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Review

Trends in the Use of Methadone, Buprenorphine, and Extended-Release Naltrexone at Substance Abuse Treatment Facilities: 2003-2015 (Update)

Cathie E. Alderks
In: The CBHSQ Report. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2013.
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Review

Trends in the Use of Methadone, Buprenorphine, and Extended-Release Naltrexone at Substance Abuse Treatment Facilities: 2003-2015 (Update)

Cathie E. Alderks.
Free Books & Documents

Excerpt

Background: Opioid addiction is a serious concern in the United States that can be treated successfully through medication-assisted treatment (MAT). Methadone, buprenorphine, and extended-release, injectable naltrexone are three medications that have been approved by the FDA for treatment of opioid use disorder. Method: National Survey of Substance Abuse Treatment Services data for years 2003 through 2015 were used to assess the usage and trends of MAT in facilities with and without OTPs. Results: This analysis found that the numbers of facilities utilizing MAT for opioid use disorder and the numbers of clients receiving each of the three medications has increased from 2003 to 2015. Conclusion: The increases in numbers of facilities providing MAT services and the increase in numbers of clients receiving MAT is an indication that facilities are responding to the demand for effective treatment for opioid use disorder. However, without a leveling off in the trends, there is indication of unmet need. Public health resources and education could be used to further increase access to treatment and inform the public about treatment options.

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References

    1. Substance Abuse and Mental Health Services Administration. (2015). National Survey on Drug Use and Health. Unpublished table. Rockville, MD. - PubMed
    1. Mental Health and Drug & Alcohol Office, New South Wales Department of Health. (2008). NSW drug and alcohol withdrawal clinical practice guidelines (SHPN [MHDAO] 070083). Retrieved from http://www1.health.nsw.gov.au/pds/ActivePDSDocuments/GL2008_011.pdf
    1. An opioid agonist is a drug that activates the opioid (mu) receptors on nerve cells in the brain. A full agonist (methadone) continues to produce effects on the receptors until all receptors are fully activated or until the maximum effect is reached resulting in a relief of cravings, blocking of the euphoric effects associated with heroin and other opioids, and preventing withdrawal. A partial agonist (such as buprenorphine) activates the mu receptors, but not to the same extent as a full agonist; the effects increase until a plateau is reached. Once a plateau is reached and maintained, those with opioid addiction will not experience withdrawal symptoms. An opioid antagonist (such as naltrexone) binds to the opioid receptors with greater affinity than agonists, but does not activate the receptors; they block the receptor; therefore, preventing the neurons from responding to opioids, effectively blocking the effects of opioids. The result is a reversal of the effects of opioids and is used in the management of opioid use disorder to aid in the prevention of relapse.
    1. Center for Substance Abuse Treatment. (2005). Medication-assisted treatment for opioid addiction in opioid treatment programs. Treatment Improvement Protocol (TIP) Series 43 (Rev. ed.; HHS Publication No. SMA 12–4214). Rockville, MD: Substance Abuse and Mental Health Services Administration. - PubMed
    1. Volkow, N. D., Frieden, T. R., Hyde, P. S., & Cha, S. S. (2014). Medication-assisted therapies—tackling the opioid-overdose epidemic. The New England Journal of Medicine, 370(22), 2063–2066. 10.1056/NEJMp1402780 - DOI - PubMed

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