Iteration is not solving the opioid crisis, it's time for transformation
1Department of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
The American Journal of Drug and Alcohol Abuse
|March 15, 2023
Summary
Opioid use disorder (OUD) treatment faces significant access barriers due to outdated regulations. Transformative approaches are needed to improve care for those not benefiting from current interventions.
Area of Science:
- Addiction Medicine
- Public Health Policy
- Pharmacology
Background:
- Opioid use disorder (OUD) causes high morbidity and mortality globally.
- Current OUD treatment systems show poor retention rates, with 90% not entering and 72% leaving treatment within 60 days.
Purpose of the Study:
- To analyze the limitations of current OUD treatment systems stemming from historical regulatory policies.
- To propose transformative strategies for improving OUD care for non-responsive patients.
Main Methods:
- This perspective reviews historical regulatory policies impacting OUD treatment access.
- It analyzes the shortcomings of incremental improvements in the existing treatment framework.
- Four potential transformative considerations are outlined for future OUD care.
Main Results:
- Past OUD treatment policies prioritized restriction over empirical best practices.
- Iterative gains in treatment access have been minimal over the last decade.
- Existing strategies are insufficient for a significant portion of patients with OUD.
Conclusions:
- Fundamental transformation of OUD care is necessary for meaningful change.
- Key considerations include expanding treatment options, embracing safe use, reforming distribution, and patient partnership.
- Shifting towards transformative strategies is crucial to substantially reduce opioid-related harms.
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