Question 1

What is addiction?

Accepted Answer

ASAM: Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences. Treatment approaches for addiction are generally as successful as those for other chronic diseases.

Question 2

What is Medication-Assisted Treatment (MAT)?

Accepted Answer

Medication-assisted treatment (MAT) is the use of medications in combination with counseling and behavioral therapies, which is effective in the treatment of opioid use disorders (OUD) also referred to as opioid addiction. MAT medications can help many people to achieve and sustain recovery. There are 3 medications approved by the FDA to treat opioid use disorder including methadone, buprenorphine and naltrexone. Naltrexone is also an FDA approved MAT medication for alcohol use disorder (AUD).

Question 3

What is MOUD (Medications for Opioid Use Disorder) therapy?

Accepted Answer

Medications for opioid use disorder (MOUD) is a comprehensive treatment approach for individuals diagnosed with opioid use disorder (OUD). This approach combines the use of FDA-approved medications with counseling and behavioral therapies, aiming to provide effective support for recovery.

According to the National Institutes of Health (NIH), two commonly used medications in MOUD, methadone and buprenorphine, have shown to significantly reduce the risk of death following an opioid overdose. This highlights their importance in saving lives and promoting overall well-being.

Moreover, MOUD has been found to have positive impacts on relapse rates. Research indicates that individuals receiving MOUD experience a decreased relapse rate of 50% at the one-year mark. This demonstrates the effectiveness of MOUD in supporting long-term recovery and reducing the likelihood of relapse.

By combining medication, counseling, and behavioral therapies, MOUD offers a comprehensive approach to opioid use disorder treatment, addressing both the physical and psychological aspects of addiction.

Question 4

What is Buprenorphine?

Accepted Answer

Buprenorphine is an opioid medication that is used to treat people who have been diagnosed with an OUD. Like all opioids, buprenorphine works by attaching to the opioid receptors in the brain, which relieves withdrawal symptoms, opioid cravings and helps prevent overdose. Many studies have shown that taking buprenorphine reduces or stops opioid use in most patients, whether they have been using prescription opioids or illicit opioids like fentanyl and heroin.

Question 5

How do medications to treat opioid use disorder work?

Accepted Answer

Opioid Agonists and Partial Agonists (Maintenance Medications)
Studies show that people with opioid use disorder who follow detoxification with complete abstinence are very likely to relapse or return to using the drug. While relapse is a normal step on the path to recovery, it can also be life-threatening, raising the risk for a fatal overdose. Thus, an important way to support recovery from heroin or prescription opioid use disorder is to maintain abstinence from those drugs. Someone in recovery can also use medications that reduce the negative effects of withdrawal and cravings without producing the euphoria that the original drug of abuse caused.
Methadone is a synthetic opioid agonist that eliminates withdrawal symptoms and relieves drug cravings by acting on opioid receptors in the brain—the same receptors that other opioids such as heroin, morphine, and opioid pain medications activate. Although it occupies and activates these opioid receptors, it does so more slowly than other opioids and, in an opioid-dependent person, treatment doses do not produce euphoria. It has been used successfully for more than 40 years to treat opioid use disorder and must be dispensed through specialized opioid treatment programs.
 Buprenorphine is a partial opioid agonist, meaning that it binds to those same opioid receptors but activates them less strongly than full agonists do. Like methadone, it can reduce cravings and withdrawal symptoms in a person with an opioid use disorder without producing euphoria, and patients tend to tolerate it well. Research has found buprenorphine to be similarly effective as methadone for treating opioid use disorders, as long as it is given at a sufficient dose and for sufficient duration.13 The U.S. Food and Drug Administration (FDA) approved buprenorphine in 2002, making it the first medication eligible to be prescribed by certified physicians through the Drug Addiction Treatment Act. This approval eliminates the need to visit specialized treatment clinics, thereby expanding access to treatment for many who need it. Additionally, the Comprehensive Addiction and Recovery Act (CARA), which was signed into law in July 2016, temporarily expands eligibility to prescribe buprenorphine-based drugs for medication-assisted treatment (MAT) to qualifying nurse practitioners and physician assistants through October 1, 2021. Buprenorphine has been available for opioid use disorders since 2002 as a tablet and since 2010 as a sublingual film. The FDA approved a 6-month subdermal buprenorphine implant in May 2016 and a once-monthly buprenorphine injection in November 2017. These formulations are available to patients stabilized on buprenorphine and will eliminate the treatment barrier of daily dosing for these patients
 Naltrexone is an opioid antagonist, which means that it works by blocking the activation of opioid receptors. Instead of controlling withdrawal and cravings, it treats opioid use disorder by preventing any opioid drug from producing rewarding effects such as euphoria. Its use for ongoing opioid use disorder treatment has been somewhat limited because of poor adherence and tolerability by patients. However, in 2010, an injectable, long-acting form of naltrexone (Vivitrol®), originally approved for treating alcohol use disorder, was FDA-approved for treating opioid use disorder. Because its effects last for weeks, Vivitrol® is a good option for patients who do not have ready access to health care or who struggle with taking their medications regularly.
NIDA. 2021, April 13. How do medications to treat opioid use disorder work?. Retrieved from https://www.drugabuse.gov/publications/research-reports/medications-to-treat-opioid-addiction/how-do-medications-to-treat-opioid-addiction-work on 2021, December 11

