What treatments are effective for those living with OUD?

Methadone is a medication that people can use to treat . People may use the term medications for opioid use (MOUD) to describe methadone and other medications that treat OUD. Methadone works by changing how the brain and nervous system respond.

Methadone is a synthetic, long-term opioid agonist medication. This means that it helps to eliminate withdrawal symptoms by acting on the same opioid receptors in the brain that opioids activate.

Although it activates these receptors, it does so slower than opioids. As such, this does not cause euphoric feelings in a person with OUD.

Health experts may refer to methadone as a maintenance medication. This is because methadone is an opioid and can cause euphoria in those not dependent on opioids. However, for those with an OUD, the drug does not produce a euphoric high. Instead, it helps to minimize withdrawal symptoms and cravings, helping them better manage their day-to-day activities.

The length of time that a person needs to take methadone varies. Typically, healthcare professionals advise that a person takes methadone for at least 1 year, although some people take it for life. Health experts consider a person to be in recovery if they continue to abstain from the uncontrolled use of opioids regardless of whether they take methadone for life or gradually taper their dose.

Methadone is available in pill, liquid, and wafer formulations. Typically, a person takes methadone once or twice a day to treat OUD. To receive methadone for OUD treatment, a person must receive it from a methadone clinic, which some people may find difficult to access.

Learn about methadone withdrawal.

Buprenorphine is also a MOUD. A doctor can prescribe or dispense buprenorphine in an office-based setting, meaning the drug is more easily accessible for those who require it.

Buprenorphine is a synthetic partial opioid agonist. This term means that the drug also binds to the same opioid receptors but causes reduced activity. This helps reduce cravings and withdrawal symptoms in a person with OUD without producing euphoric sensations.

Buprenorphine is available as a sublingual film or tablet that a person places under their tongue or an extended-release subcutanous injection that a health professional can administer.

Often, a doctor may recommend combining buprenorphine with naloxone. This is to help decrease the likelihood of a person misusing buprenorphine.

Learn more about Buprenorphine for OUD.

Naltrexone is another MOUD that can treat OUD. It is also available to help treat alcohol use disorder (AUD).

Naltrexone is an opioid antagonist. This term means that the medication works by blocking the activation of opioid receptors. Instead of controlling cravings and withdrawal symptoms, it works by preventing any opioid drug from producing euphoric effects.

Naltrexone is available in a pill form that a person takes once per day or as an injection that a health professional administers once a month. However, for OUD, it is typically only available as an extended-release injection.

In some parts of the world, naltrexone is also available as an implant. This involves a doctor inserting a pellet of naltrexone under the skin during a minor surgical procedure. The body slowly absorbs the medication over a few weeks.

Learn more about naltrexone daily tablets.

Counseling and behavioral therapies are also treatment options for OUD. While medications help to reduce cravings and withdrawal, psychotherapy encourages a person to change and provides education and tools to help prevent relapses. It also helps them to develop practical and valuable life skills and stick with other forms of treatment, such as medications.

Different types of counseling for OUD can include:

• cognitive behavioral therapy (CBT)
• motivational enchancement therapy
• contingency management
• group counseling
• family counseling

Learn more about other types of therapy.

The National Practice Guideline by the American Society of Addiction Medicine (ASAM) recommends combining MOUD and counseling. The guide highlights that the standard of care for treating OUD should involve both medications and psychotherapy tailored to the individual’s needs.

Medication-assisted treatment (MAT) describes the combination of medications with counseling and behavioral therapies to help treat OUD.

Evidence notes that methadone, buprenorphrine, and naltrexone are all effective medications in helping reduce opioid use and related symptoms. The Food and Drug Administration (FDA) has approved all three medications for treating OUD.

Although each medication works differently, they are generally as effective as each other at reducing opioid use. A healthcare professional will recommend the best medication for an individual’s circumstances. They will consider factors such as the drug regimen, doses, a person’s health, and the severity of illness.

Similarly, a 2023 review on psychotherapies for OUD suggests that the best strategy will vary between people and will depend on their individual needs.

Learn more about OUD, including treatment and recovery.

The most effective treatments for opioid use disorders will typically involve a combination of medications and counseling. Health experts may refer to this as medication-assisted treatment.

The medications help to reduce cravings and withdrawal symptoms from opioids. Counseling helps a person to adjust their behaviors to help prevent relapses. No one treatment is more effective than others. The most effective options will vary between individuals. A person can work with their healthcare professional to find the most suitable options.