Module 1, Unit 2: What are Medications for Opioid Use Disorder (MOUD)?
Opioids
What are opioids?- Opioids are a class of medicine that are typically used to reduce pain.
- Opioids work by blocking pain signals between the brain and the body.
- Opioids can also produce feelings of being relaxed, happy, or high, and can be addictive.
- Hydrocodone
- Oxycodone
- Codeine
- Morphine
- Fentanyl
- Opioids also include heroin, and have been found mixed in with other drugs, e.g., cocaine and counterfeit pills.
Opioid Use Disorder
What is opioid use disorder (OUD)?
Recovery is …
“A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. Even individuals with severe and chronic substance use disorder (SUD) can, with help, overcome their SUDs and regain health and social function. Although abstinence from all substance misuse is a cardinal feature of a recovery lifestyle, it is not the only healthy, prosocial feature. Patients taking FDA-approved medication to treat OUD can be considered in recovery” (SAMHSA, 2021).
What is MOUD?
Medications for Opioid Use Disorder (MOUD) (which you may have heard referred to as Medication Assisted Treatment, or MAT) utilizes medication to treat substance use disorder. It’s typically provided in with behavioral health supports to promote recovery of the whole person. This may include but is not limited to the following:
- counseling / therapy
- case management
- other medical treatment
- vocational, educational, or employment related assessments and services
There are currently three (3) FDA-approved medication treatment options for MOUD. Recovery Home clients will work with their doctor to determine which course of treatment is best for their recovery.
- methadone (for example, MethadoseⓇ)
- buprenorphine (for example, SuboxoneⓇ)
- naltrexone (for example, VivitrolⓇ)
Note on Side Effects
We’ve heard and understand concerns about the use or impact of MOUD. As with any treatment, there are both benefits and side effects. Side effects may vary, but can include things like nausea, dizziness, fatigue, restlessness, along with other common and more serious side effects. Most side effects are minor and well tolerated when a client finds the dose that works for them.
There’s also a common misunderstanding that MOUD “should” be for short-term use only, but as we’ll learn in Unit 2, there are no known adverse effects for long-term use, and treatment time is unique to the individual.
Side Effects
If clients are experiencing extreme fatigue, are having difficulty staying awake, or are “nodding off” this is not an intended or expected outcome of MOUD.
We know this can be upsetting or triggering for other clients to witness in the home.
Please approach clients with compassion and encourage them to talk with their physician. It may take time to get it right.
Remember to show kindness and support as clients adjust to any medications and navigate their recovery goals.
Tolerance & Overdose
A note on tolerance and overdose risk…
Over time and with regular drug use, your body develops a tolerance to a drug. This means it may require more of the drug to feel the same effect. But the body’s tolerance to a drug can decrease if you stop, reduce, or change your drug use.
Because of this, there is an increased risk for an opioid overdose if someone abruptly stops MOUD and uses the same amount of a drug they used before starting MOUD. Risk varies by type of MOUD and clients should talk with their physicians about any concerns.
Again, please encourage clients to talk with their doctor before stopping or changing their MOUD treatment.
Overdose Prevention & Naloxone
Naloxone (Narcan®, Evzio®)
- Speaking of tolerance and overdose risk, naloxone is an opioid overdose reversal medication.
- Under Arizona Statute (A.R.S. 36-2267), anyone who administers naloxone in good faith is protected from a civil suit and is not liable for any damages.
- It will not cause harm if person is not experiencing an opioid overdose.
- Intramuscular injection, nasal sprays, and auto-injectors are available.
- Naloxone is an essential item for your first aid kit in your home. Ensure house managers have access to and know how to administer it in the event of an emergency.
Get training, resources, and naloxone from Sonoran Prevention Works
Key Takeaways
What is MOUD?
- For those who utilize it, MOUD is just one component of a recovery journey that includes both medication and therapeutic support
- MOUD is an individualized choice – clients should work with their doctors to figure out the best course of treatment for them.
- In addition to MOUD, clients are navigating their recovery, which includes building new support networks, finding new routines, seeking meaningful employment, education, or other opportunities. How can recovery homes compassionately support this journey?
