Opioid Use Disorder affects about 2.5 million Americans (aged 12 years or older), but only a small percentage are treated with Medication for Opioid Use Disorder (MOUD) [1]. Research shows that MOUD has significant benefits, including a 66-80% reduction in overdose deaths [2]. Access to MOUDs across the United States is improving, but there’s still a need for greater progress – and a need for trained clinicians willing to serve on the frontline of the opioid crisis.
Why is MOUD underused and what can be done?
- Reasons for this gap include lack of access to opioid maintenance programs, lack of trained providers (especially in rural areas), expense, and negative attitudes toward agonist maintenance in some communities.
- A dedicated, trained clinical can make a difference. Treating a patient with an opioid use disorder with MOUD not only enhances their likelihood of recovery and survival, it can also reduce the stigma associated with the disorder. A patient who is treated with dignity and compassion is more likely to see their own symptoms as a treatable illness.
- Patients seeking MOUD for opioid use disorder sometimes find that their healthcare providers may have a negative opinion of MOUD despite medical evidence of its many benefits.[3]
- Clinicians who have training and experience with MOUD can serve as an example to other medical staff and providers. This includes the use of non-stigmatizing language and “mainstreaming” addiction treatment by approaching it like any other type of medical care. Examples of non-stigmatizing language include: 1) using “patient/person with Opioid Use Disorder” rather than “addict or user”; 2) replacing “abuse” with “use or misuse”; and 3) using “in remission or recovery” rather than “being clean”. Additionally, treating patients with MOUD provides a non-judgmental approach to addiction that can serve as an example to fellow health care providers.
- A clinician with MOUD training can serve as a resource and educator for patients, families, and communities. This begins with a frank and open discussion of the benefits of MOUD, including a decreased risk of death by overdose, reduced risk of infectious diseases, better social functioning, and the increased likelihood of recovery. Additional benefits include reduced craving for opioids, a lower risk of criminal activity, and better retention in treatment [4]. Providing education on these known benefits to patients, families, and communities has the potential to reduce the magnitude of the opioid crisis and to save lives.
[1]Williams AR, Nunes EV, Bisaga A, Levin FR, Olfson M. Development of an Opioid Use Disorder Cascade of Care to Address the Addiction Treatment Gap. Am J Drug Alc Abuse. 2019; (45)1:1-10. PMID: 30675818; PMCID: PMC6404749.
[2]Sordo L, Barrio G, Bravo MJ et al. Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies. BMJ. 2017;357:j1550:1-14.
[3]Knudsen HK, Abraham AJ, Roman PM. Adoption and implementation of medications in addiction treatment programs. J Addict Med 2011;5:21-7.
[4]Krawczyk N, Mojtabai R, Stuart EA, et al. Opioid agonist treatment and fatal overdose risk in a state-wide US population receiving opioid use disorder services. Addiction. 2020 Sep;115(9):1683-1694.
