Rethinking Medication Treatment for Opioid Use Disorders

"Opioids relieve pain but are dangerous and highly addictive. In a recent 12-month period, there were 109,600 USA drug-overdose deaths, with 70% linked to opioids. In 2023, 5.7 million people in the U.S. 12 years and older had an opioid use disorder (OUD). Despite high numbers of opioid abusers needing treatment, most don't receive it. Some can't find it, others delay treatment, and others refuse it."

"Drs. Vincent Dole and Marie Nyswander pioneered MMT, conceptualizing OUD as a chronic, metabolic disease in the mid-1960s. They argued long-term medication was a necessary medical treatment for OUD, just as insulin is for type 1 diabetes. Drawing on Dole's background in endocrinology and metabolism, the researchers theorized OUD caused permanent changes in brain and body chemistry. They called this a "persistent derangement" of the opioid receptor system."

Opioids relieve pain but are dangerous and highly addictive. In a recent 12-month period there were 109,600 U.S. drug-overdose deaths, with 70% linked to opioids. In 2023, 5.7 million people aged 12 and older had an opioid use disorder (OUD). Most people with OUD do not receive treatment because of limited access, delays, or refusal. In 2022, only about 25% of U.S. adults with OUD received medication-assisted treatment (MAT) such as methadone or buprenorphine. Approximately 1,500 methadone maintenance treatment (MMT) clinics operate in the United States. MMT treats OUD as a chronic metabolic condition; methadone stabilizes the metabolic defect, suppresses cravings, blocks opioid euphoria, and enables social reintegration.

Read at Psychology Today