Naltrexone vs Suboxone for Charlotte Residents: How Opioid Treatment Options Differ
DeBinge opioid transition: When travelling to DeBinge in The Bahamas for OLANI treatment, there is no requirement to complete a separate opioid-free waiting window before arrival. DeBinge uses a medically supervised 4-to-5-day buprenorphine transition. Buprenorphine is introduced to bridge the patient away from full-agonist opioids, stabilised and tapered over the first several days, and the O’Neil Long-Acting Naltrexone Implant is typically inserted around day 4 or 5 while buprenorphine is still being tapered. The planned overlap continues as buprenorphine clears and the implant gradually releases naltrexone. This pathway is clinician-supervised because mistimed naltrexone exposure can precipitate withdrawal.
Based on DeBinge’s clinical experience in The Bahamas since 2018, the implant typically provides its strongest craving and relapse-prevention support on average 9 months, while clinically meaningful opioid-receptor blockade may persist for longer, in some patients up to about 15 months. This longer blockade may continue to reduce opioid effects and overdose risk.
Ongoing recovery: The implant is not a cure. The DeBinge programme includes a full year of professional counselling after implantation to address the behavioural and psychological side of addiction.
If you live in Charlotte and begin researching medication for opioid use disorder, the terminology can become confusing quickly. One clinic may discuss Suboxone. Another may mention buprenorphine, Sublocade, methadone or Vivitrol. Then you may encounter naltrexone tablets or longer-acting naltrexone implants.
These medications are not simply different brands of the same treatment. Buprenorphine and naltrexone interact with opioid receptors in fundamentally different ways, require different preparation and create different practical questions around withdrawal, adherence and long-term treatment.
The purpose of this guide is not to tell you which medication to choose. It is to help Charlotte-area patients and families understand the differences well enough to have a more informed conversation with an addiction clinician.
Understanding the Medication Choices
Why Charlotte Patients Encounter So Many Different Opioid Medications
Charlotte and Mecklenburg County already have established medication-based opioid treatment. Local providers advertise buprenorphine/Suboxone, extended-release buprenorphine, Vivitrol and, through appropriately regulated opioid treatment programs, methadone.
That is important context. Someone living in Charlotte, Matthews, Huntersville, Concord, Gastonia, South Charlotte or elsewhere in the Carolinas does not need to leave North Carolina simply because medication treatment is required.
The confusion arises because local treatment pages often place several medications under the same heading, usually “MAT” or “medication-assisted treatment.” The newer term medications for opioid use disorder, or MOUD, is also commonly used. But the medications inside that category work differently.
Full agonist
Methadone activates opioid receptors as a full opioid agonist under carefully controlled treatment conditions.
Partial agonist
Buprenorphine activates the same receptors, but only partially, helping suppress withdrawal and cravings while producing less receptor activation than full agonists.
Antagonist
Naltrexone does not activate the receptor. It occupies and blocks opioid receptors while adequate medication levels are present.
People considering a treatment model outside North Carolina can also review the broader addiction treatment pathway for Charlotte residents. That page is the main regional guide to consultation, preparation, treatment in Nassau where appropriate and recovery after returning home.
What Is Medication Treatment Trying to Accomplish?
Medication for opioid use disorder is not simply about “getting through detox.” A major goal is to reduce the biological pressure that can make continued opioid use or relapse more likely while giving the person a better opportunity to remain engaged in treatment and rebuild daily life.
SAMHSA identifies methadone, buprenorphine and naltrexone as FDA-approved medication approaches for opioid use disorder. Medication can be used for months, years or, for some patients receiving agonist treatment, indefinitely. There is no clinical requirement that every person should discontinue medication quickly simply to be considered “really recovered.”1
What Is Suboxone?
Suboxone is a brand of medication containing buprenorphine and naloxone. It is typically used as a sublingual or buccal film, meaning the medication dissolves under the tongue or against the inside of the cheek.
