The problem is that in the real world, which seldom resembles the clinical study world, patients are much less interested in this option. In an outpatient population, naltrexone may fail to retain even more patients — and have even worse outcomes compared to buprenorphine. First, the bad news: Naltrexone is not a wonder drug. This accessibility problem is particularly important in addiction medicine. One of the key hurdles to getting people into treatment is lack of access. As the surgeon general reported in , only about 10 percent of people with a substance use disorder get specialty treatment.
The report attributed that low rate in part to severe shortages in the supply of care — which can lead to waiting periods of weeks or even months. But access is a problem even in states with plenty of supply. As a result, it has managed to cut waiting periods for care, and estimates it has about half of people with an opioid use disorder on medications — much better than the national average.
Yet it has struggled to get the other half of potential patients into the system, in large part because hurdles, such as lack of transportation and stigma, remain. In this context, that naltrexone creates yet another potential barrier by requiring full detox is a big problem. Access is already an issue; anything that makes it even more of one is far from ideal. That means it can be another option for opioid use disorder patients. Different options are needed. After all, even though buprenorphine is still considered the gold standard for addiction care, the Lancet study found it still had an average relapse rate above 50 percent.
But for patients who sincerely hold this view, having a non-opioid alternative like naltrexone could encourage them to seek treatment. Naltrexone also only requires one shot a month, while buprenorphine is typically taken daily as a pill. That could make naltrexone much easier for some patients, given that a common problem with medicine is getting people to actually follow their prescriptions.
At the same time, naltrexone is also two to three times as expensive as buprenorphine. All of these factors and more will need to be considered by health care providers and patients as they decide what treatment to use. Still, outside of clinical trials, patients often have only one or neither of these options available to them.
Alkermes, for one, has lobbied policymakers to make naltrexone the medication of choice in the criminal justice system. Yes, buprenorphine seems to have a key advantage. Yes, naltrexone can be an alternative if someone is willing to go through full detox. But until patients actually have access to both drugs, genuine choice will remain illusory — and many people will continue to overdose and die.
Correction: Due to a typo, this article originally misstated the percent of patients who initially dropped out of buprenorphine treatment in the Lancet study. Our mission has never been more vital than it is in this moment: to empower through understanding. Financial contributions from our readers are a critical part of supporting our resource-intensive work and help us keep our journalism free for all.
When taken as prescribed, Suboxone is one of only two opioid addiction treatment medications that combines buprenorphine and naloxone. Maintenance medications such as Suboxone help individuals mitigate the painful opioid withdrawal symptoms.
Medication-assisted treatment that implements Suboxone is proven to be effective in helping addicts manage these painful withdrawal symptoms in order to help these individuals focus on receiving the other treatment services provided in order to maintain long term sobriety.
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All of the information on this page has been reviewed and verified by a certified addiction professional. She currently practices in the public domain in South Africa.
She has an interest in medical writing and has a keen interest in evidence-based medicine. Suboxone offers several benefits to those with opioid dependency and to others for whom treatment in a methadone clinic is not preferred or is less convenient.
Approved for clinical use by the Food and Drug Administration, medications such as buprenorphine, in combination with counseling and behavioral therapies, provide a whole-patient approach to the treatment of opioid dependence, FDA. When taken as prescribed, buprenorphine is safe and effective.
You can get help and lead a successful, productive life. Here at Garden State Treatment Center, we provide group therapy, individual addiction counseling, relapse prevention treatment, cognitive behavioral therapy, family therapy, 12 step addiction treatment and many other services that help teach you the skills you need to lead a Suboxone and Heroin free life. We believe in treating the entire person, not just their addictions. Our admissions team is standing by for your call. Medical Disclaimer The content of this website such as text, graphics, images, and other material contained on the website are for informational purposes only and does not constitute medical advice; the Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
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