Opioid Use Disorder Treatment in South Carolina

Medications We Use for Opioid Use Disorder

• Suboxone (buprenorphine/naloxone) — Daily sublingual film or tablet. The most widely prescribed first-line MAT medication for OUD. Reduces withdrawal, suppresses cravings, and blocks the euphoric effects of opioids.
• Sublocade (extended-release buprenorphine) — Monthly subcutaneous injection. Eliminates daily adherence requirements and eliminates diversion risk. Administered at a local healthcare facility.
• Brixadi (extended-release buprenorphine) — Available in weekly or monthly subcutaneous injection formulations. Provides consistent buprenorphine levels without the variability of daily dosing.
• Vivitrol (naltrexone) — Monthly intramuscular injection. An opioid antagonist — not a controlled substance — that blocks opioid effects and also treats alcohol dependence. Appropriate for patients who have completed detox and are fully opioid-free.

How Telehealth MAT Works

Your first appointment is a comprehensive clinical evaluation covering your opioid use history, prior treatment attempts, current medications, and any co-occurring medical or mental health conditions. Your provider develops an individualized treatment plan based on your situation, goals, and which medication is the best fit.

Regarding telehealth prescribing of buprenorphine: An initial evaluation determines whether telehealth-based buprenorphine prescribing is appropriate for your specific situation under current DEA guidelines. Please contact our office to discuss your circumstances. Vivitrol (naltrexone) and oral naltrexone do not carry the same telehealth prescribing restrictions and can be managed via telehealth following a proper evaluation.

Some patients coordinate urine drug screens and periodic vitals through their existing primary care or family medicine provider — others use a nearby certified lab location. Not all primary care practices participate in MAT monitoring, and we understand that — we will help find the right fit. Your clinical appointments remain virtual.

Vivitrol for Alcohol Dependence

Vivitrol (naltrexone) is FDA-approved for both opioid use disorder and alcohol dependence. For patients managing alcohol use disorder — alone or alongside opioid use disorder — monthly Vivitrol injections significantly reduce cravings and relapse rates. Vivitrol is not a controlled substance and can be managed via telehealth in South Carolina following a proper evaluation. Oral naltrexone (Revia) is also available for patients who prefer daily oral medication.

What the Research Says About MAT

Medication-assisted treatment is the evidence-based standard of care for opioid use disorder. Multiple decades of clinical research and the American Society of Addiction Medicine, SAMHSA, and the CDC all endorse MAT as the most effective treatment approach for OUD, significantly reducing overdose risk, improving treatment retention, and supporting long-term recovery.

MAT is not "replacing one drug with another." Buprenorphine and naltrexone are prescribed medical treatments that stabilize brain chemistry, reduce cravings, and allow patients to function normally. At a stable prescribed dose, buprenorphine does not cause a high, and its overdose risk is much lower than illicit opioids. It can still be dangerous with alcohol, benzodiazepines or other sedatives, and it must be locked away from children.

Prescriptions and Safety

Vivitrol (naltrexone) requires being opioid-free for 7 to 10 days and is given as an in-person monthly injection; follow-up visits can be by telehealth. Using opioids on top of Vivitrol, or after a missed or stopped dose, can cause a fatal overdose because your tolerance is lower.

Keep naloxone on hand: if someone may have overdosed, call 911 and give naloxone. Stay with the person, and give a second dose after 2 to 3 minutes if they do not respond, because naloxone can wear off before the opioid does.

Telehealth visits are evaluation and management visits. A prescription can be part of your treatment when your provider, using professional judgment and deciding together with you after weighing the risks and benefits, finds it medically necessary. Whether you are seen in person in West Ashley or by telehealth, prescriptions are sent electronically to your pharmacy.

Hope Integrative Medicine is not an emergency service. In a crisis, call or text 988; for a medical emergency or overdose, call 911.

Care in Your City

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