The component primarily responsible for treating opioid withdrawal and cravings is buprenorphine. Buprenorphine is a partial opioid agonist with very strong affinity for the mu-opioid receptor.
The naloxone in Suboxone is included primarily to discourage certain forms of misuse. When the product is taken as directed under the tongue or against the cheek, buprenorphine provides the main therapeutic effect. Naloxone should not be confused with the role of naloxone nasal spray used to reverse an opioid overdose.
The FDA prescribing information describes Suboxone as part of a complete treatment plan that includes appropriate counseling and psychosocial support.3
How Does Buprenorphine Work?
Buprenorphine binds strongly to opioid receptors but activates them less completely than full agonists such as heroin, fentanyl or methadone. When used appropriately, this can suppress opioid withdrawal, reduce cravings and help stabilize a person without producing the same pattern of intoxication associated with uncontrolled use of full-agonist opioids.
Because buprenorphine binds so strongly to the receptor, timing at the start of treatment matters. If standard-dose buprenorphine is taken too early while a full opioid agonist is still heavily occupying receptors, it can displace that opioid and trigger precipitated withdrawal.
Traditional initiation therefore generally begins after objective withdrawal has developed. In the fentanyl era, clinicians increasingly individualize initiation strategies because fentanyl exposure can make the transition less predictable.
Buprenorphine treatment can be long term
SAMHSA states that treatment duration should be tailored to the patient and can, in some cases, continue indefinitely. A patient doing well on buprenorphine should not stop it simply because another medication sounds more “drug-free.” Any transition should be based on a clinician-supervised plan.4
What Does Naltrexone Do Differently?
Naltrexone is an opioid antagonist. Instead of activating opioid receptors, it binds to them and blocks the effects of opioids while adequate medication levels are present.
It does not produce an opioid high and is not itself an opioid. It also does not maintain opioid physical dependence in the way an opioid agonist or partial agonist can.
That distinction appeals to some patients, but it creates an important treatment hurdle: naltrexone generally cannot be started while a person remains physically dependent on opioids. The person has to complete an appropriate opioid-free preparation period first.
Buprenorphine approach
Partially activates opioid receptors to suppress withdrawal and craving while stabilizing the patient.
Naltrexone approach
Blocks opioid receptors after adequate opioid withdrawal and preparation have already occurred.
Oral Naltrexone
Oral naltrexone tablets provide opioid receptor blockade when they are taken consistently. Current U.S. labeling includes treatment of alcohol dependence and blockade of the effects of externally administered opioids as part of an appropriate addiction-management plan.5
The practical difficulty is adherence. A tablet has to continue being taken. If someone intentionally or unintentionally stops the medication, antagonist coverage does not continue indefinitely.
DailyMed specifically notes that poor compliance has limited the usefulness of self-administered oral naltrexone in opioid treatment. This adherence problem was one of the reasons longer-acting naltrexone formulations were developed.
Vivitrol: Approximately Monthly Naltrexone
Vivitrol is extended-release injectable naltrexone. It is administered by a healthcare professional approximately every four weeks and is FDA-approved for prevention of relapse to opioid dependence following opioid detoxification, as well as for alcohol dependence in appropriate patients.
Its major practical difference from oral naltrexone is that the patient does not have to decide every day whether to take a tablet during the active injection period.
However, Vivitrol still requires successful opioid withdrawal and an adequate opioid-free interval before the first injection. Repeat injections also require continued engagement with care.
Starting naltrexone too early can cause severe withdrawal
SAMHSA advises waiting at least 7 days after short-acting opioids and 10 to 14 days after long-acting opioids before starting naltrexone, while actual readiness must be assessed clinically. People transitioning from methadone or buprenorphine can require particularly careful planning.6
What Is a Sustained-Release Naltrexone Implant?
A naltrexone implant is designed to release naltrexone over a longer period after being placed beneath the skin. Duration varies substantially between products and formulations, so “naltrexone implant” should not be treated as though it describes one standardized medication.
