Does Medication Assisted Treatment Reduce Opioid Overdose Risk?

Medication assisted treatment for opioid use disorder has increased in popularity since the adoption of buprenorphine-based drugs like Suboxone and Subutex. Prior to the introduction of this drug, MAT therapy was limited to drugs like methadone and naloxone-based medications like Vivitrol. One of the reasons that policymakers and clinicians are in favor of utilizing medication-assisted treatment is because it is cheaper than traditional inpatient treatment programs. There have also been a number of studies that have suggested that MAT significantyly decreases relapse rates in patients when compared with standard outpatient psychotherapy. Recently, a Rhode Island study investigated whether MAT for OUD reduces overdose rates. The study has significant implications for public health policy. Below is an overview of the study 

"This paper uses the all-payer claims database (APCD) for Rhode Island to study three questions about the use of medication-assisted treatment (MAT) for opioid use disorder (OUD): (1) Does MAT reduce the risk of opioid overdose; (2) are there systematic differences in the uptake of MAT by observable patient-level characteristics; and (3) how successful were federal policy changes implemented in 2016 that sought to promote increased use of buprenorphine, one of three medication options within MAT? Regarding the first question, we find that MAT as practiced in Rhode Island is associated with a reduced risk of repeated opioid overdose among patients who had an initial nonfatal opioid overdose, consistent with the strong endorsement of MAT by public health officials. Concerning the second, we find that factors such as age, gender, health insurance payer, and the poverty rate in one’s residential Zip code are associated with significant differences in the chance of receiving methadone and/or buprenorphine, suggesting that certain groups may face unwarranted disparities in access to MAT. About the third question, we find that a 2016 federal rule change enabled at least some experienced Rhode Island buprenorphine prescribers to reach more patients, and a separate 2016 policy aimed at recruiting new buprenorphine prescribers was also found to be effective. However, the data also suggest that many more patients in the state could be treated with buprenorphine if prescribers took full advantage of their prescribing limits."

The researchers analyzed data from 17,568 adult subjects in Massachusetts. They found that treatment with methadone and buprenorphine resulted in lower overdose mortality. However, they did not find a clear correlation between the two drugs and the risk of overdose. Despite their promising results, MAT remains underutilized. Only one-third of patients receiving medication for opioid use disorder within the first year of their overdose were actually prescribed one. Furthermore, more than five percent of patients received more than one type of medication.

Among the many benefits of methadone, a greater affinity for opioid receptors than buprenorphine does. Its reinforcing properties reduce craving and reduce the risk of misuse. As a result, this treatment is highly effective. It has improved the lives of people suffering from opioid use disorders and has lowered the incidence of criminal justice involvement. Therefore, it should be offered in all opioid addiction treatment programs.

The Centers for Disease Control and Prevention (CDC) are working to empower states to implement comprehensive strategies that include MATs. Among these strategies are enhanced surveillance, effective policies, and clinical practices to combat the overdose epidemic. The states also aim to develop statewide prescribing norms and develop data sources that identify patients who are outside the norms. The Centers for Medicare and Medicaid Services is also working to improve access to MAT for those who qualify for such programs.

Medication Assisted Treatment (MAT) is an excellent choice for treatment. It can help patients get back on track, reduce costs and improve treatment retention. Studies also have shown that MAT can reduce the risk of overdose. Its advantages and disadvantages are similar to those of traditional therapy. While it may be effective for reducing overdose, it may have limited benefits for some patients. Therefore, it is important to consider this approach carefully before implementing it in your practice.