Most People With Opioid Use Disorder Don't Get Medication For It, But These 3 Changes Can Help - MedCity News

Medications that treat opioid use disorder (OUD)—such as methadone, buprenorphine, and extended-release naltrexone—are life-saving medications that are proven to cut opioid overdoses by more than half. However, 86.6% of people who have OUD do not receive these medications, according to a study published on Thursday in International Journal of Drug Policy.

For the study, researchers from NYU The Grossman School of Medicine analyzed two databases: a publicly available one that tracks the dispensing of OUD medications by licensed methadone clinics and a private one that tracks prescriptions filled for buprenorphine and extended-release naltrexone. Through their analysis, they found that although the use of OUD drugs has more than doubled in the past 10 years, the use of these drugs is still too low to address the opioid overdose death rate that have been rising over the past decade, a trend driven primarily by the rise of synthetic opioids such as fentanyl.

When the researchers looked at state-by-state data, they found that OUD medication use varied widely. OUD medication treatment rates were lowest in South Dakota and highest in Vermont. But even in the states with the highest rates of use, at least half of the people who could benefit from OUD medications are still not getting them.

There are three key ways to tackle this problem, Noah Krawczyk, the study’s lead author, said in an interview.

One is by relaxing the strict regulations on dispensing methadone. Methadone is one of the most effective ways to treat OUD, according to Krawczyk, but the drug can only be dispensed by licensed opioid treatment programs (OTPs). She pointed out that about 80% of US counties don’t even have an OTP. When it comes to expanding access to methadone, providers and harm reduction advocates almost have their hands tied because federal law provides that the drug can only be dispensed through these programs.

This is not the case in other countries, Kravcik noted. For example, in the UK, patients can get a prescription for methadone from their doctor and collect it from the pharmacy, just as they would any other chronic treatment drug. Having a similar system in the U.S. would make the life-saving drug much more accessible, Krawczyk said.

Another change the U.S. health care system needs to make to increase access to OUD medications is removing the special exemption requirements for doctors to prescribe buprenorphine. To prescribe buprenorphine in this country, providers need the rejection of Xa requirement imposed by Congress in 2000 that requires doctors to complete a day of training before they can prescribe the drug.

Last year, a bipartisan group of six members of Congress introduced Addiction Treatment Integration (MAT) Act. to remove X-denial. The bill cited a National Institutes of Health study it showed that opioid overdose deaths in France fell by 79 percent over a four-year period after the country took similar measures to make it possible to prescribe buprenorphine without an exemption. Krawczyk said passage of this bill would not only free up bureaucratic hurdles, but also remove “the perception that buprenorphine is a very complicated treatment when it really isn’t.”

The final change needed to increase access to OUD medications is to expand the implementation of these medications in mobile health clinics and community organizations, as well as in the criminal justice system. To achieve this, the medical community will need to work to reduce the stigma surrounding OUD, Krawczyk said. She pointed out that many providers have a stigma against people with OUD because they were never trained to understand the condition in medical school.

“If you work in any hospital or community clinic, you’re going to come across patients with substance use disorders,” Krawczyk said. “So it’s really quite shameful that we don’t spend more time educating our doctors about this.” Opioid use disorder is the only chronic illness that is treated in this way – no other chronic medication requires a special license or must be provided in these specific settings.

Photo: sorbetto, Getty Images

Source link

Leave a Reply

Your email address will not be published. Required fields are marked *