Medications for Opioid Addiction
The treatment of Opioid Use Disorders has evolved. Although complete abstinence from dangerous drugs is obviously the best clinical outcome, many people suffering from addiction to opioid drugs cannot seem to stop entirely. This has given rise to the general therapeutic theme of “harm reduction”. In other words, reducing one’s use of illicit drugs is an outcome that by itself may improve the person’s physical and psychological health, reduce social problems related to addictions, such as legal, employment and housing issues
Although using a medication related to opioids to treat an opioid addiction may seem counter-intuitive, pharmacotherapy for addictions has been well recognized to be beneficial for many people struggling with addictions. Methadone was developed as a pain medication, but has also been used for the treatment of opioid addiction for over 50 years. Buprenorphine is a more recently developed therapeutic option. While both medications are effective at reducing cravings and withdrawal symptoms, there are some key differences between the two.
A key difference between buprenorphine and methadone is their pharmacology. Methadone is a full opioid agonist, which means that it activates the same receptors in the brain as other opioids like heroin and oxycodone. Buprenorphine, on the other hand, is a partial opioid agonist, which means that it only partially activates these receptors. This difference in pharmacology means that methadone has a greater potential for abuse and overdose than buprenorphine.
Another difference between the two medications is the way they are administered. Methadone is administered in a registered clinic or treatment center, while buprenorphine can be prescribed by a healthcare provider and taken at home. This makes buprenorphine more convenient for many patients, as they may not have to travel to a clinic every day to receive their medication. Moreover, there is now a long-acting, injectable formulation of buprenorphine that may improve compliance and possibly improve outcomes.
Finally, there is some evidence to suggest that buprenorphine may be more effective than methadone in certain populations. For example, pregnant women who are addicted to opioids may be better served by buprenorphine, as it has been shown to reduce the risk of neonatal abstinence syndrome (NAS) in newborns. Buprenorphine may also be a better choice for patients who have a history of overdose or who are at high risk of overdose.
Medications to treat opioid addictions are a plausible option for harm reduction in some individuals. There are some key differences between the methadone and buprenorphine. Healthcare providers should work with their patients to determine which medication is best suited to their individual needs and circumstances.
