New Medication Approaches
This information is on the newest approaches for heroin and opioid addiction medications (called Medication Assisted Treatment or MAT). This includes new medications, combinations of medications and new ways to take them.
As with all medication-assisted treatment, it is strongly recommended that this be combined with counseling and support for lifestyle changes and personal growth.
Comparing different medications for non-prescribed opioids such as heroin and other opioids
The National Institute on Drug Abuse (NIDA) compared two medications to prevent relapse in a 2017 study. The combination of buprenorphine and naloxone (brand name Suboxone) was given daily as a film put under the tongue. Naltrexone (brand name Vivitrol) was given as a monthly injection into the muscles. To take Vivitrol you must have fully detoxed before it can be used. This made Suboxone easier to use. The study showed that patients who are not able to complete detoxification and use Vivitrol can now start treatment with Suboxone instead and get the same good results. Suboxone is also much less expensive than Vivitrol, which costs $1,000 per injection.
Implantable Buprenorphine (Probuphine)
In May 2016 the FDA approved the use of Probuphine, a form of buprenorphine that is implanted in the arm. It provides a constant, low-level dose of buprenorphine for six months in patients who are already stable on low-to-moderate doses of the pill or film placed under the tongue. Because the medication is implanted under the skin, people don’t have to remember to take the medication or visit a clinic every day. In a study of Probuphine, 63% of patients had no evidence of opioid use throughout the six months of treatment.
Monthly Sublocade Injection
Sublocade is a once-a-month injection of buprenorphine approved by the FDA in December 2017. Buprenorphine reduces opioid withdrawal symptoms and the desire to use opioids. In order to have a Sublocade injection you must have been on a stable dose of buprenorphine taken as a tablet or film that dissolves in the mouth for at least seven days.
Sublocade was studied in 850 adults with opioid addiction. Patients taking the Sublocade injection had more drug-free weeks compared to those who took a dummy pill that has no actual effect (called a placebo). The most common side effects included constipation, nausea, vomiting, headache, drowsiness and injection-site pain.
Naloxone is a medication that quickly reverses opioid overdose. It restores normal breathing in a person whose breathing has slowed or stopped because of overdosing on heroin or prescription opioids. Many states allow you to get naloxone from a pharmacist without bringing in a prescription from a doctor. This was done to help family, friends, and other potential bystanders of overdose save lives.
It is available as a prefilled auto-injection device (EVZIO) or as a prepackaged nasal spray (NARCAN Nasal Spray). Visit NIDA’s Naloxone Resources webpage to learn more.