New method could improve opioid use disorder treatment

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Opioid use disorder is a serious problem affecting many people in the United States. It can lead to addiction and even death from drug overdose.

Methadone is a medication commonly used to treat opioid use disorder and prevent relapse. However, many patients drop out of their treatment within a year.

Researchers from the University of Maryland School of Medicine conducted a study to see if taking a placebo (a “sugar pill”) alongside methadone could help patients stay in their treatment.

Background

Substance use disorder, including opioid use disorder, is a widespread issue in the United States, affecting millions of people.

According to the Centers for Disease Control and Prevention, over 100,000 individuals died from a drug overdose in 2021 alone.

Methadone is a medication that has been shown to be effective in preventing relapse for those with opioid use disorder. Unfortunately, about half of the patients discontinue their treatment within a year.

The Role of Placebos

A placebo is a pill or treatment that does not contain any active medication. In some cases, placebos have been found to have a positive effect on patients, even when they are aware that they are taking a placebo.

Previous studies have shown that placebos can reduce symptoms and improve outcomes in certain conditions.

The researchers wanted to see if taking a placebo alongside methadone could help patients stick to their treatment and experience additional benefits.

The Study

The researchers enrolled 131 patients with moderate-to-severe opioid use disorder in a randomized clinical trial.

The patients were divided into two groups: one group received methadone along with a placebo pill, while the other group received only methadone.

The patients in the placebo group were informed that they would be taking a placebo and were told about previous studies showing the potential benefits of placebos in relieving symptoms like pain and depressed mood.

The clinicians who administered the treatment were not aware of which patients were receiving the placebo.

Results and Benefits

After three months of follow-up, the researchers found that 78% of the patients in the placebo group remained on methadone treatment, compared to 61% in the group that received only methadone.

The placebo group also reported improved sleep quality. These findings suggest that taking a placebo alongside methadone can increase the chances of patients sticking to their treatment and experiencing additional benefits.

Importance of Treatment Adherence

Adherence to opioid use disorder treatment is crucial for successful outcomes. Many factors can make it challenging for patients to stay in treatment, such as the slow induction process of methadone dosing, which can take weeks to reach a therapeutic dose.

The researchers believe that incorporating placebos into the treatment plan could help address the problem of low treatment retention rates.

Implications and Future Research: The use of placebos alongside methadone treatment shows promise in improving adherence to opioid use disorder treatment.

It is a low-cost and low-risk intervention that could be easily implemented in clinical settings. Further research is needed to explore the long-term effects and benefits of using placebos in this context.

The study also highlights the importance of the patient-clinician relationship in the success of open-label placebo treatments.

Taking a placebo alongside methadone treatment has been found to improve adherence to treatment for opioid use disorder.

This simple intervention could help more patients stay on their treatment, leading to better outcomes and reduced risk of relapse.

The findings of this study provide hope for improving the effectiveness of treatment for opioid use disorder and addressing the challenges faced by individuals struggling with addiction.

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The study was published in JAMA Network Open.

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