Why are Opioid Recovery Drugs Rarely Used?

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Photo by Jose Banks via Flickr.

Only 12.5 percent of individuals suffering from opioid use disorder have been treated with buprenorphine or methadone in recent years, despite its being the newest and “the most effective treatment,” according to a new JAMA Network Open study.

These “opioid recovery” drugs, buprenorphine and methadone, are narcotics that treat moderate to severe pain. They both have a high risk for addiction and dependence, but they’ve been proven to help manage opioid withdrawal symptoms and dramatically reduces opioid cravings, US News reports.

It’s “the most effective way to prevent overdoses and hospitalizations,” US News details.

Dr. Sarah Wakeman, the study’s lead author and medical director of Massachusetts General Hospital’s Substance Use Disorders (SUDs) Initiative, said that medical professions have “known for years” that these drugs are the most effective treatment.

However, Dr. Wakeman explains, “I think there’s been a real gap between what science has shown us is most effective and then what actually happens in real-world clinical practice.”

It was revealed that 1.7 percent of the study’s 41,000 patient sample size who received no treatment eventually overdosed, and 1.9 percent were hospitalized or had visited an ER within three months after their initial treatment visit, US News reported.

Conversely, “those treated with buprenorphine or methadone were 76 percent less likely to overdose within three months and 59 percent less likely to overdose within a year, the analysis showed,” US News said.

“These medications save lives,” Dr. Wakeman concluded, as quoted by US News. “They keep people healthy and they keep them out of the emergency department. And we need to be doing everything we possibly can to make them broadly accessible.”

The issue doesn’t just span the lack of treatment; it also encompasses the lack of buprenorphine and methadone availability.

Ann Maxwell, an assistant inspector general with the Office of Inspector General (OIG) at the Department of Health and Human Services, told NPR  “40 percent of counties across the country don’t have a single provider who is approved to prescribe buprenorphine.”

Providers are not approved because of a lack of licensing, since under the Drug Addiction Treatment Act of 2000 (DATA 2000), only “qualified U.S. physicians, and mid-level practitioners with an X-license can offer buprenorphine for opioid dependency.”

Maxwell described a real situation in Arizona to NPR, explaining that the trained providers are clustered around Phoenix, and if a patient lived in the southwest corner of Maricopa County encompassing Phoenix, it’s an estimated 115-mile drive to get to the nearest provider.

In that same interview with NPR, Dr. Paul Earley, president of the American Society of Addiction Medicine, said he supports legislative proposals to “increase the number of doctors specializing in addiction treatment and get them to high-need areas.”

Dr. Earley also suggested helping to pay off medical school loans for doctors practicing so that they can pursue the further licensing that’s needed to prescribe the narcotics.

Additional Reading: Opioid Epidemic Drives Increase in Rural Jail Populations

This summary was prepared by TCR staff writer Andrea Cipriano.

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