Summary and Analysis

According to this RAND Corporation study, more than two-thirds of patients who received buprenorphine to treat opioid use disorder in emergency departments do not sustain their treatment. The study recommends developing “a system of care that seamlessly transitions patients from the emergency setting to community treatment providers who can continue treatment.”

Certainly, systems to help people maintain treatment and move into long-term recovery are much needed. However, one concern with this study is that it omitted half of what constitutes Medication-Assisted Treatment (MAT) as defined by SAMHSA and elsewhere. These agencies define MAT as follows:

“Medication-assisted treatment (MAT) is the use of medications in combination with counseling and behavioral therapies, which is effective in the treatment of opioid use disorders (OUD) and can help some people to sustain recovery.” (emphasis added)

MAT is more than simply prescribing pharmaceutical treatment drugs to someone and ensuring that they take them. It includes counseling and behavioral therapies leading to long-term recovery as a fundamental part of its workability. The use of these drugs without the use of these therapies is likely to greatly limit the success rate for individuals moving into long-term recovery.

 

Excerpted from Annals of Emergency Medicine

Conclusion

The majority of patients filling buprenorphine prescriptions written by emergency physicians do not subsequently fill prescriptions written by other clinicians, and the rates of subsequent prescriptions were lower after the declaration of the COVID-19 public health emergency. These findings highlight the need for a system of care that improves buprenorphine treatment continuity of care for patients with opioid use disorder from emergency settings to community treatment providers.
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