Summary and Analysis

A recent study published in JAMA Network Open concluded that not enough people are getting medication-assisted treatment (MAT). Given the starting point for the study and its funding source, it’s difficult to imagine how it could have arrived at any other conclusion. Specifically:

  • The study begins with the premise that MAT is “the standard treatment for opioid use disorder,” a notion based on an assumption that addiction is a brain disease. However, this assumption is far from having scientific consensus: See here, here, and here.
  • The study was funded by NIDA (National Institute on Drug Abuse) which has been a primary proponent of the brain disease model of addiction, often to the exclusion of other models.

When you begin by assuming that MAT is the proper answer to OUD and you then find that many with addictions did not receive MAT, the conclusions drawn in any subsequent work is obvious: There should be more MAT.

What is missing in the authors’ viewpoints is a nuanced recognition of the value of multiple pathways to recovery. The potential problem with studies such as this is its apparent justification of policy decisions that solely focus on increasing MAT instead of focusing on broadening the availability of help for all by making multiple pathways more readily available.

 

Excerpted from JAMA Network

As reported at drugfree.org:

“Researchers from Columbia University analyzed 2019 national survey data on teens and adults who could benefit from medication for OUD. They found 57% received no treatment and 15% received only services without medication. Just 28% received medication such as methadone, buprenorphine or naltrexone, HealthDay reports.

“Our nationally representative research revealed critical gaps in treatment engagement and use of medication for opioid use disorder. Increased efforts to address barriers to care are critically needed,” study lead author Pia Mauro, Ph.D., said in a news release. “Evidence supporting the effectiveness of medication for opioid use disorder such as methadone, buprenorphine, or naltrexone is unequivocal, but most people who needed OUD treatment in the US did not receive this gold standard treatment.”

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