Opioid Medications Overview

Buprenorphine

• Trade names include Buprenex®, Suboxone®, and Subutex®.
• Acts as a partial opioid agonist, providing similar benefits to methadone but with fewer side effects.
• Can be adjusted after patients stabilize to minimize cravings and withdrawal.

Naltrexone

• Known by the trade names ReVia, Vivitrol, and Depade.
• Administered orally, typically 50 mg once daily, with higher doses possible (100-150 mg) for supervised use.
• Requires abstinence from opioids for at least 7 days prior to starting the medication.

Narcan (Naloxone)

• Recognized as opioid reversal agents, used to counteract the effects of opioids.
• Provides critical emergency intervention for opioid overdoses.

Opioid Agonists

• Agonists actively bind to opioid receptors in the brain, producing full opioid effects.
• Full agonist examples include heroin, oxycodone, methadone, hydrocodone, morphine, and opium.

Opioid Antagonists

• These bind to opioid receptors but do not activate them, blocking the effects of opioids.
• Naloxone is a key example, used primarily to reverse opioid overdoses.

Methadone

• A long-acting oral opioid used for detoxification and maintenance therapy in opioid use disorder (OUD).
• Properties similar to heroin but with reduced potency and slower onset.
• Administered daily, available as liquid, powder, or tablets, and requires supervision initially.

Methadone Administration

• Patients must typically receive methadone under practitioner supervision initially before home administration.
• Treatment duration often lasts a minimum of 12 months, with gradual dose reduction to prevent withdrawal.

Buprenorphine Administration

• Treatment requires patients to abstain from opioids for 12-24 hours and be in early withdrawal.
• Once stabilized, dosing frequency may shift to alternate days based on individual needs.

Naltrexone Administration

• May be taken with or without food, regular monitoring is recommended, particularly in the early stages.
• Must confirm absence of recent opioid use through urine tests prior to starting treatment.

Requirements for Methadone

• Patients undergo assessments for stability and compliance before receiving medications independently.

Overview of Buprenorphine

• Serves as an effective alternative to methadone for OUD, characterized by a lower side effect profile and minimal withdrawal upon discontinuation.