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Novel Therapeutic and Program-Based Approaches to Opioid Use Disorders
Patricia Liu1, P Todd Korthuis1,2, Bradley M Buchheit1,3
1Section of Addiction, Division of General Internal Medicine & Geriatrics, Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA;
Annual Review of Medicine
|October 12, 2023
Summary
Opioid use disorder remains a major public health crisis, driven by illicit fentanyl. Effective medications like methadone and buprenorphine are underutilized, despite innovations in treatment delivery improving access to care.
Area of Science:
- Public Health
- Addiction Medicine
- Pharmacology
Background:
- Opioid use disorder (OUD) is a significant driver of overdose deaths globally, particularly in the United States.
- Illicit fentanyl and its analogues are major contributors to OUD-related mortality and morbidity.
- Despite proven efficacy, medications for OUD (MOUD) like methadone and buprenorphine are underutilized.
Purpose of the Study:
- To review the current landscape of opioid use disorder.
- To highlight challenges in treatment, including polysubstance use and emerging adulterants.
- To discuss innovations in treatment delivery that can improve access to care.
Main Methods:
- Literature review of current research on OUD and its treatment.
- Analysis of trends in substance use and mortality related to OUD.
- Examination of recent clinical and policy innovations in MOUD delivery.
Main Results:
- OUD, particularly driven by illicit fentanyl, continues to cause substantial mortality.
- Polysubstance use and novel substances like xylazine complicate treatment approaches.
- Innovations such as telemedicine and bridge clinics show promise for expanding access to MOUD.
Conclusions:
- Effective treatments for OUD exist but face significant access barriers.
- Addressing polysubstance use and emerging adulterants is crucial for effective OUD management.
- Policy and clinical innovations are vital for increasing the reach of life-saving OUD treatments.
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