The rationale is mainly adherence. A longer-acting formulation reduces the number of occasions on which a patient has to remember or choose to take another dose.
Research has evaluated implantable naltrexone, but evidence varies by product, study design and duration. A peer-reviewed review notes that implant formulations are not FDA-approved in the United States.7
Important for Charlotte and U.S. readers
DeBinge does not operate an implant clinic in Charlotte, Mecklenburg County or elsewhere in North Carolina. DeBinge treatment involving a sustained-release naltrexone implant takes place in Nassau, The Bahamas, after clinical assessment and appropriate preparation. The implant should never be described as FDA-approved in the United States.
Patients considering this pathway can review treatment information for Charlotte and North Carolina residents before making any travel plans.
Suboxone vs Oral Naltrexone vs Vivitrol vs Naltrexone Implant
| Feature | Suboxone / buprenorphine-naloxone | Oral naltrexone | Vivitrol | Sustained-release naltrexone implant |
|---|---|---|---|---|
| Medication type | Buprenorphine is a partial opioid agonist; naloxone is included mainly to deter misuse. | Opioid antagonist. | Extended-release opioid antagonist. | Longer sustained-release opioid antagonist. |
| Opioid receptor activity | Partially activates mu-opioid receptors with high receptor affinity. | Blocks opioid receptors without activating them. | Blocks opioid receptors without activating them. | Designed to maintain antagonist exposure over a longer period. |
| Primary clinical role | Suppress withdrawal and cravings and maintain stabilization. | Provide opioid blockade after detoxification when taken consistently. | Provide sustained blockade after opioid detoxification. | Provide longer sustained antagonist delivery after appropriate preparation. |
| Preparation before starting | Standard initiation generally begins after sufficient withdrawal appears; alternative clinician-guided approaches may be used in selected cases. | Requires adequate opioid-free preparation. | Requires adequate opioid-free preparation. | Requires adequate opioid-free preparation and clinical assessment. |
| Typical dosing pattern | Often daily for sublingual formulations, although other buprenorphine formulations exist. | Regular oral dosing, commonly daily. | Approximately every four weeks. | Potentially months depending on the specific formulation. |
| Adherence issue | Medication has to remain part of the ongoing treatment routine. | Daily adherence can be a major limitation. | Patient must return for repeat injections. | Fewer repeat dosing decisions, but the initial treatment decision and follow-up become especially important. |
| If treatment stops | Stopping after physical dependence has developed can cause withdrawal and may increase risk of return to opioid use; discontinuation should be medically planned. | Naltrexone itself does not produce opioid withdrawal when stopped, but receptor blockade fades and opioid tolerance may be lower. | Blockade decreases as the injection wears off; overdose vulnerability can increase if opioids are resumed. | Medication exposure eventually declines; post-treatment overdose and relapse planning remains important. |
| U.S. regulatory status | FDA-approved medication for opioid dependence/OUD. | FDA-regulated prescription naltrexone; labeling includes opioid blockade and alcohol dependence. | FDA-approved for appropriate opioid- and alcohol-use indications. | Not FDA-approved in the United States. |
| Counseling and recovery support | Still important. | Still important. | Still important. | Still important. |
What Happened When Buprenorphine-Naloxone and Vivitrol Were Compared Directly?
One of the most useful studies for understanding this choice is the NIDA-supported X:BOT trial, which compared extended-release naltrexone with buprenorphine-naloxone in 570 adults with opioid use disorder entering short-term inpatient treatment.
The major difference was the induction hurdle. Patients had to complete opioid detoxification before receiving extended-release naltrexone, and more participants failed to reach that stage.
Across everyone assigned to treatment, relapse events were more frequent in the extended-release naltrexone group, largely because of early relapse among people who could not complete naltrexone induction. Among patients who successfully started their assigned medication, relapse outcomes were similar between the two treatment groups during the trial.
Source: Lee JD et al., Lancet, X:BOT comparative effectiveness trial.
