Treating Opioid Use Disorder With Monthly Injections

Medically Reviewed By William C. Lloyd III, MD, FACS
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Medication-assisted treatment (MAT) has been proven to be an effective way to help people recover from opioid use disorder. Methadone, for example, is a well-studied and frequently used MAT. But in most cases, it requires daily trips to a treatment clinic to receive your dose of medication.

As an alternative, some people may be candidates to receive monthly injections of other medications instead. Could this be an option for you? Here’s what you need to know about the different forms of MAT treatment. 

Benefits and Challenges of Medication-Assisted Treatment

Opioids, such as hydrocodone/acetaminophen (Vicodin) or oxycodone (Oxycontin), can be legally prescribed and used to treat pain. However, when it’s time to come off these drugs, the withdrawal symptoms can be so severe that many people can’t tolerate them. When tapering off opioids, you may experience pain, gastrointestinal distress, restlessness, sweating, insomnia, tremor, and mood changes–for days, weeks, or even months. These severe symptoms can cause many people to continue taking opioids and go extra lengths to secure them when their prescription runs out. Plus, when legal opioids are misused, or illegal opioids, such as heroin, are taken, they can create an intense pleasure or “high.” Some people become addicted to this high, and their cravings, as well as their inability to tolerate withdrawal symptoms, lead to ongoing misuse. Over time, these drugs can create changes in your brain, leading to cravings and the need for greater amounts of the drug to achieve the same effect.  

This is where medication-assisted treatment can help. There are several drugs available, and they help relieve withdrawal symptoms as well as cravings so people can successfully quit opioids. Two of the primary medications used for treating opioid use disorder are methadone and buprenorphine. Since they are types of opioids themselves, these medications activate the same receptors in your brain as other opioids. But when they are taken at the proper dose, they can eliminate or decrease symptoms of withdrawal without causing the “high.” These MAT treatments can also reduce your physical cravings but do keep you dependent on medication (though at carefully regulated dosages). Some people may need to stay on these treatments indefinitely, although this isn’t the case for everyone.

Naltrexone is a third type of medication for treating opioid addiction. It works differently than methadone and buprenorphine since it’s not an opioid. It’s an opioid antagonist, meaning it blocks opioid receptors in your brain. This prevents any opioid drugs from having an effect or pleasurable experience. It was first developed as a pill.

Methadone, most forms of buprenorphine, and the oral form of naltrexone need to be taken each day to work properly. Medication adherence can be a challenge, and those who struggle with remembering to take medication daily may have poorer outcomes.  Dropping out of treatment can result in higher rates of relapse and overdose. Fortunately, once-monthly injectable medications for opioid use disorder can make it easier for patients to adhere to their treatments, since they don’t need to commit to a daily medication.

Differences Between Injections for Medication-Assisted Treatment

Monthly injections can help improve compliance with medication-assisted treatment. Two types of injections are currently available to treat opioid use disorder:

  • Sublocade: This is an injectable form of buprenorphine. To be eligible, you need to have already taken at least seven days of a stable dose of oral buprenorphine. It’s usually given as a shot in your abdomen, and you’ll have to go to your doctor’s office to get it. Once it’s injected, the medication forms a solid mass (called a depot) that slowly releases a steady dose throughout the month.
  • Vivitrol: This is an injectable form of naltrexone. To be eligible, you must be fully detoxified from all opioids, which can take 7 to 10 days from your last use, to avoid severe withdrawal symptoms. It’s given as an injection into your muscle once a month.

If you are recovering from opioid use disorder and would like to learn more about monthly injections, talk to your doctor. Some people may prefer Vivitrol since it’s not an opioid, while for others, Sublocade may be a better option, as it doesn’t require several days of abstinence from opioids. Your individual circumstances and preferences will help guide your doctor to select the best MAT for you.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Sep 1
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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