Medications Used to Treat OUD
Finding What’s Right for You
There are three drugs approved by the FDA for the treatment of opioid dependence: methadone, buprenorphine, and naltrexone. These medications can be used as part of a medication-assisted treatment program, or to assist with withdrawal management during detox. Treatment plans should be patient-specific, so it’s important to work with a healthcare provider when determining the appropriate medication.
Methadone
Methadone has been used to treat opioid dependence for decades. The goals of methadone maintenance are to relieve cravings, lessen the physical effects of withdrawal, and dampen the euphoric effects associated with commonly misused opioids. Methadone is long-acting, meaning its effects are slower and last in the body for a longer period of time (around 24-36 hours). By law, only a SAMHSA-certified opioid treatment program (OTP) can dispense methadone for the treatment of OUD.
If misused, the cumulative effect of large doses of methadone can approach the effects of other opioid use. Because of this, methadone treatment often requires observed dosing in a clinical environment. Methadone comes as an oral tablet, oral dispersible tablet (tablet that can be dissolved in liquid), oral concentrate solution, and oral solution. Methadone also comes in an intravenous (IV) form, which is only given by a healthcare provider.
| Other Names | Medication Type |
Methadone, Methadose | Agonist |
| How it’s Taken | How Often it’s Taken |
Liquid, edible wafer, or tablet | Daily |
| Who Can Prescribe It | |
Any prescriber at a certified opioid treatment program |
Methadone Summary
- Produces fewer opioid-like effects at low levels
- Often requires daily dosing in a clinic
- Eases withdrawal symptoms
- Recommended for detox and maintenance
Buprenorphine
Buprenorphine (commonly referred to as “bupe”) is a more recent medication for the treatment of OUD. Like methadone, buprenorphine can relieve cravings, lessen the physical effects of withdrawal, and block euphoric effects. Prior to the first dose, an OUD patient must abstain from using opioids for at least 12 to 24 hours, according to SAMHSA. Buprenorphine is long-acting, and in its injectable form is given once per month. Buprenorphine is also available as a sublingual tablet, buccal and sublingual film, implants, and injections.
Buprenorphine has a much lower risk for misuse or overdose than methadone, allowing it to be more commonly distributed through “take home doses” from a prescriber. Recent formulations like suboxone include naloxone, which helps to block the effects of buprenorphine when used other than prescribed, further deterring misuse.
| Other Names | Medication Type |
Suboxone, Probuphine, Subutex, Sublocade | Partial agonist |
| How it’s Taken | How Often it’s Taken |
Tablet, oral dissolving strip, implant or injection | Tablet or strip: Daily Injection: Monthly Implant: Every 6 months |
| Who Can Prescribe It | |
Any prescriber (check for clinic availability) |
Buprenorphine Summary
- Produces fewer opioid-like effects
- More available for take-home dosing
- Eases withdrawal symptoms
- Recommended for detox and maintenance
Naltrexone
Naltrexone works by blocking and preventing the effects of any opioids in the system, similar to naloxone. As a maintenance tool, it discourages opioid use by preventing opioids from producing the feelings of euphoria or sedation that are the primary goals of recreational use. SAMHSA recommends patients wait at least 7 days after their last use of short-acting opioids and 10 to 14 days for long-acting opioids before starting naltrexone. Naltrexone is long-acting, and its injectable form (Vivitrol) is given once per month. Naltrexone is also available as a pill (ReVia) that is taken once every 1-3 days.
| Other Names | Medication Type |
Vivitrol, ReVia | Antagonist |
| How it’s Taken | How Often it’s Taken |
Tablet or injection | Tablet: Every 1-3 days Injection: Monthly |
| Who Can Prescribe It | |
Any prescriber (check for clinic availability) |
Naltrexone Summary
- Blocks the effects of other opioids
- Deters opioid use
- Requires full detoxification before use, will cause withdrawal if opioids are still in the system
SRHN does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a substitute for medical advice, and you should not take any action before consulting with a healthcare professional. Prior to starting any medication or treatment plan always consult a medical doctor or other qualified healthcare provider regarding questions that you may have about any past, present, or suspected medical conditions and how those medical conditions may be impacted by starting any medication or treatment plan. Never disregard professional medical advice in seeking treatment because of something you have read on the SRHN Website.