Read the full study on PubMed Central
This is an important clinical lesson. Naltrexone can be an effective option after successful induction, but getting from active opioid dependence to antagonist treatment can be more difficult than initiating buprenorphine. That difference should be discussed before anyone assumes the medications are interchangeable.
Why Naltrexone Requires an Opioid-Free Preparation Period
Someone who is physically dependent on opioids has opioid receptors adapted to ongoing opioid exposure. An opioid antagonist can suddenly displace opioid activity from those receptors.
If naltrexone is administered too early, the result can be abrupt, severe precipitated withdrawal. Current oral naltrexone labeling describes post-marketing cases severe enough to require hospitalization and, in some cases, intensive-care management.5
This is one of the biggest differences from ongoing buprenorphine maintenance. A person doing well on Suboxone should not abruptly stop it on their own in order to become eligible for naltrexone.
Do not create your own transition schedule
Transitioning from fentanyl, heroin, prescription opioids, methadone or buprenorphine to naltrexone requires professional planning. The necessary preparation can vary according to the opioid, dose, treatment duration, physical dependence and individual medical circumstances.
Switching From Suboxone or Methadone to Naltrexone Is a Clinical Transition
A person may have valid reasons for asking about an antagonist-based treatment. They may prefer not to remain on an opioid agonist, may have had adherence problems, may be entering a setting where agonist treatment is difficult to continue, or may simply want to understand alternatives.
Those preferences deserve discussion, but they do not make abrupt discontinuation safe.
Stopping buprenorphine or methadone can produce withdrawal and can create a period of substantial vulnerability to return to opioid use. The clinician must consider how withdrawal will be managed, how long the patient needs to remain opioid-free and whether naltrexone induction is realistic.
For many patients, remaining on buprenorphine or methadone will be the safer and more appropriate plan. For others who can complete opioid withdrawal and prefer an antagonist approach, naltrexone may be reasonable.
Do not discontinue effective treatment simply to pursue a different medication
The fact that naltrexone is not an opioid does not automatically make it clinically superior. Shared decision-making should include the risk of destabilizing successful buprenorphine or methadone treatment.
Fentanyl Makes Medication Transitions More Complex
Fentanyl has changed opioid treatment. High-potency synthetic opioid exposure can make withdrawal and medication initiation less predictable, particularly when clinicians are deciding when to begin buprenorphine or when someone is sufficiently opioid-free for naltrexone.
ASAM guidance emphasizes individualized buprenorphine initiation strategies for people exposed to high-potency synthetic opioids. Some patients use traditional initiation after sufficient withdrawal; others may require different clinician-directed approaches.8
Research also supports buprenorphine’s continued usefulness in people exposed to fentanyl. A randomized-trial analysis published in 2024 found rapid reductions in withdrawal and craving among participants with fentanyl exposure receiving buprenorphine formulations.9
For naltrexone, fentanyl history is another reason not to rely on a simple calendar calculation. Clinical assessment is needed to determine whether physical dependence has resolved sufficiently before an antagonist is administered.
Adherence Can Matter as Much as the Medication Name
Patients often compare medications based only on pharmacology. In real life, adherence can be equally important.
Daily medication
Suboxone and oral naltrexone may require regular self-administration. The patient must remain engaged enough to continue the medication as prescribed.
Monthly treatment
Vivitrol reduces daily dosing decisions, but the patient still has to return for the next injection when the previous dose is wearing off.
Longer sustained release
An implant may reduce repeated dosing decisions further, but longer exposure also makes careful pre-treatment selection and follow-up especially important.
A treatment plan should therefore ask not only, “Which medication can work?” but also, “Which treatment can this particular person realistically start and remain engaged with?”
Naltrexone Blockade Does Not Make Opioid Use Safe
While adequate naltrexone levels are present, opioids may produce substantially less of their expected effect because opioid receptors are blocked.
That does not make an opioid challenge safe. Attempting to overpower the blockade by taking large quantities of fentanyl, heroin or another opioid can result in severe or fatal poisoning.
