In an effort to find ways to improve long-term outcomes for people with opioid use disorder, Dr. Elizabeth Evans, assistant professor of health promotion and policy at University of Massachusetts Amherst School of Public Health and Health Sciences, set out to study the obstacles to treating this chronic condition with an effective medication, buprenorphine-naloxone.
“Very few people with opioid use disorder ever get treatment for it – 10 percent or less,” says Dr. Evans. “Of those who do, few remain in treatment long enough to really benefit from it.”
In a newly published paper in the Journal of Substance Abuse Treatment, Dr. Evans and colleagues identify factors that inhibit the long-term use of buprenorphine, which was approved in 2002 by the U.S. Food and Drug Administration (FDA) to treat opioid use disorder.
Conducted from 2011 to 2014, the study included interviews with a cohort of 1,269 adults with opioid use disorder who had participated in a clinical trial comparing the effects of buprenorphine and methadone. Individuals who perceived buprenorphine to be unacceptable were least likely to use the medication during follow-up, regardless of access to the medication. Common reasons cited for disliking buprenorphine were: negative physical reaction, side effects, can’t feel opioids when taking buprenorphine, had to pick it up at the clinic every day and the medication was not strong enough.
“We need to flip the narrative,” says Dr. Evans, who is co-principal investigator for a $10 million grant included in the Justice Community Opioid Innovation Network (JCOIN) initiative, an ambitious effort to improve opioid addiction treatment in criminal justice settings. “The good news is that buprenorphine is effective, but only if patients take it. We need to help patients access and use medication that will help them avoid a return to opioid use.”Tags: Friday Letter Submission, Publish on September 06