Question 6

Why is Medication- Assisted Treatment (MAT) better than abstinence?

Accepted Answer

MAT is evidence-based and is the recommended course of treatment for opioid addiction. The American Society of Addiction Medicine, American Academy of Addiction Psychiatry, American Medical Association, National Institute on Drug Abuse, Substance Abuse and Mental Health Services Administration, National Institute on Alcohol Abuse and Alcoholism, Centers for Disease Control and Prevention, and other agencies all universally agree and emphasize MAT as first line treatment for Opioid Use Disorder.

Question 7

Will buprenorphine cure my opioid addiction?

Accepted Answer

Opioid use disorder (aka addiction) is a chronic medical disease that can be effictively managed. Buprenorphine and buprenorphine compounds with naloxone, such as Suboxone®, can help people overcome their opioid addiction and lead more productive and full lives. Buprenorphine prevents withdrawal symptoms and helps eliminate cravings so that you can focus on addressing the causes and consequences of addiction.

Question 8

Does buprenorphine replace one addiction with another?

Accepted Answer

No. Buprenorphine is an FDA approved medication that is proven to help manage opioid use disorder. This is no different than medications prescribed to treat and manage other chronic illnesses like diabetes or high blood pressure. Buprenorphine binds to the same opioid receptors that illicit and abused opioids do, but works differently at that receptor. Buprenorphine reduces withdrawal symptoms and cravings to encourage healthy behaviors and when taken as prescribed, does not cause euphoria or a "high". Patients can become physically dependant on buprenorphine and stopping abruptly can cause withdrawal, but this is not addiction. The myth that buprenorphine replace one opioid addiction with another incorrect and not supported by the medical or scientific community. Medications such as buprenorphine help patients control their drug-seeking urges so they can build recovery skills.

Question 9

What is the difference between Suboxone, Subutex, and buprenorphine?"

Accepted Answer

Suboxone is a combination of Buprenorphine and Naloxone, whereas Subutex is just Buprenorphine. Both of these medications are taken sublingually daily or twice daily.

Question 10

Can you take Buprenorphine if you are pregnant?

Accepted Answer

American College of Obstetricians and Gynecologists (ACOG): The best treatment for opioid use disorder during pregnancy is opioid replacement medication, behavioral therapy, and counseling. The medications that are given are long-acting opioids. This means that they stay active in the body for a long time. These opioids, called methadone and buprenorphine, reduce cravings but do not cause the pleasant feelings that other opioids cause. Treatment with either methadone or buprenorphine makes it more likely that the fetus will grow normally and not be born too early. Based on many years of research, neither medicine has been found to cause birth defects.

Question 11

How can I detox at home?

Accepted Answer

We will support and walk you through the process to safely start buprenorphine at home and alleviate withdrawal. We will also help you to reach the proper dose which will help eliminate cravings.

Question 12

Do I need to be in withdrawal before I take my first dose of Suboxone or other buprenorphine medication?

Accepted Answer

Yes, we walk you through taking the first dose of buprenorphine.

Question 13

Will buprenorphine help me feel better right away?

Accepted Answer

Buprenorphine can significantly reduce opioid withdrawal symptoms almost immediately.

Question 14

Does buprenorphine have side effects?

Accepted Answer

Common side effects of Buprenorphine can be nausea, vomiting, and constipation.

Question 15

What Are Signs That My Buprenorphine(Suboxone) Dose Is Too Low?

Accepted Answer

If Buprenorphine(Suboxone) is being used for pain management, experiencing discomfort is an indicator that the dose may be too low. On the other hand, for individuals using Buprenorphine(Suboxone)  to treat opioid use disorder (OUD), cravings and withdrawal symptoms may suggest the need for a higher dosage.