Another risk appears when antagonist treatment wears off or stops. A period without opioids can lower tolerance. Returning to a previously used amount can then cause overdose at a dose the person once survived.
Buprenorphine treatment also requires overdose planning. Although buprenorphine has a safer respiratory profile than full agonists when appropriately prescribed, combining it with alcohol, benzodiazepines or other respiratory depressants can be dangerous.
Keep naloxone available
CDC recommends naloxone for people at increased risk of opioid overdose. Naloxone can reverse overdose from fentanyl, heroin and prescription opioids when administered in time. If an overdose is suspected, administer naloxone if available, call 911, support breathing and stay with the person until emergency help arrives.10
Counseling and Behavioral Recovery Still Matter
Medication can substantially change the biological conditions around opioid use, but it does not automatically change relationships, trauma responses, housing instability, stress, boredom, sleep, social networks or the routines that have become linked with substance use.
SAMHSA recommends a whole-person approach that can include medication, counseling, behavioral therapies and relevant medical and social services.1
The same principle applies whether someone receives buprenorphine in Charlotte, methadone through a North Carolina opioid treatment program, Vivitrol locally or an appropriately selected naltrexone treatment in Nassau.
- Identify personal relapse triggers.
- Continue counseling where appropriate.
- Address co-occurring mental-health needs.
- Build a stable weekly routine.
- Develop family and peer support without stigma.
- Maintain overdose planning and naloxone access.
- Reassess treatment rather than abandoning care if substance use recurs.
Questions to Ask an Addiction Clinician Before Choosing Medication
About your current opioid use
- Am I physically dependent on opioids right now?
- Does fentanyl exposure change the safest way to begin treatment?
- What withdrawal risks should I expect?
- Would buprenorphine, methadone or naltrexone fit my current clinical situation?
About previous treatment
- What happened when I previously used Suboxone or another medication?
- Was the medication ineffective, or did I stop it too early?
- What caused previous treatment to become difficult to maintain?
About naltrexone
- How will you determine that I am sufficiently opioid-free?
- What happens if precipitated withdrawal occurs?
- What evidence supports the exact formulation being proposed?
- What is its regulatory status?
About long-term recovery
- How long might medication treatment continue?
- What counseling and support will accompany it?
- What is the plan if I return to opioid use?
- Who will manage treatment after I return home?
How the DeBinge Pathway Fits Into the Wider Treatment Choice
DeBinge should be considered as one possible treatment pathway rather than a replacement for every local opioid-use-disorder service.
Charlotte and the surrounding Carolinas already have established buprenorphine providers, opioid treatment programs, counselors, residential services and outpatient care. For many people, remaining in North Carolina and beginning or continuing buprenorphine or methadone may be the most appropriate option.
Other patients may want to discuss whether an antagonist-based pathway involving longer-acting naltrexone is relevant to them.
Charlotte
Discuss opioid use, fentanyl exposure, current medication, previous treatment and treatment goals.
Assessment
Determine whether naltrexone is clinically appropriate and what preparation would be required.
Nassau
Travel for the relevant clinical phase only after medical preparation and treatment timing have been established.
North Carolina
Return with counseling, support, trigger planning, appropriate medical follow-up and an overdose-safety plan.
DeBinge does not operate a medical clinic in Charlotte. The implant-based clinical phase takes place in Nassau, The Bahamas. The main DeBinge Charlotte treatment guide explains the regional pathway, preparation and return-home planning in more detail.
Returning to Charlotte Still Requires a Recovery Plan
Medication selection is only one decision. The larger question is what happens during ordinary life in Charlotte, Mecklenburg County or elsewhere in North Carolina after treatment begins.
Someone returning to Matthews, Huntersville, Concord, Gastonia, South Charlotte or another community may again encounter the same work stress, relationships, neighborhoods, social contacts and routines that existed before treatment.
Before returning home, clarify who will provide counseling, whether local medical follow-up is needed, how medication information will be shared with North Carolina clinicians and what will happen if cravings or opioid use return.
