Treatment and Setbacks for Opioid Addiction Recovery
Written by Jacob Gomez
Edited by Tanishq Vaidya
July 31st 2021
Edited by Tanishq Vaidya
July 31st 2021
Compared to other drugs, opioids are the most abused and the least understood class of medications by the general public. Opioids, such as morphine and OxyContin, are a class of natural or synthetic drugs that are commonly prescribed for those suffering from severe pain (Hoffman et al., 2019).
In short, they work by chemically binding to structures called opioid receptors in the brain, which inhibit the brain from receiving pain signals from the rest of the body (“Opioid Epidemic”). Although highly effective at reducing pain, opioids are also highly addictive and those taking them for extended periods may develop opioid use disorder (OUD). Like many other substance use disorders, OUD is extremely deadly. For example, In 2017 alone, 68% of all drug overdose fatalities were caused by opioids, and almost 60% of these opioid-related deaths were due to a synthetic opioid called fentanyl (Scholl et al., 2019). The rising prevalence of opioid-related deaths and OUD in the United States has led to the development of drug treatments designed to help OUD patients recover from addiction, however, these methods continue to be underutilized as the death toll continues to rise.
Due to the complex nature of OUD, treatment plans often include a combination of drug therapy and counseling. The drugs used in this process are called medications for opioid use disorder, or MOUD. One type of MOUD is extended-release naltrexone (XR-NTX), which is an opioid antagonist (Kampman & Jarvis, 2015). An antagonist is a drug that inhibits the binding of another drug to a particular receptor, and XR-NTX does this against opioids by blocking opioid receptors (Kampman & Jarvis, 2015). This allows for patients taking XR-NTX to face less severe cravings and withdrawal symptoms as they stop opioid usage (Hoffman et al., 2019). Along with these life saving drugs, the U.S. federal government has also made it a requirement for centers offering MOUD treatments to provide professional counseling resources (McCarty et al., 2018). However, there are still no regulated or standardized psychoanalytic therapies for OUD and, without these adequate services, patients are less likely to continue their treatments towards sobriety (Hoffman et al., 2019). Likewise, facilities offering MOUDs like XR-NTX are extremely limited, with only 36% of treatment centers offering MOUDs that are FDA approved (Mojtabai et al., 2019).
As a result of these under resourced treatment methods, researchers are pushing for a more preventative approach to reducing the rising opioid addiction rates. According to the U.S. Centers for Disease Control and Prevention, proper guidelines which opioid prescribers should abide by before giving patients medication must be implemented. These guidelines would include regulations for assessing a patient's individual need for opioids for pain management, duration of usage, and potential risks for developing dependence with long-term usage (Dowell et al., 2016). By following these procedures, a patient’s likelihood of developing OUD can be minimized greatly. Similarly, continuing to fund programs that educate prescribers on the benefits and harmful effects of opioids, as well as providing regular expert consultations, can reduce addiction in patients suffering from chronic pain.
Pain is a serious affliction for many patients, and the misuse of opioids caused by dependence and negligent doctors prescribing them needs to be addressed. Although public policies and treatments to combat the rise in OUD are progressing quickly, there is still more research that needs to be done before MOUDs and other therapies can be implemented on a larger scale. Nevertheless, the discovery of MOUDs and the promising effects of counseling programs are still major breakthroughs in the fight towards reversing the alarmingly high rates of opioid-related deaths. Only time can say whether these efforts will be enough to flatten the curve.
Works Cited
Dowell, D., Haegerich, T. M., & Chou, R. (2016). CDC guideline for prescribing opioids for chronic PAIN—UNITED States, 2016. JAMA, 315(15), 1624. doi:10.1001/jama.2016.1464
Hoffman, K. A., Ponce Terashima, J., & McCarty, D. (2019). Opioid use disorder and treatment: Challenges and opportunities. BMC Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-4751-4
Kampman, K., & Jarvis, M. (2015). American society of addiction Medicine (ASAM) National PRACTICE guideline for the use of medications in the treatment of ADDICTION involving opioid use. Journal of Addiction Medicine, 9(5), 358-367. doi:10.1097/adm.0000000000000166
McCarty, D., Priest, K. C., & Korthuis, P. T. (2018). Treatment and prevention of opioid use disorder: Challenges and opportunities. Annual Review of Public Health, 39(1), 525-541. https://doi.org/10.1146/annurev-publhealth-040617-013526
Mojtabai, R., Mauro, C., Wall, M. M., Barry, C. L., & Olfson, M. (2019). Medication treatment for opioid use disorders in substance use treatment facilities. Health Affairs, 38(1), 14-23. doi:10.1377/hlthaff.2018.05162
Opioid Epidemic: The Crisis Continues. 4. Pharmaco-kinetics and -dynamics of Opioids | ATrain Education. (n.d.). https://www.atrainceu.com/content/4-pharmaco-kinetics-and-dynamics-opioids.
Scholl, L., Baldwin, G., Wilson, N., Kariisa, M., & Seth, P. (2019). Drug and Opioid-Involved Overdose Deaths - United States, 2013–2017. Centers for Disease Control and Prevention. https://www.cdc.gov/mmwr/volumes/67/wr/mm675152e1.htm.