Withdrawal symptoms associated with opioids can manifest in various ways, including:
-Cravings
-Sweating
- Anxiety
-Nausea
- Tremors
- Abdominal pain
- Diarrhea

Question 16

How long do I need to stay on MAT?

Accepted Answer

Research shows that patients on MAT for at least 1-2 years have the greatest rates of long-term success. There is currently no evidence to support benefits from stopping MAT.

Question 17

Does MAT increase my risk of overdosing ?

Accepted Answer

MAT helps to prevent overdoses from occurring. Even a single use of opioids can result in a life-threatening or fatal overdose. Following detoxification, tolerance to the euphoria brought on by opioid use remains higher than tolerance to respiratory depression.

Question 18

Can I carry my medication with me?

Accepted Answer

It is illegal to carry controlled substances unless you have the printed prescription with you.

Question 19

How do I store my Buprenorphine?

Accepted Answer

Keep out of the reach of children. This medicine can be abused and can cause harm to opioid naive people--especially children. Keep your medicine in a safe place to protect it from theft. Do not share this medicine with anyone. Take the medication only as prescribed. Selling or giving away this medicine is dangerous and against the law.

Question 20

What is Sublocade ?

Accepted Answer

Sublocade is an injection of extended-release (XR) buprenorphine that is administered once a month. As an extended-release medication, the injection slowly absorbs into the body over the course of a month providing stable blood levels of buprenorphine. Many people prefer Sublocade over Suboxone because they don’t have to worry about taking a sublingual film each day and do not experience daily fluctuations in buprenorphine blood levels.

Question 21

How is Sublocade different from other opioids?

Accepted Answer

Sublocade is an injection of extended-release (XR) buprenorphine that is administered once a month. As an extended-release medication, the injection slowly absorbs into the body over the course of a month providing stable blood levels of buprenorphine. Many people prefer Sublocade over Suboxone because they don’t have to worry about taking a sublingual film each day and do not experience daily fluctuations in buprenorphine blood levels.

Question 22

Is Sublocade better than Buprenorphine?

Accepted Answer

Sublocade has many advantages over sublingual buprenorphine. It provides a stable blood concentration so there are no peaks and valleys between doses. Not having to think about or remember to take your daily or twice daily dose is another major benefit. There is no chance of losing the medication, having it stolen, or having someone take it by accident. Tapering off of injectable buprenorphine is much easier than sublingual because it leaves your body very slowly over many months.

Question 23

What are the benefits of Sublocade compared to other treatments?

Accepted Answer

Sublocade offers several benefits, including improved medication adherence as it eliminates the need for daily dosing, reduced risk of diversion or misuse, and sustained opioid receptor activation for a month.

Question 24

How long until I feel the effects of the Sublocade?

Accepted Answer

Sublocade starts working immediately, with therapeutic levels reached within a few hours. Studies show that it takes on average 24 hours for buprenorphine (the medication in Sublocade) to reach maximum (peak) levels after a Sublocade injection.

Question 25

How long does it take for me to get Sublocade?

Accepted Answer

It could take anywhere from 5-15 days depending on your insurance.

Question 26

How long will the "bump" be felt on my abdomen?"

Accepted Answer

ublocade turns into a solid mass in your body after it’s injected and slowly releases buprenorphine over the course of several weeks. This bump slowly releases medication into your body keeping the buprenorphine at a steady state. The bump will get smaller or go away within 1-2 months.

Question 27

What treatment do you have for Alcohol cravings ?

Accepted Answer

We have two options for alcohol cravings. Naltrexone which is oral medication and an injectable extended-release (XR) form of naltrexone called Vivitrol, which is given once monthly.

Question 28

What is the difference between Kloxxado® and Narcan® (naloxone HCl) nasal spray 4 mg?

Accepted Answer

Kloxxado® offers a higher dose of naloxone per spray compared to Narcan®, with 8 mg versus 4 mg respectively. Additionally, both products come with two devices per box. Therefore, by choosing Kloxxado®, you are getting double the amount of naloxone per box. This is significant because studies have shown that 34 percent of opioid overdose reversals required at least two doses of naloxone. By having more naloxone available in each box, Kloxxado® ensures that you have a higher chance of effectively reversing an opioid overdose.

Question 29

What is Brixadi?

Accepted Answer

Brixadi is a medication used for the treatment of opioid dependence in adults. It is a brand name for buprenorphine extended-release injection, which is administered once monthly. Brixadi contains buprenorphine, a partial opioid agonist, which helps to reduce withdrawal symptoms and cravings in individuals dependent on opioids. Brixadi is designed to provide a sustained level of buprenorphine in the body over the course of a month, helping individuals maintain abstinence from opioids and work towards recovery.

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