Quick Guide: MAT Use for Opioid and Alcohol Use Disorders

QUICK GUIDE: MAT Use for MOApT Uisoeifodr OUpiosideUsDe Diissoordrerder

BUPRENORPHINE

COMMON BRANDS TYPE

Suboxone, Zubsolv, Bunavail, Subutex, Probuphine, Sublocade

? Implant ? Pill ? Patch ? Injection

METHADONE

Methadose, Diskets, Dolophine

? Pill ? Liquid

Implant Pill Patch Liquid Injection

Vivitrol

NALTREXONE

? Injection

HOW IT WORKS THINGS TO CONSIDER

? Makes the brain think it is still getting the problem opioid. Prevents cravings and withdrawal symptoms and reduces the risk of overdose.

? Buprenorphine can be prescribed by a trained provider in a doctor's ofice or other health care setting, as well as in a narcotic treatment program (NTP).

? Treatment can start quickly, as soon as someone enters withdrawal.

? Flexible dosing schedule.

? Relapse risk increases if you forget or choose not to take medication.

? Common side efects are headache, nausea, and constipation.

? Makes the brain think it is still getting the problem opioid. Prevents cravings and withdrawal symptoms and reduces the risk of overdose.

? Methadone is dispensed only in highly regulated NTPs.

? Blocks the efects of opioids.

? Naltrexone is not a controlled substance and can be prescribed or administered in any health care or substance use disorder (SUD) setting, such as a doctor's ofice or clinic.

? Treatment can start right away, no need for detoxification.

? Less flexible schedule. Dosing occurs in the early morning.

? Less evidence for effectiveness in OUD treatment than

bup?reLnoerpshsinee voridmeetnhacdeonfeo.r? DeofeescnotitvceaunseespshyisnicaOl UD dcaenptehrnaedramentmtchee.e?bnaNbtoytt.hrMeaceontmhambdeounnpdeeroedrnfbouorpprrrpeenghoniranpnhetinweooarmreemn easthde-tox recoamdmoenndee.d for pregnant women with OUD.

? Does not cause physical dependence.

? Side efects include constipation, sexual problems, swelling, and sweating and potential heart problems.

? Not recommended for pregnant women as detox can harm the baby. Methadone or buprenorphine are recommended for pregnant women with OUD.

CONTINUED ON BACK

QUICK GUIDE: MAT Use for Opioid Use Disorder

CONTINUED FROM FRONT

THINGS TO CONSIDER

BUPRENORPHINE

METHADONE

NALTREXONE

? Causes physical dependence. If or when you want to come of the drug, you will need to do so slowly to minimize the

? Ca?usCesapuhsyesiscapl dhepyesnidceanlced. eIf pyoeunwdaentntocceo.mIef oyfothue drug, ? De?toDx ferotmoxopfirooidms isorepqiuoireiddsbeifsorreetaqkuinigrenadltrebxeonfoe.rSeide

you will need to do so slowly to minimize the discomfort of detox effects may include stomach pain, nausea, vomiting, headache,

symwptoamnst. ?toMacyocmausee odrfowtshineesds raut fgirs, tyboefuorewmilalinnteeneandce jointtapakinin, tgrounbalelstrleeexpoinng ean.dSaindxeietey.fSeomctespemopaleyalso report dosetoisddeotesrmoinseldo. w? Mleythtaodomneinisiomfteiznea gthooed odpitsiocnofomr - soreinnecslsuindtehesatroeamoaf tchehinpjeactiinon,.n? aInujescteioan,fovrommofitthieng,

discomfort of detox symptoms.

peofpolerwt hoofhdaveetuosxedsoypmioipdstofomr aslo. ng time or have been medhiceataiodnalacshtsefo,r ajoboinutt3p0 adainys, bterofourebitlweesalrseoefp. Oinvegrdose

? Buprenorphine is sometimes used

unsuccessful with other treatments.

