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Medication-assisted treatment for opiod use disorder (OUD)

Medication-assisted treatment (MAT) for opioid use disorder (OUD) has emerged as a key strategy for combatting the opioid epidemic. Controlled research has shown it to be more effective than abstinence programs in treating patients with the disorder (Connery, 2015). The ability of physicians and other healthcare professionals to use MAT for treatment of OUD was recently expanded through changes in federal legislation, but according to the Substance Abuse and Mental Health Services Administration (SAMSHA), MAT is greatly underused.

SAMHSA provides a concise overview of MAT and its potential benefits. Important points include:

  • MAT combines prescribed medications in combination with counseling and behavioral therapies. “Research shows that a combination of medication and therapy can successfully treat these disorders, and for some people struggling with addiction, MAT can help sustain recovery.”
  • The drug options include methadone, buprenorphine, and naltrexone. “The prescribed medication operates to normalize brain chemistry, block the euphoric effects of alcohol and opioids, relieve physiological cravings, and normalize body functions without the negative effects of the abused drug…. People may safely take medications used in MAT for months, years, several years, or even a lifetime.”
  • “Under federal law, MAT patients must receive counseling, which could include different forms of behavioral therapy. These services are required along with medical, vocational, educational, and other assessment and treatment services.”

While methadone must be administered through a SAMHSA-accredited Opioid Treatment Program, buprenorphine can be prescribed by a qualified physician, physician assistant, or nurse practitioner. MAT is safe for pregnant women, and “pregnant women on MAT are more likely to adhere to prenatal care and substance use treatment programs,” according toMitra Ahadpour, M.D., DABAM, who is the deputy director of the FDA’s Center for Drug Evaluation and Research Office of Translational Sciences.

SAMHSA maintains an interactive map that provides locations and contact information for physicians across the country who provide buprenorphine in their practices.

References

“Medication and Counseling Treatment.” SAMHSA. https://www.samhsa.gov/medication-assisted-treatment/treatment

“CDER Conversation: Treatment for Opioid Use Disorder.” US Food and Drug Administration. https://www.fda.gov/Drugs/NewsEvents/ucm611659.htm

“Buprenorphine Treatment Practitioner Locator.” SAMHSA. https://www.samhsa.gov/medication-assisted-treatment/physician-program-data/treatment-physician-locator

Connery HS. Medication-assisted treatment of opioid use disorder: review of the evidence and future directions. Harv Rev Psychiatry. 2015 Mar-Apr;23(2):63-75