TUESDAY, Feb. 25, 2020 — People treated for an opioid addiction stand a much better chance of breaking their dependency if they take opioid-blocking medications, a new study finds.
In fact, addicts who took methadone or buprenorphine had an 80% lower risk of dying from an overdose than those in treatment who are not using these drugs. Yet, many treatment programs don’t offer these drugs as part of their regimen, the researchers added.
“Treatments with medications are much more effective for reducing overdose risk than medication-free treatments. All opioid treatment programs should offer and encourage use of medications such as methadone and buprenorphine,” said lead researcher Noa Krawczyk, an assistant professor at the Center for Opioid Epidemiology and Policy at NYU Langone Health in New York City.
Keeping addicts in treatment is fundamental for sustaining its protective effects, she said. “We need to ensure patients remain in medication treatment for as long as the treatment is helping and working for them.”
Krawczyk and her colleagues also found that getting treatment for opioid addiction, with or without medication, reduced the odds of dying from an overdose, compared with not being in treatment at all.
But neither treatment reduced the risk of dying from an overdose after someone leaves treatment, the researchers noted.
To put the opioid crisis in perspective and the need for effective treatment in focus, all one needs to know is that overdose deaths increased from about 16,500 in 2007 to more than 47,000 in 2017.
Across America, some 60% of patients don’t get these medications, and many who do discontinue them, Krawczyk said.
Methadone and buprenorphine are often stigmatized as crutches that prevent cures, and some people think using them merely trades one addiction for another.
Moreover, access to these drugs is often restricted, Krawczyk said.
Methadone works by reducing the craving for opioids and helps with withdrawal and blocks the effects of opioids.
Buprenorphine also lessens the effects of physical dependence on opioids, such as withdrawal symptoms and cravings.
“Efforts to address the opioid crisis should ensure substance use treatment systems make opioid agonist medications highly accessible to all patients who present with opioid use disorder and focus efforts on promoting engagement and retention in these programs,” Krawczyk said.
For the study, Krawczyk and researchers from Johns Hopkins Medicine collected data on more than 48,000 patients being treated for opioid addiction in Maryland in 2015 and 2016.
They linked these data with figures from Maryland’s Office of the Chief Medical Examiner. In all, 72% of the patients received medication and 28% didn’t.
The researchers were not able to tell if one medication was better or worse than the other. Moreover, their data consisted of claims forms for the medications, not clinical use.
Emily Feinstein, executive vice president at the Center on Addiction, reviewed the study and said it confirms that methadone and buprenorphine save lives and are better at preventing overdose than treatment without medication.
“The fact that so few addiction treatment providers offer these medications is unconscionable and should no longer be tolerated,” she said.
The resistance to these medications stems from stigma, and this stigma is endangering lives, Feinstein said.
“We need to do more to remove the barriers to methadone and buprenorphine, including insurance barriers, so that people can access the care they need,” she said.
These data also suggest that medications to treat opioid use disorder work better if they are taken for longer periods of time, at least a year, Feinstein said, “although more data is needed to understand the association between length of treatment and outcomes.”
The report was published online Feb. 25 in the journal Addiction.
For more on treating opioid addiction, head to the U.S. National Institute on Drug Abuse.
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Posted: May 2020