? May cause drowsiness at first before

riskacanndbeahnigxhieertayf.teSr noamltreexopnee owepalres oafldsuoe troedpeocrretase in tolersaoncree.ness in the area of the injection.

short term to relieve pain associated with maintenance dose is determined.

detox, but more often used long term,

? Injection form of the medication lasts

known as maintenance treatment.

? Methadone is often a good option for

for about 30 days before it wears of.

people who have used opioids for a long Overdose risk can be higher after nal-

time or have been unsuccessful with

trexone wears of due to decrease in

other treatments.

tolerance.

? Can you commit to taking this medication daily? ? Are you

QUESTIONS com?foCrtaabnle wyiothutackiongmammeitdictoatiotan kthiant greqtuhiriess mtimeedtoictaap-er

FOR CLIENTS

of totimoinnimdizaeiltyhe?discomfort of detox?

? Are you comfortable with taking a medication that requires time to taper of to minimize the discomfort of detox?

? Have you used opioids for a long time, or have you found other ? Have you detoxed from opioids, or would you be willing to detox

trea?tmHenatsvheavyeonuotuwsorekedd owpelliofoirdysouf?o?rCaanloyonugcotmime teo,the to ta?keHthaisvemeydoicuatiodne?t?oCxaendyofurocommmoitptoiomiadksin,goarn

clinioc rinhthaeveearlyyomuornfoinug nfodr doostinhge?rWtirlleyaoutmneeend ttosmhaakeve appwoinotmuelndt oynoceuebveerywmoilnlithntgo ctoontdineuetorexcetiovintgatkhee this

arranngoetmwenotsrfkoer wdorwk oerltlrafnosrpoyrotautio?n? ? Do you work in an injecmtioend? i?cDaotyioounh?ave any medical needs that would be

industry with heavy machinery? Could your work be affected by affected by blocking the opioid receptors? For example, do you

possible drowsiness during your initial dosing period? ? Are you use opioids to reduce chronic pain?

com?foCrtaabnle wyiothutackiongmaemetodictahtioen cthlaint riecquiinresthtimeeetoatralpyer ? Can you commit to making an appoint-

of tommoinrimniiznegthefodriscdoomsfoirnt ogf?deWtoxi?ll you need to

ment once every month to continue

make arrangements for work or transpor- receiving the injection?

tation?

? Do you have any medical needs that

? Do you work in an industry with heavy would be afected by blocking the opioid

machinery? Could your work be afected receptors? For example, do you use opi-

by possible drowsiness during your initial oids to reduce chronic pain?

dosing period?

? Are you comfortable with taking a medication that requires time to taper of to minimize the discomfort of detox?

QUICK GUIDE: MAT Use for Alcohol Use Disorder

COMMON BRANDS TYPE

NALTREXONE

Revia, Vivitrol

? Pill ? Injection

ACAMPROSATE

Campral

? Pill

Pill Injection

DISULFIRAM

Antabuse

? Pill

HOW IT WORKS

? Medication that blocks the effects of alcohol and reduces

? Medication to reduce cravings for patients who have already

cra?vinMgse. ?dOicffearteidoans athdaaitlybplilol ocrkmsontthhley inejefcetiocnt.s? of

Naltrexone is not a controlled substance and can be prescribed

or aadlmcionihsteorledainn danryehdeaultch ecasrecorraSvUinDgsestt.ing, such as a

doctor's office or clinic.

stop?pMed edrdinikcinagt.iIot dnoetsonroet hdeulpcweithcwraithvdirnawgasl sfyomrptoms but

does reduce cravings. If relapse occurs, patients can continue

takipngatthieemnetsdicwathionowhithaovuet naeelrdeinagdtoydesttooxpfirpste. ?dOffered as a tadblreitntakkienngth. rIetedtimoeessandaoyt. ?hAeclapmpwroistahtewisinthotdaraw-

? Ofered as a daily pill or monthly injec- conatrol lsleydmsupb-tsotamncse banudtcdanobeesprreescdriubecdeorcardamviinnisgtesre.d in

tion.

anyIfheraeltlhacpasreeoroScUcDusrestt,inpga, stuiechnatssacdaonctocr'soonfftiicneuoreclinic.

taking the medication without needing to

? Naltrexone is not a controlled sub-

detox first.

stance and can be prescribed or admin-

istered in any health care or SUD setting, ? Ofered as a tablet taken three times a

such as a doctor's ofice or clinic.

day.

