March 1, 2017

Many undergoing treatment for opioid misuse are still prescribed opioids, study finds

Daily Briefing

Many individuals undergoing medication-assisted treatment for opioid misuse between January 2010 and July 2012 filled at least one prescription for other opioids during treatment, according to a study published Thursday in the journal Addiction.

Study details

For the study, researchers reviewed records for 38,096 individuals in 11 states who were using buprenorphine, a drug commonly used for medication-assisted treatment for opioid misuse, between January 2010 and July 2012.

The researchers also analyzed a subset of individuals who received Suboxone, a form of buprenorphine that is used exclusively for medication-assisted opioid treatment, as other forms of buprenorphine are sometimes prescribed for pain.

Findings

The researchers found that, overall, 43 percent of individuals who received buprenorphine filled at least one prescription for opioids during the treatment episode.

Of those who stopped taking buprenorphine, the study found 67 percent filled an opioid prescription after stopping the treatment. The researchers found that the median time patients were on buprenorphine was 55 days, which is considerably less than the months or years that experts believe it may take to overcome a substance use disorder with medication-assisted treatment, the Washington Post's "To Your Health" reports.

Among the 20,124 individuals who were prescribed Suboxone, the researchers found 27 percent used another opioid during treatment and 54 percent obtained opioids after treatment.

Discussion

While research shows that medication-assisted treatment is one of the most successful and common ways for fighting a substance use disorder, Caleb Alexander, study co-author and co-director of the Center for Drug Safety and Effectiveness at the Johns Hopkins Bloomberg School of Public Health, said the findings "raise important questions about the real-world quality of medication-assisted treatment." The study also raises "questions about the quality of care these patients are receiving," he added, "and the degree to which their care is coordinated across our fragmented health care system."

While states have started using databases to help providers monitor patients' opioid prescriptions, providers still are often unaware of other providers' prescriptions, "To Your Health" reports.

Alexander said an individual receiving medication-assisted opioid treatment may see other providers in addition to the provider who wrote the prescription for the treatment. He said that state databases "are not a panacea," adding that they are not widely used by doctors (Bernstein, "To Your Health," Washington Post, 2/23; Daubresse et al., Addiction, 2/23).

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