Blog 2- Opioid Use Treatment

 

Pharmacological

The most widely prescribed pharmacological opioid treatment medication is methadone and buprenorphine, or Suboxone (Patel et al., 2021).  Methadone can help neuropathic pain and opioid intolerance and mimics the effects of both morphine and heroin (Patel et al., 2021).  Suboxone also can be used to treat pain but has a less withdrawal effects than methadone (Patel et al., 2021).  Methadone and suboxone both involve regulations for prescribing, including only being dispensed through certified treatment programs (Patel et al., 2021).

(What Is Methadone And How Does It Really Work? , n.d.).

Barriers to pharmacological treatment

                When first starting methadone, it must be taken every 8 to 12 hours (Patel et al., 2021).  This is difficult for patients because it can only be dispensed at a certified treatment center.  These treatment centers may not always be at a close distance to patients.  Especially if patients can’t drive, transportation to the treatment centers may be very difficult and stressful (Patel et al., 2021). Lifting regulations around dispensary rules will allow patients to fill these medications like the rest of their medications and allow them to take their medications at home (Patel et al., 2021).

                Only 6% of physicians have received the authorization waiver to prescribe suboxone, which leaves many counties in the United States without a physician who can prescribe suboxone for treatment.  This number is concerning, especially regarding the lack of care those with opioid use addiction receive.  Many physicians admit to lacking knowledge, education, and experience in prescribing suboxone and have little interest in participating in the training to be certified in prescribing suboxone (Patel et al., 2021).  Education around addiction, treatment, and prescribing suboxone and methadone needs to be done at a graduate level.  Mandated training and certification can help increase access to physicians able to prescribe these medications (Patel et al., 2021).

Contingency Management

Contingency management is proven to be one of the most effective treatments for opioid addiction, but it is rarely used in healthcare (Patel et al., 2021).  It uses positive reinforcement to reward those who submit negative drug tests (Patel et al., 2021). Rewards such as vouchers for money, food, and gift cards are given to those who continuously provide negative drug screens (Patel et al., 2021).  This seems like a great system to provide positive reinforcement to those struggling with opioid abuse, but I honestly have never heard of this!  I have taken care of hundreds of patients who have a substance use disorder and have never heard them mention contingency management before.   

(Stock, 2024).

     Barriers to contingency management of course include funding (Patel et al., 2021). Who would fund all of these prizes?   An idea for funding could be through donations of treatment centers and rehabilitation centers.

References

Patel, K., Bunachita, S., Agarwal, A. A., Lyon, A., & Patel, U. K. (2021). Opioid use disorder: Treatments and barriers. Cureus, 13(2). https://doi.org/10.7759/cureus.13173

Stock, P. (2024). Prizes Stock Illustrations – 7,636 Prizes Stock Illustrations, Vectors & Clipart - Dreamstime. Dreamstime. https://www.dreamstime.com/illustration/prizes.html

What Is Methadone And How Does It Really Work? (n.d.). Methadone.org. https://www.methadone.org/