struggling to overcome OUD. The three most effective medications in treating opioid addiction are:

1. Buprenorphine
2. Methadone
3. Extended-release naltrexone.

Their mechanisms of action differ, but they all help to suppress cravings and withdrawal symptoms which are what ultimately allow one to remain clean in the long run.

Buprenorphine is a weak opioid agonist, as it activates the same receptors in your brain as regular opioids do. It helps to reduce the urge and withdrawal symptoms without making you feel "high". Research also shows that buprenorphine can help keep people sober and is one of the only drugs a doctor can dispense at their office which users can take home.

Methadone is a full opioid agonist and one of the oldest known treatments for OUD. It prevents cravings and withdrawal symptoms while obstructing other opioids from having their effect. There are pros and cons, as methadone can only be used at certain clinics (pro from the perspective of ensuring proper management; bad if you are withdrawing in areas far away from known sites) It helps in avoiding misuse of the medication due to its controlled use but daily visits are required and this might cause some patients not attend.

Extended-release naltrexone is an opioid receptor antagonist. It totally blocks opioids and any high a person might get if they relapse. The drug naltrexone is usually taken immediately after detox. It blocks opioids completely and the high a person can have should they return to it. Typically, the drug naltrexone is prescribed immediately following detox. Treatment can only be initiated after the patient has been opioid-free for seven to ten days. This drug is especially useful in preventing relapses. It comes as a monthly injection.

MAT is a full spectrum type of treatment that combines medication and therapy to assist those with opioid use disorder. A psychological behavioral condition for which treating physical dependency is inadequate, SUD represents a new organ-based disorder that should be treated with integrated multicomponent care.

This method should help the addict cope with his withdrawal symptoms and prevent relapse by taking the pills a day he requires to manage the cravings. Though the initial objective of MAT is detoxification, it serves a higher purpose in offering long-term recovery and a better quality of life for patients.

Research reports that MAT has been found to be one of the best strategies in reducing opioid use and decreasing occurrences of death related to an overdose. After buprenorphine was rolled out in Baltimore, for instance, heroin overdose deaths plummeted by 37%. It also increases the quality of care for which people return, a vital part of long-term recovery. Medication (in the case of patients enrolled in treatment medical programs) also plays a role in lowering sticking percentages to treatments compared with psychological counseling.

More new and improved treatments for opioid addiction keep surfacing. These new medications and therapies are being developed to potentially enhance recovery outcomes.

For example, the latest prescription drugs that have been developed in the past few years have the ability not only to help adherence treatment but also flexibility and multifunctional actions. Sublocade™ was the first monthly buprenorphine injection for moderate-to-severe OUD, providing a new treatment option that may be more appealing to patients who struggle with taking daily medications. Probuphine®, the FDA-approved implantable buprenorphine formulation, helps in maintaining consistent medication levels over 6 months leading to reduced frequency of coverage dosing and increasing treatment retention.

But medication-assisted treatment is helping more and more people to find recovery. There is no consensus about the duration of time a patient should continue maintenance therapies. There has been debate over whether treatment should end after about 1 year, with some clinicians working to get patients off of medication at this point and others recommending that maintenance should be indefinite as it could remain useful long-term.

The important thing to remember is that it does get better and help is available for anyone who needs it so long as they persist in seeking continuous support and the resources aligned with what works best for them, whatever that may be.