Medications for Opioid Use Disorder at VHP
Those interested in entering a MAT program should see one of our providers who is trained to prescribe this medication. While patients are receiving MAT in one of our practices, our team will help ensure they are connected to counseling and peer support.
Descriptions of some of these medications are below.
Buprenorphine
Buprenorphine acts at the opioid receptor. Putting it another way, it works at the same place in the brain where opioids attach. Buprenorphine occupies the place of the opioid receptor with one difference – it does not provide a high. Instead, withdrawal and cravings are lessened.
What is the process to start taking buprenorphine?
It is important that the person starting buprenorphine has not recently used an opioid or must be in opioid withdrawal, which feels like having the flu. The prescribing provider will guide a person through this process. Once the person starts taking buprenorphine, these symptoms improve. Sometimes, medicines that help marginalize the flu-like opioid withdrawal symptoms will be prescribed.
What if I have a painful surgery when I am taking buprenorphine?
We recommend a person continue taking buprenorphine before, during and after surgery. If required, opioids can be given for pain along with buprenorphine.
Naltrexone
Naltrexone acts at the opioid receptor. It works in the place where opioids work – like a key into a lock. When an opioid acts at the receptor, the person feels the effects of that opioid, such as pain relief or a “high.” Naltrexone fits into that same lock but does not provide a “high.” Instead, it blocks the receptor, so if the person takes an opioid, it will not have an effect.
Are there requirements before someone starts naltrexone treatment?
Given that naltrexone blocks the opioid receptor, it is important the individual starting the treatment has abstained from opioid use for at least seven days. Medication that assists with the flu-like symptoms of opioid withdrawal will sometimes be prescribed to help a person abstain from using opioids for seven days before starting the naltrexone.
Does naltrexone help treat other disorders beside opioid use?
Yes, naltrexone can be used to treat alcohol use disorder. That’s because a separate effect of the medicine is reducing the pleasurable “high” of drinking alcohol. Unlike using naltrexone for opioid use disorder, when the drug is prescribed for alcohol use disorder, it is safe to begin the naltrexone treatment while the person is still consuming alcohol. That’s because naltrexone can help the person diminish alcohol use.
How does someone take naltrexone?
Naltrexone can be taken once daily as a swallowed pill, or once monthly as an injection in the buttocks area.
What if I have a surgery or procedure scheduled while taking naltrexone?
If someone is scheduled for a painful procedure such as a surgery, when possible, naltrexone usage is ceased before surgery to allow opioids to be given, if needed.
Is it dangerous to increase opioid use to overcome naltrexone’s effect?
Yes. Some people attempt to consume extra opioids to overcome the blocking effect of naltrexone. This could be very dangerous and has resulted in overdose death.
Methadone
Some people need methadone. We will help anyone interested in methadone treatment get care at a licensed methadone program.