Medication for opioid use disorder (MOUD) that employs buprenorphine or methadone to treat people with opioid use disorder has the best chance of preventing individuals from overdosing again, according to a
February 5 JAMA Network Open study, whose authors include Sarah E. Wakeman, M.D., of Massachusetts General Hospital, and Marc R. Larochelle, M.D., of Boston Medical Center.
The study tracked 41,000 patients with OUD, who received a variety of interventions ranging from MOUD with buprenorphine or methadone, MOUD with naltrexone, intensive and non-intensive behavioral healthcare, or inpatient detoxification or residential services. During 3-month follow-up, 707 participants (1.7%) experienced an overdose, and 773 (1.9%) had serious opioid-related acute care use. Only treatment with buprenorphine or methadone was associated with a reduced risk of overdose during the 3-month period.
Chapter 208 of the Acts of 2018 requires acute care hospitals that provide emergency services within an emergency department (ED) and satellite emergency facilities to have the capacity to initiate opioid agonist therapy, including buprenorphine, to patients that present after an opioid-related overdose. The patient must also be directly connected to continuing treatment prior to discharge. MHA convened a member workgroup composed of ED clinicians, addiction specialists, psychiatrists, nurses, social workers, and others, and in 2019 issued comprehensive guidelines to assist acute care hospitals implement MOUD programs.