Opioid medications are commonly prescribed to patients to relieve moderate to severe pain. Opioids are effective and often fast-acting drugs that directly influence how the brain responds to pain. In a high dosage, opioid drugs — including codeine, oxycodone, morphine and methadone — can create a state of euphoria for people. However, the high is short-lived causing people to abuse opiates more frequently and at higher doses to induce the same effects.
Frequent opioid abuse increases the risk of tolerance and opiate addiction. Though some people attempt to quit cold turkey, doctors usually strongly advise people to gradually taper off of the medication to alleviate withdrawal symptoms and to ease into recovery.
One of the most effective forms of addiction treatment is medication-assisted treatment. Medication-assisted treatment consists of opioid replacement therapy with the buprenorphine-naloxone combination drug or methadone. These medications alleviate withdrawal symptoms while preventing people from getting high. called opioid antagonist, or opiate blocker therapy. Within this treatment, users are tapered off of abused opiates with counteracting drugs that help to prevent a high.
Opioid Agonist vs. Opioid Antagonist
In opioid agonist therapy, doctors use drugs producing the same effects as common opiate drugs. The agonist drugs used in treatment are long-acting and help alleviate withdrawal symptoms and cravings for up to 36 hours. People in agonist therapy can quickly develop a tolerance to the medication, but without the high. They are also at risk of developing a physiological dependence.
Opioid antagonists prevent chemical reactions in brain receptors. Antagonist drugs — naltrexone and naloxone — also referred to as opiate blockers, block addictive drugs from triggering brain receptors and prevent a high. Unlike people who are participating in agonist therapy, antagonist treatment patients are less likely to develop a tolerance to the medication. Antagonist drugs are effective but not addictive. Antagonist drugs protect people from the adverse side effects of opiate addiction and can help prevent drug cravings.
There are two different opiate blockers used for antagonist treatment: naloxone and naltrexone. Naloxone is used most frequently in a medical emergency to reverse or prevent opiate overdose. If a person overdoses, they will be given a naloxone shot, nasal spray or intravenous injection to counteract effects of the drug. Naloxone and other opioid blockers are not addictive.
Naltrexone is commonly used to treat opioid addiction, but should only be used while in recovery. This drug is not to be used during withdrawal because it can intensify symptoms. Taking naltrexone during recovery can help to block drug-induced highs and can decrease the urge to use drugs.
Because naltrexone and naloxone are so effective, they will block pain-relief effects when used in combination with other opioid drugs.
- Naltrexone: This prescription antagonist drug comes in the form of a shot and an oral tablet. The liquid, Vivitrol, is injected into the muscle monthly. However, the opiate blocker pill is taken once a day. Patients should not start taking naltrexone until they have been off of opioids for seven to 10 days to make sure all traces of opioids are cleared from their systems. The monthly shot of Vivitrol is thought to be more effective than the tablet because many people do not adhere to the prescribed tablet regimen.
- Naloxone: This antagonist drug commonly known as Narcan can be injected or inhaled through the nose during a medical emergency to reverse overdose effects. Once administered, opioid withdrawal symptoms will occur.
- Buprenorphine-Naloxone Combination Drug: Buprenorphine itself is an opioid, a partial agonist. On its own, it is not a blocker, but it is when it is combined with naloxone, as is the case with buprenorphine-naloxone combination drugs. Buprenorphine most commonly comes in the forms of buccal film (Bunavail), dissolvable tablets (Zubsolv) and a dissolvable film (Suboxone). Buprenorphine is also available on its own, but the combination with naloxone is now preferred because it is harder for people to abuse it. All of these forms are mixed with naloxone to prevent the temptation to abuse the drug by injecting it. If a person attempts to inject these drugs, the naloxone will prevent them from getting high.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.
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