Medication-assisted treatment (MAT) is an evidence-based, whole-person approach to treating opioid use disorder (OUD) that addresses the physical struggles experienced by a person when they stop taking opioids. It stabilizes brain function, reduces cravings, and helps prevent relapse. Among MAT options, buprenorphine treatment for opioid use disorder is one of the most trusted strategies for recovery. In studies, it has been shown to significantly lower the risk of death by overdose and other adverse outcomes while also increasing treatment retention.
MAT with buprenorphine doesn’t have to be a one-size-fits-all journey. FDA-approved MAT medications that include Suboxone, Sublocade, and Brixadi offer patients different buprenorphine-based options for their needs and lifestyles. This article breaks down the differences between these three medication options for anyone considering buprenorphine treatment and answers questions like: is Brixadi better than Suboxone?
Buprenorphine is a partial opioid agonist. It reduces cravings and withdrawal symptoms without producing a high, allowing patients to focus on therapy and healthy habit development.
Buprenorphine is commonly prescribed for people in recovery from heroin, oxycodone, hydrocodone, and morphine misuse. In studies, buprenorphine has been shown to improve treatment outcomes for people with opioid use disorder. Buprenorphine treatment for opioid use disorder has been proven to reduce instances of overdoses when compared with other treatments. There are generally three requirements to begin MAT for opioid use disorder using buprenorphine:
Manages withdrawal symptoms
Stabilizes brain chemistry disrupted by opioid use
While buprenorphine treatment has been shown to be more effective than nonpharmacological therapies alone, it’s commonly combined with counseling and behavioral therapy when used in comprehensive MAT programs. Buprenorphine helps to stabilize brain chemistry that was disrupted by opioid use. For many people struggling with addiction, buprenorphine can also help to alleviate withdrawal symptoms that would make talk and behavioral therapies too difficult to be genuinely productive or beneficial.
While withdrawal management with buprenorphine is tightly controlled and monitored by care providers, patients have much more flexibility when it comes to the types of therapy they choose. For example, some patients may choose to explore the roots of their substance use using art therapy, adventure therapy, meditation, or group therapy. A care setting can also be an ideal place for family therapy. This allows an individual struggling with OUD to include loved ones in the healing process.
Suboxone is one of the more prevalent addiction recovery meds. It is a long-acting medication that is prescribed as a tablet or sublingual film that is taken daily. It is a combination medication that contains buprenorphine and naloxone. The naloxone component in Suboxone is included to deter misuse by injection. If the tablet is ground up and injected, it causes withdrawal symptoms. By tightly binding to the same receptors in the brain as other opiates, Suboxone also works to reduce cravings during withdrawal.
A major benefit of Suboxone is that prescribers can offer flexible dosing based on an individual’s needs. In addition, its low misuse potential and fast-acting mechanisms make it easier to start than some other MAT options. Additionally, Suboxone’s wide availability at most pharmacies around the country removes frustrating barriers and delays.
Consistency is an essential factor for people considering Suboxone. Taking the medication daily is required for Suboxone to be beneficial. When not taken exactly as prescribed, there is a risk of misuse. The most common Suboxone side effects include headache, nausea, vomiting, constipation, insomnia, and sweating.
Sublocade is a long-acting injectable buprenorphine that is administered by a healthcare provider. Each extended-release dose lasts for a month. Sublocade helps to block cravings and reduce withdrawal symptoms by stimulating receptors instead of inhibiting them. Sublocade also acts as an opioid deterrent by blocking the rewarding effects of opioids.
One of the main benefits of Sublocade is that it eliminates the need for daily self-administered medications. All the injections are performed under the care of a medical professional. This can make adhering to a treatment plan easier for some people. It also reduces risks for diversion or misuse.
However, Sublocade does require an in-office visit for each injection. Sublocade is typically initiated after a person has been stabilized on a daily dose of transmucosal buprenorphine, such as Suboxone, for at least seven days. The most common side effects of Sublocade include constipation, headache, nausea, injection-site itching and pain, and tiredness.
Like Sublocade, Brixadi is an extended-release injection of buprenorphine that must be administered by a healthcare provider. This FDA-approved shot can be administered through monthly or weekly doses. When doing a Brixadi versus Sublocade comparison, an advantage of Brixadi is that it may be initiated after a single dose of transmucosal buprenorphine, making it accessible earlier in treatment than Sublocade.
Brixadi offers a more flexible dosing schedule compared to other types of opioid addiction medication. It can either be administered in weekly or monthly doses to support individualized treatment. While Brixadi use is expanding, this is a newer treatment compared to Sublocade and Suboxone. As a result, fewer providers and pharmacies may provide it.
Additionally, Brixadi’s long-term use and side effects are still being evaluated. The most common adverse reactions with Brixadi include injection-site pain, headache, constipation, nausea, injection-site erythema, insomnia, and urinary tract infections (UTIs).
Choosing the right buprenorphine treatment for opioid use disorder is a highly personal decision. There are many different factors that influence buprenorphine effectiveness. Where a person is in the recovery process can dramatically impact whether they should consider injectable versus oral buprenorphine treatment options. Generally, a care team will evaluate a patient’s health history to develop a buprenorphine maintenance treatment plan that carefully addresses withdrawal symptoms in light of individual lifestyle and risk factors.
The first consideration that a care team looks at when prescribing one form of buprenorphine over another is a preference for daily versus long-acting treatment. Long-acting buprenorphine that is administered weekly or monthly provides sustained release of the medication to help keep symptoms and cravings under control with fewer doses and clinic visits. This provides several benefits. Possibly the biggest is that there is no risk of forgetting to stay on track with doses. Far from being just a problem that impacts recovery, nonadherence to medication plans is a long-standing issue in healthcare.
In some cases, misuse of buprenorphine medications can stem from a lack of understanding or forgetfulness. However, misuse can be intentional. When there is a high risk of relapse or misuse, a buprenorphine injection can be preferable because the lack of self-administration removes the potential for tampering.
Access to care providers should also be considered. For example, extended-release injectable formulations have been shown to be preferable for people experiencing homelessness and others who might have difficulty getting to appointments consistently.
Daily self-administered tablets or films available at a local pharmacy could be beneficial for people who have limited access to healthcare providers or adequate transportation options. While long-acting injectables reduce the need for daily dosing, their requirement for in-office administration can pose challenges for individuals with limited access to healthcare facilities.
It’s a myth that a person is not truly in recovery if they are taking buprenorphine or other drugs as part of MAT. Similar to people managing all kinds of life-threatening conditions using medications like diabetes for example, people who utilize MAT for OUD are taking advantage of carefully researched, FDA-approved medications to manage their conditions.
Being empowered by information about opioid treatment support involving medications is important for anyone living with an OUD. While they have been shown to help sustain recovery and prevent overdose deaths, these medications are still vastly underused.
Suboxone, Sublocade, and Brixadi are all FDA-approved MAT medications that can aid in opioid recovery. Getting started isn’t a matter of simply “picking” one. After entering a treatment center, a patient works closely with doctors, nurses, and other care providers to enter into a recovery plan that meets their individual needs.
Are you interested in learning more about buprenorphine treatment for you or a loved one? Reach out to Middlesex Recovery to learn about science-backed, holistically minded opioid treatment options today. Simply place a call or fill out our confidential form to speak with us about the many options we provide at our highly respected treatment centers located throughout Massachusetts and New Hampshire.
If opioid addiction is impacting your life or the life of someone you care about, reach out to our treatment center. We are here to provide the support and care you need to take the first step toward recovery.
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