"The first large headtohead comparison of two opioid addiction medications found that although they were equally effective in getting people off of high levels of opioids users had a significantly more difficult time starting a regimen of naltrexone compared with buprenorphine.  Buprenorphine is commonly known by the the brand name Suboxone and naltrexone is sold under the brand name Vivitrol.  The study published Tuesday in the Lancet http looked at  patients with opioid addiction at eight inpatient treatment centers across the country for  weeks. Half of the group was assigned to naltrexone and the other half to bupenorphine.  Six percent of those enlisted to use buprenorphine were unable to start their treatment whereas  of those assigned to naltrexone dropped out before starting the therapy.  That hurdle is attributed to the fact that in order to start naltrexone a person has to have detoxed or not used opioids for several days whereas a user can transition from opioids to buprenorphine seamlessly. If youre currently opiatedependent ... naltrexone takes more work said Dr. Joshua Lee httpnyulangone.orgdoctorsjoshuadlee the lead author of the study who studies opioid addiction behavior and treatment at New York University.  Once on either of the medications people fared equally well. They tend to stay on medications about the same rate. They report good outcomes avoiding heroin use Lee said. However both groups also reported similar challenges staying with the regimens Just  of patients still used the drugs after  weeks.  What was important Lee said was for opioid addicts as well as treatment providers to understand that addiction isnt onesizefitsall. Much like you would expect if the doctor told you you have cancer or you have diabetes then there are different ways you could pursue treatment he said.  The gold standard of addiction treatment Public health experts consider medicatedassisted treatment the gold standard of opioid addiction treatment. It combines medication with counseling to help addicts wean off of high opioid use. Public health experts say it can help solve the staggering opioid overdose epidemic.  This year alone the CDC estimates that more than  people https have died of drug overdoses most of them from opioids  more than the number of American troops lost during the entire Vietnam War https Studies have found that using medicatedassisted treatments can reduce overdose mortality by half. http  Methadone may be the bestknown form of medicatedassisted treatment but it requires patients to have the drug administered daily in a clinic. Two other options have become increasingly popular buprenorphine which can be taken outside a clinic and naltrexone which is administered monthly.  Naltrexone has become become an increasingly popular choice among drug courts httpsndcrc.orgresourcedrugcourtpractitionerfactsheetextendedreleasenaltrexone. Some say thats because of the onceamonth administration and others say its because it requires that users completely detox before starting the regimen.  Understanding addiction People need choices said Caleb BantaGreen httpsph.washington.edufacultyfac_bio.aspurl_IDBantaGreen_Caleb a professor at the University of Washingtons School of Public Health. BantaGreen who was not involved in the new study said that getting the right treatment means understanding addiction from a psychological as well as biological perspective.  Legally prescribed opioid drugs like oxycodone and hydrocodone work in the same manner as illicit drugs like heroin. They all chemically bind to the opioid receptors in the brain to help dull pain and in some people provide euphoria.  The body also produces natural opioids but the more narcotics a person takes the less opioids the body naturally produces. Without the opioids people can go into withdrawal all contributing to a cycle of dependency.  To feel normal they need opiates on those receptors BantaGreen said. Buprenorphine and methadone which are opioids work by reducing peoples cravings. They bind to prevent withdrawal giving some opiate effect he said. On the other hand naltrexone works by chemically blocking those receptors which is why someone needs to detox before starting the regimen. Youre not getting an opiate effect BantaGreen explained.  If a person takes an opioid while on naltrexone it is unlikely they will feel any opioid sensation. If a person is using opioids and takes naltrexone it can induce a feeling of withdrawal. It addresses craving in a different way. The person knows they cant use he said.  So for example a person who is actively using opioids and cant manage the withdrawals may be better suited for buprenorphine while someone coming from a facility where he or she has detoxed and who doesnt want to use opioids may be better suited for naltrexone.  What is key said Dr. Miriam Komaromy is meeting a patient where they are and understanding what best meets their needs.  Addiction is an incredibly deadly disease said Komaromy an addiction specialist at the University of New Mexico Health Sciences Center. And as public policymakers prisons and drug courts play a larger role in treating addiction public health experts like Komaromy argue that it is imperative to look at evidencebased ways instead of having a moralistic view.  BantaGreen says he talks to a lot of judges who are trying to understand addiction treatment. I say this a lot to judges You cant just offer one medication. Just like any other medication some people are going to feel right with one as opposed to the other.  Clarification This story has been updated to reflect how naltrexone interacts with opioids."