________________________________ Substance Use Disorders and Pain Management: MATE Act Training
MEDICATIONS USED IN THE TREATMENT OF SUBSTANCE USE DISORDERS
Drug
Dose Range
Typical Starting Dose
Potential Adverse Effects
Route(s)
DEA Schedule
Opioid Use Disorder Buprenorphine/ naloxone (Bunavail, Suboxone, Zubsolv)
Buprenorphine: 0.7–24 mg/day Naloxone: 0.18–6 mg/day 20–120 mg/day
4/1 mg/day
Pain, headache, nausea, diaphoresis
Buccal film, sublingual film, sublingual tablet
CIII
Methadone (Dolophine, Methadose, DISKETS)
20–30 mg/day
Pruritus, constipation, cardiac abnormalities
PO, IV
CII
Naltrexone (Vivitrol)
PO: 25-50 mg/day IM: 380 mg/week
PO: 25 mg/day IM: 380 mg/week
Injection site reactions, anxiety, syncope
PO, IM
Not scheduled
Buprenorphine (Belbuca, Buprenex, Butrans, Probuphine, Sublocade) Alcohol Use Disorder Acamprosate (Campral) Naltrexone (Vivitrol)
SQ: 100–300 mg/ month SL: 2–24 mg/day
SQ: 300 mg/month Implant: 4 implants SL: 2–4 mg/day
Few
Sublingual tablet, subdermal implant, SQ injection
CIII
666 mg TID
666 mg TID
Diarrhea
PO
Not scheduled Not scheduled
PO: 25–100 mg/day IM: 380 mg/month
PO: 50 mg/day IM: 380 mg/month
Injection site reactions, anxiety, syncope
PO, IM
Disulfiram
125–500 mg/day
250 mg/day
Bitter taste, impotence, drowsiness
PO
Not scheduled
Tobacco Use Disorder Bupropion, sustained- release (Zyban)
150 mg daily or BID 150 mg/day
Weight loss, constipation, agitation, xerostomia, nausea
PO
Not scheduled
Nicotine
Gum: Up to a maximum 30 pieces/day Inhaler: 6–16 cartridges/day Lozenge: Titrate to 1 lozenge every 4 to 8 hours Nasal spray: Maximum 80 sprays/day Patch: One patch/day for 8 weeks
Gum: 1 to 2 pieces/ hour (2 mg/piece) Inhaler: 6 cartridges/ day Lozenge: One lozenge every 1 to 2 hours Nasal spray: 1 spray in each nostril once or twice per hour Patch: One patch/day
Oral irritation, headache, dyspepsia, nasal discomfort, cough, rhinitis
PO, intranasal, transdermal
Not scheduled
Varenicline (Chantix) 1 mg BID up to 12 weeks Not scheduled BID = two times per day, DEA = Drug Enforcement Administration, IM = intramuscular, IV = intravenous, PO = oral, SL = sublingual, SQ = subcutaneous, TID = three times per day. Source: [39] Table 2 0.5 mg/day Nausea, abnormal dreams, headache PO
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MDNJ1525
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