There are many reasons that someone may be using opioids. More than 2 million people in the US have an opioid use disorder (OUD) related to prescription opioids. Another quarter of a million people have an OUD related to heroin.
For people who want to reduce or stop using opioids, evidence-based approaches are available to do this safely. Medications for opioid use disorder (MOUD) are one such approach and they’re most effective when someone chooses to start treatment (versus being coerced or mandated) for long-term success.. These treatments are most effective when someone is ready for them (versus coerced into treatment) for long-term success.
Benefits of Medications for Opioid Use Disorder
Since there are many reasons why someone may use opioids, we believe that treatment is most effective when the individual is ready to stop using drugs and considers other competing needs and life circumstances.
This evidence-based treatment has been proven to:
- Support people who to choose to reduce or stop their opioid use stop using drugs
- Increase the likelihood that a person will continue to not use drugs
- Reduce opioid use and symptoms related to opioid use disorder
- Reduce the risk of infectious disease transmission
- Reduce the chances of an overdose related death
Types of Medications for Opioid Use Disorder
There are two types of evidence-based medications used to treat opioid use disorder that we support: methadone and buprenorphine.
- Methadone
- What it is: synthetic opioid agonist that binds to opioid receptors
- How it works: eliminates withdrawal symptoms and relieves cravings
- How to get it: must be dispensed through specialized opioid treatment programs (OTPs)
- Buprenorphine
- What it is: is a partial opioid agonist, meaning that it binds to those same opioid receptors but does not completely activate them.
- How it works: reduces cravings and withdrawal symptoms without producing euphoria.
- How to get it: can be prescribed by certified healthcare providers through the Drug Addiction Treatment Act.
- Naltrexone
- What it is: is an opioid antagonist, which means that it works by blocking the activation of opioid receptors
- How it works: prevents any opioid drug from producing rewarding effects such as euphoria
- How to get it: can be prescribed by any medical professional who can prescribe medication
Our Position on MOUD
We do not support the use of naltrexone given the lack of evidence around efficacy. While there are movements around the United States to increase access to MOUD in prisons and jails, Naltrexone is often offered in prisons upon release. This is dangerous as naltrexone does not reduce mortality, and in fact creates a higher risk due to reduced tolerance.
We do support exploration of other opioid replacement therapies including prescription heroin and morphine that are used in other countries but have not been approved for use in the United States.
Beyond the Clinic
There are many settings that are meeting people where they’re at by offering lower-threshold ways of getting access to MOUD. Widespread access to treatment on demand is one key ingredient to end the overdose crisis and offer options for people using drugs. Here are some examples:
- Syringe Service Programs
- Learn more about San Francisco’s street-based medicine team offering buprenorphine at syringe service programs on Episode 2 of The Gold Standard podcast
- Mobile Outreach
- San Jose program
- Housing Programs
- Project Renewal
- Emergency Departments
- Jails and Prisons
- Pharmacies
- NJ pilot
Find Buprenorphine
Harm reduction organizations around the country are working to make medications for opioid use disorder accessible to anyone who needs them.
- Local harm reduction organizations and SSPs can help connect you with services.
> Find Harm Reduction Near You
- SAMHSA’s buprenorphine finder is a directory of thousands of providers around the country who are authorized to treat opioid use disorder. Please note that we have not vetted the providers on this list. You may want to call ahead to be sure that the information is still accurate.
> Find a provider near you.
Increasing Accessibility to Medications for Opioid Use Disorder
We’re working to bring harm reduction strategies to scale in every corner of the US. Today, many of the communities that have the highest rates of opioid-related deaths have the lowest access to MOUD.
Stay tuned for updates and actions you can take to increase access to MOUD in your community.