What Should You Discuss With a Doctor Before Choosing an Opioid Treatment Medication?
This educational quiz can help identify subjects worth raising with an addiction clinician. It does not diagnose opioid use disorder and does not determine whether Suboxone, methadone, Vivitrol, oral naltrexone or an implant is appropriate.
Your answers are calculated inside this page and are not submitted to DeBinge by this quiz.
1. Are you currently using opioids or experiencing withdrawal when you stop?
2. Could fentanyl or another high-potency synthetic opioid be part of your recent opioid exposure?
3. Have you previously used Suboxone or another buprenorphine medication?
4. Have you previously used oral naltrexone or Vivitrol?
5. How easy is it for you to continue medication consistently?
6. Has overdose or high-risk opioid use been part of your history?
7. What are you hoping to understand most clearly?
8. What support would accompany medication treatment?
9. How realistic is ongoing medical follow-up for you?
10. Are you comparing local North Carolina treatment with treatment in Nassau?
Topics to Take Into Your Clinical Consultation
Your answers identify subjects that may deserve more attention when you speak with an addiction clinician. These results do not recommend a specific medication or treatment location.
Medication choice requires the full clinical picture
A clinician should review current opioid use, physical dependence, fentanyl exposure, previous medications, overdose history, medical conditions, adherence, treatment goals and recovery support before deciding which options are reasonable.
Learn How the DeBinge Treatment Pathway Works for Charlotte Residents Considering Treatment in Nassau
If you are comparing buprenorphine, Vivitrol, oral naltrexone and longer-acting antagonist treatment, the next step should be understanding which options are clinically realistic in your individual situation.
DeBinge can explain how assessment, opioid preparation, treatment in Nassau where appropriate and recovery planning after returning to North Carolina fit together. A consultation does not mean an implant will be recommended.
For some patients, continuing or beginning evidence-based treatment with buprenorphine or methadone in North Carolina may remain the more appropriate option.
View the Charlotte Treatment PathwayNaltrexone vs Suboxone for Charlotte Residents: FAQ
1. Is Suboxone the same thing as buprenorphine?
Suboxone contains buprenorphine plus naloxone. Buprenorphine is the partial opioid agonist that provides the main therapeutic effect for opioid use disorder. Naloxone is included primarily to discourage certain forms of misuse.
2. Is Suboxone simply replacing one opioid with another?
No. Buprenorphine is an evidence-based medical treatment for opioid use disorder. It partially activates opioid receptors in a controlled way that can suppress withdrawal and cravings, improve treatment retention and reduce harms associated with uncontrolled opioid use. Treatment may appropriately continue long term.
3. What is the biggest difference between Suboxone and naltrexone?
Buprenorphine partially activates opioid receptors, while naltrexone blocks them. Buprenorphine can be used to stabilize someone who remains opioid dependent, whereas naltrexone generally requires successful opioid withdrawal and an adequate opioid-free period before treatment begins.
4. Is Vivitrol the same as naltrexone?
Vivitrol is a specific extended-release injectable formulation of naltrexone. It is generally administered approximately every four weeks. Naltrexone is also available as oral medication, and longer-acting implant formulations have been developed separately.
5. Which works better, Suboxone or Vivitrol?
There is no universal answer for every patient. In the X:BOT trial, extended-release naltrexone was harder to initiate because patients first had to complete opioid detoxification. Among participants who successfully started their assigned medication, outcomes were similar. Individual treatment history, preference, physical dependence and ability to remain engaged all matter.
6. Can I stop Suboxone and immediately start naltrexone?
No. Naltrexone should not be started while someone remains physically dependent on buprenorphine or another opioid. Transitioning requires clinician-supervised withdrawal and an appropriate opioid-free period. Abruptly discontinuing effective buprenorphine treatment without medical planning can increase risk.
