Opioid pain relievers are one of the most abused prescription drugs. Those abusing prescription drugs usually do not find out until it is much too late that these drugs are highly addictive, can cause overdoses, and can even result in death. These are high-powered medications that are as easily addictive as heroin. There are other prescription drugs that are also being abused, such as stimulants and antidepressants.
Methadone and buprenorphine are two of the mainline medications used in the U.S. for the treatment of addictions to opioid substances of abuse. Doctors typically consider a number of factors when determining which of these medications to use in their patients. In a study in the journal Drug and Alcohol Dependence, researchers compared the effectiveness of methadone and buprenorphine treatment for pregnant women seeking treatment for opioid addiction.
Methadone is a synthetic medication designed to chemically resemble morphine, a naturally occurring opioid narcotic found in a plant called the opium poppy (which serves as the chemical template for essentially all opioid drugs and medications). Doctors commonly use this medication to treat people addicted to the powerful narcotic heroin. However, they may also use it to treat other forms of opioid addiction or to address the impact of significant forms of pain. In addiction treatment, methadone produces its benefits by mimicking the effects of heroin or other potent opioids, but at a slower rate and with a reduced ability to trigger the extremely pleasurable state called euphoria. Since the medication does not create the same intense high associated with heroin and other frequently abused opioids, doctors can use it as a short- or long-term replacement for these substances during the addiction recovery process. Available forms of methadone include injectable solutions, ingestible solutions, and tablets.
Buprenorphine is also a synthetic opioid medication. However, compared to methadone, it produces substantially lower levels of euphoria and other desirable effects associated with narcotic use. When given to someone accustomed to taking a more powerful opioid drug or medication, buprenorphine provides enough of a narcotic effect to act as a temporary replacement substance during addiction recovery; however, when used in a suitably low dose, it does not produce enough of an effect to sustain ongoing addiction. In addition, when used above a certain relatively modest dosage, it ceases to produce increasing levels of euphoria. This built-in ceiling limits an addict’s temptation to abuse buprenorphine as a substitute for a stronger opioid substance. Doctors can further limit this temptation by combining the medication with a second anti-opioid substance called naloxone, which gradually cancels out buprenorphine’s narcotic effects. Buprenorphine/naloxone comes in the form of a sublingual (under the tongue) tablet.
Meth and buprenorphine derive their primary usefulness from their ability to address the symptoms of opioid withdrawal, a deeply unpleasant condition that occurs when an opioid addict either stops the use or decreases that use rapidly. However, current research indicates that doctors can have a harder time starting pregnant opioid addicts on buprenorphine treatment than on methadone treatment. The researchers point toward the need for further research to uncover the effects and explain them fully.