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Member Research & Reports

Member Research & Reports

WashU: Some Patients Suffer from Treatment Resistant Opioid Use Disorder

A subpopulation of patients suffering from opioid use disorder do not respond to standard treatments and should be recognized as such, according to a new paper from the Brown School at Washington University in St. Louis.

Dr. David Patterson Silver Wolf, associate professor at the Brown School and an addiction expert, suggests a new category for these types of patients: treatment resistant opioid use disorder (TROUD).

“The field has suggested that if a treatment does not work, it is either the patient’s fault, they have not hit bottom, or we simply need to try the same treatment again,” he said. “This paper challenges the addiction research and treatment providers to change focus from individuals being resistant to the unique conditions associated with this brain disorder as being resistant to treatment as usual.”

The paper, co-authored by Dr. Mark Gold, adjunct professor in the Department of Psychiatry at Washington University School of Medicine, was published online recently in the Journal of the Neurological Sciences.

Dr. Patterson Silver Wolf said the disorder is similar to that of patients who are resistant to treatment for depression.

“It is unethical to recommend the same depression treatment that has already failed,” he said. “But in substance use disorder treatment, this is exactly what we do, over and over again.”

He said more research needs to be done on how widespread treatment resistance may be and new ways to help people who are afflicted with it.

The opioid overdose epidemic kills about 130 people a day in the United States and it is estimated that there are about 2.1 million people who suffer from an opioid use disorder.

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