Treating addiction to prescription opioids

Treating addiction to
prescription opioids

Several options are available for
effectively treating prescription
opioid addiction. These options
are drawn from research on the
treatment of heroin addiction
and include medications (e.g.,
naltrexone, methadone, and
buprenorphine) as well as
behavioral counseling approaches.
Naltrexone is an antagonist
medication that prevents opioids
from activating their receptors.
It is used to treat overdose and
addiction, although its use for
addiction has been limited due to

poor adherence and tolerability by
patients. Recently, an injectable,
long-acting form of naltrexone
(Vivitrol), originally approved
for treating alcoholism, has also
received FDA approval to treat
opioid addiction (i.e., heroin
or other opioids). Because its
effects last for weeks, Vivitrol
is ideal for patients who do not
have ready access to healthcare
or who struggle with taking their
medications regularly. Methadone
is a synthetic opioid agonist that
eliminates withdrawal symptoms
and relieves drug cravings by acting
on the same brain targets as other
opioids like heroin, morphine,
and opioid pain medications. It
has been used successfully for
more than 40 years to treat heroin
addiction, but must be dispensed
through opioid treatment
programs. Buprenorphine is a
partial opioid agonist (i.e., it has
agonist and antagonist properties),
which can be prescribed by
certified physicians in an office
setting. Like methadone, it
can reduce cravings and is well
tolerated by patients. NIDA is
supporting research needed to
determine the effectiveness of these
medications in treating addiction
to opioid pain relievers.