Only 30 Percent Get Medicine to Treat Addiction After Opioid Overdose

More than 115 Americans die every day of opioid overdose. Many more who overdose survive due to antidote medication, naloxone. But a new study finds that just 3 in 10 patients revived by an EMT or in an emergency room received the follow-up medication known to avoid another life-threatening event. The study, published in the Annals of Internal Medicine, followed 17,568 patients who overdosed on opioids from 2012 to 2014 in Massachusetts. It looked at survival rates over time and whether patients received medicines that treat addiction.

Of the patients who did receive medication, 3,022 adults were on buprenorphine, known by the brand name Suboxone, and 2,040 patients were on methadone. The Suboxone group had a 40 percent lower death rate after one year, compared with those who did not receive any medication. The results for methadone were even stronger: a 60 percent lower death rate. About 6 percent of patients were on the opioid blocker naltrexone (brand name Vivitrol), but often for just one month. They were no more likely to be alive after a year than those who were not offered or did not take a medication.

“The stunning finding here is that we have effective treatments for people who survive an overdose but only 3 in 10 are getting those medications,” said Dr. Marc LaRochelle, lead author on the study. For some perspective, LaRochelle mentions the routine recommendation that patients who’ve had another life-threatening event, a heart attack, take aspirin. “The mortality reduction we see with these drugs is similar to giving someone who suffers a heart attack aspirin. It’s one of the most effective treatments we have in medicine,” said LaRochelle, a primary care physician and researcher at the Grayken Center for Addiction at Boston Medical Center.

Dr. Nora Volkow, who directs the National Institute on Drug Abuse wrote in an accompanying editorial, “A great part of the tragedy of this opioid crisis is that, unlike in previous such crises America has seen, we now possess effective treatment strategies that could address it and save lives. Yet tens of thousands of people die each year because they have not received these treatments.” Many communities continue to reject applications to open methadone clinics. Patients in rural areas often drive more than an hour each way to get their daily dose. The obstacles to care contribute to a feeling among many opioid addiction patients that doctors and hospitals just don’t want to help.

LaRochelle worries that patients, as seen in this study, are still not staying on treatment for more than a few months and are losing prime years of their lives. Some 66 percent of people in the study were under the age of 45. “We need to reevaluate how we’re providing the care and make sure we can keep people there when they’re there,” LaRochelle said. “We just still have overwhelming stigma for patients with the disease of addiction,” said Sarah Melton, a professor of pharmacy practice at East Tennessee State University.

Reference: https://khn.org/news/after-opioid-overdose-only-30-percent-get-medicine-to-treat-addiction/
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