In a groundbreaking study published in the Journal of Drug and Alcohol Dependence, Yale researchers highlight alarming findings that abstinence-only treatment for opioid use disorder (OUD) is deadlier than receiving no treatment at all. The study, led by Professor Robert Heimer and his team, analyzed data from 965 individuals who succumbed to opioid-involved overdoses in 2017.
Despite medications like methadone and buprenorphine being widely recognized as effective for treating OUD, a substantial number of individuals still receive abstinence-based treatment or no treatment whatsoever. This study is the first to directly compare the outcomes of abstinence-only treatment, medication-based treatments, and no treatment.
The results are staggering: methadone and buprenorphine significantly reduced the risk of death by 38% and 34%, respectively. On the contrary, individuals subjected to abstinence-only therapy were 1.2 to 1.7 times more likely to die than those who received no treatment.
Professor Heimer explained that the danger of abstinence-only treatment lies in patients losing tolerance to previously taken drugs, leading to potentially fatal relapses. The study emphasizes the critical role of medications for OUD in reducing mortality rates and challenges the persisting stigma around their use.
Heimer identified stigma as a major barrier preventing patients from accessing medication for OUD. The misconception that these medications merely substitute one drug for another perpetuates a harmful narrative, hindering individuals from seeking the most effective and safe treatment.
Stephanie Strong, CEO of Boulder Care, a substance use disorder treatment provider, emphasized the impact of stigma and misinformation on treatment decisions. Strong highlighted the fatal consequences of advising patients to taper off medications based on stigma, urging a shift in the paradigm of addiction treatment.
The study’s authors hope these findings will influence the allocation of opioid settlement funds and promote greater accessibility to medications like methadone. Current FDA regulations and state restrictions limit the distribution of methadone, hindering its potential as an effective treatment option.
The urgency to change the status quo in OUD treatment is echoed by Boulder’s Medical Director, Stephen Martin, who stated, “This is cause for alarm,” drawing parallels to past medical practices that were eventually abandoned for more effective treatments.
The study encourages a reevaluation of funding directed towards abstinence-based programs and emphasizes the need to prioritize evidence-based, life-saving medications. The call for increased access to buprenorphine and methadone, coupled with reducing funding for programs lacking medication-assisted treatment, signals a significant shift in the approach to OUD treatment.
As the study’s findings unveil the dire consequences of abstinence-only treatment, it prompts urgent action within the medical community to embrace proven, effective methods and discard outdated practices that contribute to the ongoing opioid crisis.
