In a new study from Case Western Reserve University, researchers found methadone is the most effective drug in medication-assisted treatment for opioid-use disorder.
The study is published in the Journal of Substance Abuse Treatment and was conducted by Krystel Tossone et al.
Since the early 2000s, the United States has seen alarming and unprecedented increases in opioid-related deaths nationwide.
In Ohio alone, the death rate from accidental opioid-related overdoses increased 1,081% from 2000 to 2017, according to the state’s Department of Health.
Medications for the opioid-use disorder are linked to lower death rates and improved quality of life for people in recovery. But scientists did not know the most commonly used medications for the disease.
In the study, the team examined those questions in hopes of improving recovery rates for what has become a national epidemic.
They analyzed data from nearly 82,000 Medicaid claims in Ohio.
They examined the length of time between when a person started and stopped taking each of the three common medications for OUD: methadone, buprenorphine and naltrexone.
The medications in the study are used to treat OUDs for short-acting drugs such as heroin, morphine and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone.
The team found that overwhelmingly, methadone was associated with the lowest risk of treatment discontinuation, followed by buprenorphine, then naltrexone.
Among patients on buprenorphine, after a period of time, the risk of discontinuation of treatment was similar to that of methadone.
They also found that medication-assisted treatment, coupled with behavioral health therapy such as counseling, increased success in patient retention.
The team hopes the research demonstrates the need to expand access to methadone and buprenorphine treatment, noting that medications for OUD aren’t always available in some areas.
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A previous study at Washington University in St. Louis examined the use of buprenorphine in people with opioid use disorders.
Most people treated for the disorder are given medications, such as buprenorphine, that activate opioid receptors.
But there is disagreement about whether it’s safe to prescribe buprenorphine for people who also take benzodiazepines, which are potentially addictive medications prescribed for stress, sleep and anxiety.
In that study, researchers support the use of buprenorphine in patients also taking benzodiazepines.
They found that the drug can protect opioid users from overdosing, even when such patients also take benzodiazepines, such as Valium, Xanax and Ativan.
The team examined the medical data of more than 23,000 patients being treated for opioid use disorder.
They focused on buprenorphine because patients often can fill prescriptions for the medication at a pharmacy and take the drug at home.
Every patient tracked in the database had experienced at least one overdose event, but none suffered a fatal overdose.
Each individual was followed for two years to track what prescriptions they filled and how often each person ended up in the emergency department with drug-related poisoning.
The researchers discovered that opioid users who took buprenorphine had a 40% reduction in their risk for an overdose compared with not receiving the treatment.
Meanwhile, opioid users with benzodiazepine prescriptions who did not take buprenorphine were almost twice as likely to suffer an overdose that put them in the hospital.
The findings showed that even for people taking benzodiazepines, buprenorphine had a protective effect.
Buprenorphine didn’t protect those patients from overdose as much as it protected users not taking benzodiazepines, but it still made overdoses less likely.
What that means about drug interactions between buprenorphine, opioids and benzodiazepines still aren’t completely clear.
But what is clear is that prescribing buprenorphine for opioid users in treatment can protect them from an overdose, even if they also are taking a benzodiazepine drug.
If you care about pain, please read studies about common painkiller that may deeply affect liver health, and new way to treat chronic pain without opioids.
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