What are buprenorphine alternatives?

When it comes to buprenorphine, are there other options available?

Buprenorphine, methadone, and naltrexone are all medications for opioid use disorder (MOUD) medications that work to lessen opioid desires, withdrawal symptoms, and the risk of overdosing. Suboxone contains the drug buprenorphine.

The US Food and Drug Administration (FDA) has approved buprenorphine, methadone, and naltrexone for this purpose, and MOUD is most effective when combined with counseling and psychosocial support.

Methadone is an opioid agonist with a lengthy half-life, therefore it acts similarly to oxycodone, heroin, and fentanyl. It works by inhibiting or blunting the effects of other opioids by saturating opioid receptors in the brain. Buprenorphine has a number of advantages over methadone:

When taken as recommended, buprenorphine/naloxone (Suboxone) is usually believed to be safer than methadone, with a lower risk of drowsiness and overdose. Effective methadone doses varies unexpectedly from person to person and might take weeks to accomplish; and

Buprenorphine/naloxone (Suboxone) can be prescribed in any treatment environment by licensed and trained medical practitioners, whereas methadone is carefully regulated and can only be provided through federally certified outpatient treatment programs.

More information regarding the similarities and differences between buprenorphine and methadone can be found here.

Naltrexone is an opioid antagonist that binds to opioid receptors in the brain, preventing users from feeling euphoric from narcotics like heroin or fentanyl. It works as a "blocker" and decreases both opiate and alcohol cravings.