The findings build on the knowledge that drugs that treat people who use opioids are often not used up.
“This is the equivalent of giving people with advanced cancer a less aggressive treatment“Senior Investigator Laura J. Bierut, MD, Alumni Favored Professor of Psychiatry at the University of Washington.”For many of us, it seems that we should offer the most aggressive and effective treatments to those most severely ill.. “
The potentially life-saving drug, buprenorphine, has been shown to reduce the risk of overdose – but an analysis of health insurance data involved about 180,000 people being treated for an opioid use disorder showed that nearly 53% of patients with this disorder did not receive a prescription. .
Among people with multiple substance use disorders, the number of people prescribed buprenorphine drops to about 30%.
The study was published in the journal Open JAMA Network.
“The worrying thing is that the majority of people who abuse multiple substances don’t seem to be getting the life-saving drugs they really need“First author Kevin Xu, MD, a resident in the Department of Psychiatry at the University of Washington, said.
“Even among people who only use opioids, buprenorphine is prescribed only about half the time. While the data we analyzed predates COVID-19, the pandemic has seen an increase in the number of overdoses, we still haven’t seen many eligible patients prescribed buprenorphine.. “
Xu and his colleagues – including Bierut and Richard A. Grucza, PhD, professor in the Department of Family and Community Medicine at Saint Louis University – analyzed data aggregated by insurance companies. from 2011-2016 for the US IBM MarketScan database.
The database includes detailed information on patients being treated for an opioid use disorder, as well as those receiving treatment using opioids along with other medications.
“The data we analyzed is from several years ago“Bierut said.”But we think this information can be extrapolated to what is happening now because even more people using opioids – or using opioids and other substances – are going to emergency departments. The problem only got worse during the COVID-19 pandemic. “
During the recent 12-month period from early 2021 to early 2022, nearly 107,000 Americans died from drug overdoses. By comparison, in 2017, after years of increasing drug overdose deaths, the US Centers for Disease Control and Prevention reported 70,237 drug overdose deaths in the United States. Ky.
Buprenorphine prescribing has not kept pace with demand. One reason, says Xu, is because buprenorphine is an opiate in itself, leading to reluctance to prescribe it to people with opiate use disorders. Unlike methadone, another opiate used to treat heroin addiction, buprenorphine can be taken at home and doesn’t require a daily clinic visit.
But that lack of oversight, as well as a lack of data on the drug’s effectiveness in people with multiple abusers, has made some doctors reluctant to prescribe it. Xu said the concerns appeared to be unfounded.
“Buprenorphine appears to be a safe opiate,” he said. It is specifically designed to be different from other opiates in that it won’t stop the user from breathing, which most other opiates will. That means it can be safely done at home, very useful, even essential for recovery.. “
The study also compared buprenorphine’s ability to help prevent future overdoses with that of naltrexone. Buprenorphine is known as an opioid partial agonist, which means it activates the same receptors that heroin and fentanyl activate. Naltrexone, on the other hand, blocks that receptor on brain cells.
The data in this study indicate that while both drugs reduce the risk of future overdose, buprenorphine reduces this risk more than naltrexone.
“For a long time, people thought that blocking the receptor was as good as using a drug, like buprenorphine, to activate the opioid receptor.“Xu said.”But recent data suggest that buprenorphine is fundamentally more effective. Now the challenge will be to convince more doctors to prescribe this safe and effective drug to patients who need it. “