7. Does fentanyl change the medication decision?
It can. Fentanyl and other high-potency synthetic opioids can make medication initiation and withdrawal management more complicated. Current addiction-medicine guidance supports individualized buprenorphine initiation strategies, and naltrexone preparation should also be determined clinically rather than through a fixed home timetable.
8. Is methadone still an appropriate opioid treatment?
Yes. Methadone is another evidence-based medication for opioid use disorder and may be highly appropriate for some patients. In the United States it is provided for OUD through federally regulated opioid treatment programs. It should not be dismissed simply because other medications are available.
9. Is a naltrexone implant FDA-approved in the United States?
No. Naltrexone implant formulations are not FDA-approved for clinical use in the United States. Implant formulations have been researched and are used in some settings outside the United States. DeBinge implant-based treatment takes place in Nassau, The Bahamas.
10. Does DeBinge operate a clinic in Charlotte?
No. DeBinge does not operate a medical treatment facility in Charlotte or North Carolina. Charlotte residents can begin consultation and treatment planning from home, while the relevant DeBinge clinical phase involving the implant takes place in Nassau.
11. Can naltrexone guarantee protection from fentanyl overdose?
No. Naltrexone should never be described as guaranteed overdose protection. Attempting to overpower receptor blockade with large opioid doses can be dangerous, and overdose vulnerability can increase after blockade declines because opioid tolerance may be lower.
12. Should I carry naloxone if I am receiving addiction treatment?
Where opioid exposure remains possible, naloxone is an important safety measure. CDC recommends naloxone access for people at increased overdose risk. Family members and other close contacts should know where it is and how to use it.
13. Do I need counseling if medication is working?
Medication can be extremely important, but recovery often also involves coping skills, mental-health care where needed, trigger management, relationships, daily structure and support. SAMHSA recommends a whole-person treatment approach rather than relying on medication as the only component.
14. Where should a Charlotte resident start?
Start with a qualified addiction clinician who can assess current opioid use, physical dependence, fentanyl exposure, overdose history, previous treatment and medical circumstances. Charlotte residents interested specifically in the Nassau pathway can also review DeBinge’s regional information before making travel arrangements.
Evidence Used in This Guide
Current federal guidance describing buprenorphine, methadone and naltrexone as medications for opioid use disorder within a whole-person treatment model.
Read SAMHSA guidance
NIDA information explaining buprenorphine’s partial-agonist mechanism, effects on withdrawal and cravings and evidence supporting medication treatment.
Read the NIDA resource
Official prescribing information covering buprenorphine/naloxone, treatment indication, induction, maintenance and major safety precautions.
Review Suboxone prescribing information
Current information covering partial-agonist pharmacology, withdrawal, cravings, safety and individualized treatment duration.
Read SAMHSA’s buprenorphine guide
Current U.S. labeling covering opioid blockade, contraindications, opioid-free preparation and adherence limitations.
Review DailyMed labeling
Current guidance on extended-release naltrexone, opioid-free preparation, overdose vulnerability and use within comprehensive treatment.
Read SAMHSA’s naltrexone guide
Randomized multicenter comparison of extended-release naltrexone and buprenorphine-naloxone for opioid relapse prevention.
Read the X:BOT trial
Review of sustained-release implant research and the distinction between implant research and FDA-approved U.S. formulations.
Read the review
Clinical considerations addressing individualized buprenorphine initiation and stabilization in the fentanyl era.
Read ASAM clinical recommendations
Current guidance explaining naloxone access and what to do when an opioid overdose is suspected.
Read CDC naloxone guidance
Medical and emergency information
This article provides general educational information and does not replace individual medical assessment, diagnosis or treatment. Do not abruptly stop buprenorphine, methadone, prescription opioids or other medications simply to prepare for naltrexone or treatment travel.
If someone is unconscious, cannot be awakened, has slow or stopped breathing, or you suspect an opioid overdose in the United States, administer naloxone if available and call 911. Stay with the person and follow emergency-dispatch instructions. For an immediate suicide or mental-health crisis in the United States, call or text 988.