Written and medically reviewed by Dorcas Morak, Pharm.D
September is National Recovery Month, a time to recognize that opioid use disorder (OUD) is a treatable medical condition, not a moral failing. Medication for opioid use disorder (MOUD) is one of the most effective, evidence-based treatments available, yet many patients and families still have questions about how it works. Here's what you should know about the medications used to support recovery and how they can help people regain their health and quality of life.
What Is Opioid Use Disorder (OUD)?
Opioid use disorder is a chronic medical condition that affects the brain and behavior, making it difficult to stop using opioids despite harmful consequences. It can develop from prescription opioid pain medications, heroin, or synthetic opioids such as fentanyl. Like other chronic conditions, OUD can be effectively managed with ongoing treatment and support.
What Is MOUD (Medication for Opioid Use Disorder)?
Medication for opioid use disorder (MOUD) uses FDA-approved medications to reduce cravings, ease withdrawal symptoms, and lower the risk of relapse and overdose. MOUD is considered the gold-standard treatment because it has been proven to save lives and improve long-term recovery outcomes.
While counseling, peer support, and behavioral therapies can provide additional benefits, treatment with medication should not be delayed if those services aren't immediately available.
Why Is MOUD Considered the Gold Standard for Treatment?
Research consistently shows that MOUD can:
- Reduce the risk of fatal overdose
- Decrease opioid cravings and withdrawal symptoms
- Improve long-term recovery and treatment retention
- Help people return to work, school, and family responsibilities
- Lower the risk of infections associated with injection drug use
Like medications used to treat diabetes or high blood pressure, MOUD helps manage a chronic condition and may be used safely for months or years under medical supervision.
What Medications Are Approved to Treat Opioid Use Disorder?
The U.S. Food and Drug Administration (FDA) has approved three medications to treat opioid use disorder: buprenorphine, methadone, and naltrexone. While each works differently, they all share the same goal of helping people recover by reducing cravings, preventing relapse, and lowering the risk of overdose.
The right medication depends on several factors, including a person's medical history, treatment goals, access to care, and whether they're already experiencing withdrawal symptoms. Your healthcare provider can help determine which option is most appropriate for your situation.
How Does Buprenorphine Work?
Buprenorphine is a partial opioid agonist that helps reduce cravings and withdrawal symptoms without producing the intense high associated with full opioids. It has a "ceiling effect," meaning its opioid effects level off at higher doses, which lowers the risk of misuse and overdose compared with full opioid agonists. Common buprenorphine medications include:
- Suboxone® (buprenorphine/naloxone)
- Subutex® (buprenorphine)
- Sublocade® (extended-release monthly injection)
- Brixadi® (extended-release injection)
Since changes to federal regulations in 2023, most healthcare providers with a standard DEA registration can prescribe buprenorphine without the former special waiver requirement.
How Is Methadone Different?
Methadone is a full opioid agonist that has been used safely and effectively to treat opioid use disorder for decades. It helps prevent withdrawal symptoms and reduces cravings, making it especially helpful for people with long-standing or severe opioid dependence.
Unlike buprenorphine, methadone for opioid use disorder is generally dispensed through certified opioid treatment programs, where patients may initially receive daily supervised doses before earning take-home medication as treatment progresses.
How Does Naltrexone Work?
Naltrexone is an opioid antagonist that completely blocks opioids from producing their effects. Because it isn't an opioid itself, it doesn't cause physical dependence or withdrawal. Available forms include:
- Vivitrol®, a once-monthly injection
- Generic oral naltrexone tablets
Patients must complete opioid withdrawal before starting naltrexone to avoid triggering sudden withdrawal symptoms.
What Medications Help Manage Opioid Withdrawal Symptoms?
Some medications don't treat opioid use disorder directly but can help relieve withdrawal symptoms during detoxification. Examples include:
- Lucemyra® (lofexidine)
- Clonidine
These medications may help reduce anxiety, sweating, muscle aches, agitation, and other withdrawal symptoms while the body adjusts.
Why Should You Keep Naloxone Available?
Naloxone rapidly reverses an opioid overdose by blocking opioid receptors and restoring breathing within minutes. It is recommended for anyone at risk of opioid overdose, including people receiving treatment for opioid use disorder, as well as their family members and caregivers. Common naloxone products include:
- Narcan® nasal spray
- RiVive® nasal spray
- Generic naloxone nasal spray
- Injectable naloxone
Many states allow naloxone to be obtained directly from a pharmacy without an individual prescription.
Talking to a Doctor About Opioid Use Disorder Treatment
Opioid use disorder is a chronic medical condition, not a character flaw. Primary care providers, addiction medicine specialists, community health centers, and telehealth providers can all help patients begin treatment confidentially and without judgment.
Seeking treatment early can significantly improve long-term recovery and reduce the risk of overdose.
How Long Do People Stay on MOUD?
There is no one-size-fits-all treatment timeline. Some people remain on medication for several months, while others benefit from treatment for many years. Research shows that staying on buprenorphine, methadone, or naltrexone significantly lowers the risk of overdose and relapse compared with stopping treatment too soon.
Any decision to taper or discontinue medication should be made with a healthcare provider based on individual recovery progress and medical needs.
Can These Medications Be Used During Pregnancy?
Yes. Buprenorphine and methadone are recommended treatments for most pregnant patients with opioid use disorder because they reduce the risks associated with untreated opioid use and improve outcomes for both mother and baby.
Treatment during pregnancy should always be managed by healthcare providers experienced in caring for pregnant patients with opioid use disorder.
How Can You Save Money on Medications for Opioid Use Disorder?
Out-of-pocket costs for medications such as Suboxone®, generic buprenorphine/naloxone, Lucemyra®, or Vivitrol® can make treatment more challenging to afford. The RxLess® Assurance Plan offers free prescription savings through the RxLess® app, with real-time pharmacy price comparisons at more than 70,000 pharmacies nationwide.
Simply download the free RxLess® app from the Apple App Store or Google Play to automatically become a member of the RxLess® Assurance Plan and start comparing prescription prices. Savings are also available on many generic medications commonly prescribed as part of opioid use disorder treatment.
