What are my medication options for Opioid Use Disorder?
There are 3 main FDA approved options in the United States
Naltrexone (Vivitrol, Revia), Buprenorphine (suboxone, zubsolv, subutex, sublocade), Methadone
Each Class works differently, but they all involve the mu opioid receptor. Opioids such as heroin and Percocet bind to the mu receptor, so these medications all affect the binding in hopes to treat opioid addiction.
Naltrexone is an “antagonist.” It binds to the mu-opioid receptor and blocks opioids such as heroin to get onto the receptor preventing the opioid to work.
Buprenorphine is a “partial agonist.” It binds to the mu receptor stronger (and longer) than heroin, somewhat like naltrexone. However, instead of just being a blocker, buprenorphine partially works on the mu-opioid receptor. Because it is a partial agonist, it theoretically, has a ceiling effect so if you give more it shouldn’t cause more symptoms including respiratory depression of opioid overdose. it’s a safer opioid
Methadone is an “agonist” It binds to the mu receptor-like opioids. Acts like heroin and percocet but works for longer periods of time.