Medication-Assisted Treatment Saves Lives But Is Severely Underutilized

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Medication-Assisted Treatment Saves Lives But Is Severely Underutilized

By Maggie Ethridge 06/22/18

A new study found that in the year after an overdose less than one-third of patients were prescribed methadone, buprenorphine or naltrexone.

illustration of pharmacist giving pills to patient

A new study found that drugs used to reduce opioid use in people with addiction are seriously underutilized.

The medical journal Annals of Internal Medicine published the study, which followed close to 18,000 adults in Massachusetts. The participants in the study had gone to an emergency room between 2012 and 2014 for a non-fatal drug overdose.

Although using drug therapy to treat opioid addiction is considered a "gold standard" of treatment, the study found that just 30% received any of the Food and Drug Administration-approved medication-assisted treatments.

The FDA advises treatment for opioid addiction as a combination of behavioral therapy and the parallel use of one of three drugs. Methadone, buprenorphine, and naltrexone are all drugs approved for assistance in reducing drug cravings in those addicted to opioids.

Science Daily reported that the study showed a 59% reduction in fatal opioid overdose for those receiving methadone, and a 38% reduction for those receiving buprenorphine over a 12-month period. The drug naltrexone was unable to be evaluated due to a small sample size.

In the past, naltrexone has been shown to be as effective as methadone and buprenorphine, but there are high dropout rates and a refusal to try the drug in the first place.

Science Daily reports this could be due to the fact that patients utilizing naltrexone cannot use any opioids for seven to 10 days. Methadone and buprenorphine can be started much sooner.

As the opioid addiction crisis worsens, health officials are eager to find ways to assist people with addiction in withdrawal and abstinence from the drug. The Fix reported on an FDA-approved device that helps reduce opioid cravings, called “Drug Relief.”

The study also found that in the year after an overdose, not quite one-third of patients were prescribed one of the three FDA approved drugs—with methadone at 11%, buprenorphine at 17%, and naltrexone at 6%. Five percent received more than one medication.

According to Science Daily, Dr. Nora Volkow, director of the National Institute on Drug Abuse (NIDA), said, "A great part of the tragedy of this opioid crisis is that, unlike in previous such crises America has seen, we now possess effective treatment strategies that could address it and save many lives, yet tens of thousands of people die each year because they have not received these treatments. Ending the crisis will require changing policies to make these medications more accessible and educating primary care and emergency providers, among others, that opioid addiction is a medical illness that must be treated aggressively with the effective tools that are available.”

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Maggie May Ethridge is the author of Atmospheric Disturbances: Scenes From a Marriage (Shebooks, 2014) and the recently completed novel, Agitate My Heart. She is a freelance writer published in Rolling Stone, VOX, Washington Post, The Guardian and many others. Find her at her blog Flux Capacitor or on LinkedIn or Twitter.

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