In a crucial study led by Yale researchers, new light has been shed on the effectiveness of different treatments for opioid use disorder (OUD).
Published in the journal Drug and Alcohol Dependence, the study reveals some striking insights: treatments like short-term detox and long-term rehabilitation, which do not include medications like buprenorphine or methadone, are no more effective at preventing overdose deaths than no treatment at all.
This finding is crucial in the context of the opioid crisis that has gripped the United States.
According to the Centers for Disease Control and Prevention, opioid-involved deaths have been on a staggering rise, with over 650,000 fatalities between 2012 and 2021. This epidemic has prompted a reevaluation of treatment strategies for OUD.
Common treatments for OUD include medication-based approaches, such as buprenorphine and methadone, and abstinence-based programs like short-term medically managed withdrawal or longer rehabilitation programs. The Yale study, however, highlights a critical gap in the latter approach.
To conduct their study, the Yale team, including Professor Robert Heimer and Gail D’Onofrio from the Yale School of Medicine, analyzed data from Connecticut residents who died from opioid poisoning in 2017.
They investigated the individuals’ treatment history, assessing whether they had received medication, undergone abstinence-based treatment, or had no treatment in the six months prior to their death.
The results were revealing. Among the 965 opioid-related deaths in Connecticut that year, a significant number of individuals had received no treatment or non-medication-based treatments.
When comparing the risk of fatal overdose, methadone and buprenorphine were found to reduce the risk by 38% and 34%, respectively.
In contrast, non-medication-based treatments actually increased the risk of death by over 77% compared to no treatment.
The reason behind this, as explained by Heimer, is that abstinence-based treatments reduce the body’s tolerance to opioids. So, if a person relapses, they are at a higher risk of overdose.
On the other hand, medications like buprenorphine and methadone work on the same brain receptors as opioids, maintaining the body’s tolerance and reducing the likelihood of a fatal overdose upon relapse.
This study is particularly relevant as Connecticut, like many other states, will receive substantial opioid settlement funds.
The researchers argue that these funds should be used based on evidence-based needs, prioritizing treatments that have been proven effective, like medication-assisted therapies.
Furthermore, the study sheds light on the stigma associated with OUD treatments. Terms like “getting clean” often stigmatize the use of medications, despite their proven effectiveness.
Heimer advocates for a shift in perspective, suggesting that terms like “remission” are more appropriate for chronic conditions like OUD, emphasizing the importance of ongoing management rather than a one-time cure.
In conclusion, the Yale study underscores a critical point: for those struggling with opioid addiction, access to medication-assisted treatment is not just a better option; it’s a lifesaver.
This research has significant implications for how opioid crisis funds are allocated and could lead to a shift in treatment approaches, prioritizing effective, evidence-based methods over traditional, less effective ones.
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The research findings can be found in Drug and Alcohol Dependence.
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