1. SUBOXONE (otherwise known as buprenorphine and naloxone)
Buprenorphine, sold under the brand name Subutex among others, is an opioid used to treat opioid use disorder, acute pain, and chronic pain.[13] It can be used under the tongue (sublingual), in the cheek (buccal), by injection (intravenous and subcutaneous), as a skin patch (transdermal), or as an implant.[13][14] For opioid use disorder, it is typically started when withdrawal symptoms have begun and for the first two days of treatment under direct observation of a health-care provider.[13] In the United States, the combination formulation of buprenorphine/naloxone (Suboxone) is usually prescribed to discourage misuse by injection.[13] However, more recently the efficacy of naloxone in preventing misuse has been brought into question, and preperations of buprenorphine combined with naloxone could potentially be less safe than buprenorphine alone.[15] Maximum pain relief is generally within an hour with effects up to 24 hours.[13] Buprenorphine affects different types of opioid receptors in different ways.[13] Depending on the type of receptor, it may be an agonist, partial agonist, or antagonist.[13] Buprenorphine’s activity as an agonist/antagonist is important in the treatment of opioid use disorder: it relieves withdrawal symptoms from other opioids and induces some euphoria, but also blocks the ability for many other opioids, including heroin, to cause an effect. Unlike full agonists like heroin or methadone, buprenorphine has a ceiling effect, such that taking more medicine past a certain point will not increase the effects of the drug.[16]
2. SUBUTEX
Buprenorphine, sold under the brand name Subutex among others, is an opioid used to treat opioid use disorder, acute pain, and chronic pain.[13] It can be used under the tongue (sublingual), in the cheek (buccal), by injection (intravenous and subcutaneous), as a skin patch (transdermal), or as an implant.[13][14] For opioid use disorder, it is typically started when withdrawal symptoms have begun and for the first two days of treatment under direct observation of a health-care provider.[13] In the United States, the combination formulation of buprenorphine/naloxone (Suboxone) is usually prescribed to discourage misuse by injection.[13] However, more recently the efficacy of naloxone in preventing misuse has been brought into question, and preperations of buprenorphine combined with naloxone could potentially be less safe than buprenorphine alone.[15] Maximum pain relief is generally within an hour with effects up to 24 hours.[13] Buprenorphine affects different types of opioid receptors in different ways.[13] Depending on the type of receptor, it may be an agonist, partial agonist, or antagonist.[13] Buprenorphine’s activity as an agonist/antagonist is important in the treatment of opioid use disorder: it relieves withdrawal symptoms from other opioids and induces some euphoria, but also blocks the ability for many other opioids, including heroin, to cause an effect. Unlike full agonists like heroin or methadone, buprenorphine has a ceiling effect, such that taking more medicine past a certain point will not increase the effects of the drug.[16]
3. VIVITROL
Naltrexone, sold under the brand names Revia and Vivitrol among others, is a medication primarily used to manage alcohol use or opioid use disorder by reducing cravings and feelings of euphoria associated with substance use disorder.[6] It has also been found effective in the treatment of other addictions and may be used for them off-label.[10] An opioid-dependent person should not receive naltrexone before detoxification.[6] It is taken by mouth or by injection into a muscle.[6] Effects begin within 30 minutes,[6] though a decreased desire for opioids may take a few weeks to occur.[6] Side effects may include trouble sleeping, anxiety, nausea, and headaches.[6] In those still on opioids, opioid withdrawal may occur.[6] Use is not recommended in people with liver failure.[6] It is unclear if use is safe during pregnancy.[6][11] Naltrexone is an opioid antagonist and works by blocking the effects of opioids, including both opioid drugs as well as opioids naturally produced in the brain.[6]
4. ORAL NALTREXONE
Naltrexone, sold under the brand names Revia and Vivitrol among others, is a medication primarily used to manage alcohol use or opioid use disorder by reducing cravings and feelings of euphoria associated with substance use disorder.[6] It has also been found effective in the treatment of other addictions and may be used for them off-label.[10] An opioid-dependent person should not receive naltrexone before detoxification.[6] It is taken by mouth or by injection into a muscle.[6] Effects begin within 30 minutes,[6] though a decreased desire for opioids may take a few weeks to occur.[6] Side effects may include trouble sleeping, anxiety, nausea, and headaches.[6] In those still on opioids, opioid withdrawal may occur.[6] Use is not recommended in people with liver failure.[6] It is unclear if use is safe during pregnancy.[6][11] Naltrexone is an opioid antagonist and works by blocking the effects of opioids, including both opioid drugs as well as opioids naturally produced in the brain.[6]
5. SUBLOCADE™ (buprenorphine extended-release) injection
Buprenorphine, sold under the brand name Subutex among others, is an opioid used to treat opioid use disorder, acute pain, and chronic pain.[13] It can be used under the tongue (sublingual), in the cheek (buccal), by injection (intravenous and subcutaneous), as a skin patch (transdermal), or as an implant.[13][14] For opioid use disorder, it is typically started when withdrawal symptoms have begun and for the first two days of treatment under direct observation of a health-care provider.[13] In the United States, the combination formulation of buprenorphine/naloxone (Suboxone) is usually prescribed to discourage misuse by injection.[13] However, more recently the efficacy of naloxone in preventing misuse has been brought into question, and preperations of buprenorphine combined with naloxone could potentially be less safe than buprenorphine alone.[15] Maximum pain relief is generally within an hour with effects up to 24 hours.[13] Buprenorphine affects different types of opioid receptors in different ways.[13] Depending on the type of receptor, it may be an agonist, partial agonist, or antagonist.[13] Buprenorphine’s activity as an agonist/antagonist is important in the treatment of opioid use disorder: it relieves withdrawal symptoms from other opioids and induces some euphoria, but also blocks the ability for many other opioids, including heroin, to cause an effect. Unlike full agonists like heroin or methadone, buprenorphine has a ceiling effect, such that taking more medicine past a certain point will not increase the effects of the drug.[16]
6. ZUBSOLV® (buprenorphine and naloxone)
Buprenorphine, sold under the brand name Subutex among others, is an opioid used to treat opioid use disorder, acute pain, and chronic pain.[13] It can be used under the tongue (sublingual), in the cheek (buccal), by injection (intravenous and subcutaneous), as a skin patch (transdermal), or as an implant.[13][14] For opioid use disorder, it is typically started when withdrawal symptoms have begun and for the first two days of treatment under direct observation of a health-care provider.[13] In the United States, the combination formulation of buprenorphine/naloxone (Suboxone) is usually prescribed to discourage misuse by injection.[13] However, more recently the efficacy of naloxone in preventing misuse has been brought into question, and preperations of buprenorphine combined with naloxone could potentially be less safe than buprenorphine alone.[15] Maximum pain relief is generally within an hour with effects up to 24 hours.[13] Buprenorphine affects different types of opioid receptors in different ways.[13] Depending on the type of receptor, it may be an agonist, partial agonist, or antagonist.[13] Buprenorphine’s activity as an agonist/antagonist is important in the treatment of opioid use disorder: it relieves withdrawal symptoms from other opioids and induces some euphoria, but also blocks the ability for many other opioids, including heroin, to cause an effect. Unlike full agonists like heroin or methadone, buprenorphine has a ceiling effect, such that taking more medicine past a certain point will not increase the effects of the drug.[16]