Tuesday December 6 ,2022 – 10:00 am – 11:00 am

Our event will feature stories of struggles and accomplishments by advocates and clients on Medication Treatment for opioid addiction.

Join Zoom Meeting
https://us02web.zoom.us/j/87051503821
Meeting ID: 870 5150 3821

Suggested Donation for Event:
$ ___ Benefactor,  $250 Advocate, $100 Supporter, $50  Friend


Thank You For Your Generous Donation!

Short Video Stories By People About Their Treatment:

Kurt: The only recovery path that worked for me was medication assisted recovery.
Mitchell: It can get you get back on track.
Walter: Why do you have so much shame?
Catherine: Recovery can start on methadone
Chelle: Bupe has been the only thing that has worked for me.
Walter: It’s not you, it’s a brain disease
Pat Williams: All of my heroin using peers are dead but methadone saved my life.

We must start offering the most effective treatment for opioid addiction to those who need it

We must stop withholding our only life-saving treatment – the only treatment that reduces opioid overdose deaths:  medication treatment.

We must – finally – start ensuring access to effective treatment for opioid addiction and overdose prevention.

Tragically, ineffective treatment is the norm; it is all that most U.S. residential treatment programs offer for OUD: psychosocial treatment without maintenance OUD medication.  (Beetham 2020) (Huhn 2020).
Also, discrimination by recovery services against people in need of maintenance OUD medication is common.  (LAC 2022) 

Methadone and buprenorphine are the primary treatments for most people with moderate to severe opioid use disorder (OUD), combined wherever possible with psychosocial treatment and/or recovery support.  Injectable naltrexone also has an important role.

 

Isolated psychosocial treatments (counseling, groups and/or related services by licensed professionals, and/or psychotherapy), when provided without medication, have not been shown to be effective – on their own – for OUD;  they do not reduce overdose deaths.  (Although they may be appropriate on their own for those with mild or brief OUD, or for those who are informed of and offered medication treatment but refuse).

 

Current evidence indicates that counseling or psychotherapy do not increase retention in buprenorphine treatment or improve abstinence rates.  However, methadone or buprenorphine treatment without concomitant counseling is known to be vastly superior to no treatment.  These facts were reiterated in a 2021 review  published by Dr. Nora Volkow, Director of the National Institute of Drug Abuse, (Volkow 2021) in a 2019 review by the National Academies of Sciences, Engineering and Medicine, (NASEM 2019) and elsewhere. Other than long-term residential ‘therapeutic communities,’ methadone or buprenorphine are the only treatments ever shown to reduce fatal opioid overdoses, typically combined with counseling or other psychosocial treatment. 

 

Psychosocial treatment is an important and standard component of complete treatment which should be readily available and offered to those starting medication for OUD (unless other services are more appropriate such as recovery services for those in stable recovery). 

 

However, for those unwilling or unable to participate, psychosocial treatment should not be a condition of medication treatment for OUD according to the World Health Organization (WHO 2009), the American Society of Addiction Medicine, (ASAM 2020) the National Academies of Sciences, Engineering, and Medicine (NASEM 2019) and others. 


This ‘medication-first’ approach is especially helpful for those less likely to be engaged in treatment.  This approach reduces serious harms, saves lives, and often leads to complete treatment over time as people begin to improve with medication. 

 

Intermittent engagement and low participation in treatment are in large part due to misunderstanding about the role of medication (‘medication stigma’) even when effective treatment is offered.  Medication stigma also contributes to the widespread use of ineffective OUD treatments.  Finally, it is likely a major contributor to our failure to control the overdose epidemic.  Unfortunately, patients commonly believe that recovery does not begin until they are off of medication, or that medication is “trading one addiction for another.”  (“Addiction” is the wrong word for medications for OUD).  In reality, methadone, buprenorphine or injectable naltrexone are often needed for a number of years, or indefinitely, and can allow people to feel and function normally in society.

Stop Stigma Now (www.stopstigmanow.org) works to reduce stigma and discrimination directed against people with opioid use disorder, and their treatment. 

                                                                                                                                                                                    Stop Stigma Now, Nov 2022



REFERENCES:

 

ASAM:  The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder, updated 2020

free: www.asam.org/Quality-Science/quality/2020-national-practice-guideline

(Excerpt: “because of the potential harm associated with untreated opioid use disorder, a patient’s decision to decline psychosocial treatment or the absence of available psychosocial treatment should not preclude or delay pharmacological treatment of opioid use disorder, with appropriate medication management.)

 

Beetham T,et al.  Therapies Offered at Residential Addiction Treatment Programs in the United States.   

Research Letter August 25, 2020. JAMA. 2020; 324(8):804-806

free:  https://jamanetwork.com/journals/jama/fullarticle/2769709

 

Huhn, AS et al. Differences in Availability and Use of Medications for Opioid Use Disorder in Residential 

Treatment Settings in the United States  JAMA Netw Open. Feb 7,2020; 3(2):e1920843. 

free:  https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2760443

 

LAC: Legal Action Center. Opioid Use Disorder & Health Care: Recovery Residences

People who take medication for opioid use disorder (MOUD), like methadone or buprenorphine,

often experience illegal barriers to healthcare.   (posted in 2022)

free: https://www.lac.org/assets/files/Recovery-Home-MOUD-Info-Sheet-Feb-2022.pdf

 

NASEM: Medications for opioid use disorder save lives.  National Academies of Sciences, Engineering, and Medicine. 2019. Washington, DC: The National Academies Press. doi:https://doi.org/10.17226/25310.

(excerpt:  Lack of availability or utilization of behavioral interventions is not a sufficient justification to withhold medications to treat opioid use disorder).

 

Volkow, ND & Blanco, C.  The Changing Opioid Crisis: development, challenges and opportunities  
Mol Psychiatry. 2021 January ; 26(1): 218–233.
free: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7398847/

 

WHO  Guidelines for the Psychosocially Assisted Pharmacological Treatment of Opioid Dependence.

WHO Press, World Health Organization, Geneva, Switzerland. 2009, World Health Organization

free: https://www.who.int/substance_abuse/publications/Opioid_dependence_guidelines.pdf

(excerpt: “Psychosocial services should be made available to all patients, although those who do not take up the offer should not be denied effective pharmacological treatment.”)

 

 

 

A partial listing of organizations and agencies supporting medication assisted treatment for Opioid addiction

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