? Medication that causes severe vomiting if someone drinks alcohol.

? Ofered as daily pill.

? Disulfiram is not a controlled substance and can be prescribed or administered in any health care or SUD setting such as a doctor's ofice or clinic.

THINGS TO ? Detoxification from alcohol is required CONSIDER before taking naltrexone.

? Relapse risk increases if you forget or choose not to take pill form of the medication.

CONTINUED ON BACK

? Acamprosate is not a controlled substance and can be prescribed or administered in any health care or SUD setting, such as a doctor's ofice or clinic.

? Detoxification from alcohol is not required but is highly recommended before starting on acamprosate.

? Relapse risk increases if patients forget or choose not to take medication.

? Detoxification from alcohol is required. ? Relapse risk increases

if y?ouDfoergteotxoirfcichoaotsieonnotfrtootmakeamlcedoichaotiolni.s required.

? Relapse risk increases if you forget or choose not to take medication.

CONTINUED ON BACK

QUICK GUIDE: MAT Use for Alcohol Use Disorder

CONTINUED FROM FRONT

THINGS TO CONSIDER

NALTREXONE

? Injection form of the medication lasts for about 30 days before it wears of.

ACAMPROSATE

? Common side effects include stomach pain, dizziness or dry

mou?thC; moomremraroenly psaitdieentsemfaeycetxspeirniecncluedanexisettyoomr deparecsshionp.ain, dizziness or dry mouth; more

rarely patients may experience anxiety or depression.

DISULFIRAM

? Side efects are not common but may include headache, drowsiness or rash.

? Disulfiram can be a good option for compulsive drinking (everything is fine and then you have a strong urge to drink).

? Have you detoxed from alcohol, or would you be willing to detox ? Can you commit to taking this medication three times a day? ?

QUESTIONS to ta?keHthaisvmeeydoicautiodne? t?oCxaendyoufrcoommmaitltcootahkiongl,thoisr

Do y?oCu faeenl tyhaotucracvoinmg rmeduitcttioon taalokneinisgenthouisghmtoehdelpicyaou-

FOR CLIENTS

medwicaotiuonlddayilyo, uor bwoeulwd ailmlinongtht-loondg eintjeocxtiotnobetaakbeetttehr is stoptidorinnkitnhgr, eoredotiymouenseead dsoamye?thing more? For example, medication? option? ? Do you have any medical needs that would be affected disulfiram makes you vomit if you drink, and naltrexone takes

by blocking the opioid receptors? For example, do you use opioids to reduce chronic pain?

away

?

Dtheopyleoasuurfaebleelfetehliangt

ocfrdarivnkiningg.

reduction

? Can you commit to taking this medica- alone is enough to help you stop drink-

tion daily, or would a month-long injec- ing, or do you need something more?

tion be a better option?

For example, disulfiram makes you vomit

if you drink, and naltrexone takes away

? Do you have any medical needs that

the pleasurable feeling of drinking.

would be afected by blocking the opioid

receptors? For example, do you use opi-

oids to reduce chronic pain?

? Have you detoxed from alcohol, or would you be willing to detox

to ta?kHe tahivsemeydoicuatidone?t?oCxaendyofurocommmaitlctootahkoinlg, tohirs pill daily? ? Dowyoouuwldorkyionuanbineduwstriyllwinitgh etxopodsueretotoxatlcoohtoal-kbeastehdis prodmucetsd(ii.cea., tpiaoinnt?thinner, varnish, etc.) which could react with

the medication? ? Are you willing to run the risk of severe vomiting should you relapse?

? Can you commit to taking this pill daily?

? Do you work in an industry with exposure to alcohol-based products (i.e., paint thinner, varnish, etc.) which could react with the medication?

? Are you willing to run the risk of severe vomiting should you relapse?

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