Disclaimer: this is very basic information, please see your doctor before starting any of these medicines and see the links below for further information.
Buprenorphine (Suboxone, Subutex, Bunavail, Zubsolv)
- Stimulates the Mu-opioid receptor partially. This helps to prevent cravings and/or withdrawals.
- Partially antagonize the Kappa-opioid receptor. This causes a mild euphoria.
- Stays bound to the opioid receptors about 5-7 days with peak effect at 3 days.
- Strongly attracted to the opioid receptor therefore will knock any other opioid out of the receptor leading to precipitated withdrawal symptoms.
- Start buprenorphine 12 to 24 hours after last opioid taken (except for Methadone)
- Wait about 5 days after last methadone dose of 20-25 mg before starting buprenorphine.
Naloxone (Vivitrol, Naltrexone)
- Blocks the opioid receptors. (Enough opioids can theoretically override it).
- Give a small test dose before starting.
- Start after negative urine drug screen for opioids, suboxone or methadone.
- Naltrexone starting dose is 50 mg per day orally.
- Most common adverse effect is a headache or stomach ache, may decrease the dose to 25 mg if these persist after 1 week.
- Vivitrol starting dose is 380 mg dissolved in a 4 cc vial and injected once a month in the gluteal region.
Meds are about 10% of recovery, they help the Physiological addiction, the rest of recovery is helping the Psychological addiction.
- The psychological addiction takes daily work.
- We recommend going to NA meetings for a start.
- If you have PTSD, Depression, Anxiety, Bipolar disorder you should see Psychiatry.
- If you have a history of trauma you should see a trauma informed counselor.
- EMDR (Eye Movement Desensitization and Reprocessing) is a type of therapy that has been shown to help single episode trauma.
- Long term exposure trauma can be helped with ongoing counseling.