Review of medication-assisted treatment for opioid use disorder

Nessreen Ghanem, Devin Dromgoole, AhmadNewafhaj Hussein, R. Jermyn
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引用次数: 5

Abstract

Abstract Context The American opioid epidemic has necessitated the search for safe and effective means of treatment for opioid use disorder (OUD). Medication-assisted treatment (MAT) encompasses select medications that are proven effective treatments for OUD. Understanding the mechanisms of action, indications, and implementation of MAT is paramount to increasing its availability to all individuals struggling with opioid addiction. Objectives This review is based on an educational series that aims to educate healthcare providers and ancillary healthcare members on the use of MAT for the treatment of OUD. Methods The database PubMed was utilized to retrieve articles discussing the implementation of MAT. Boolean operators and Medical Subject Headings (MeSHs) were applied including: MAT and primary care, MAT and telehealth, methadone, buprenorphine, naltrexone, MAT and osteopathic, MAT and group therapy, and MAT and COVID-19. Results Three medications have been approved for the treatment of OUD: methadone, naltrexone, and buprenorphine. Identifying ways to better treat and manage OUD and to combat stigmatization are paramount to dismantling barriers that have made treatment less accessible. Studies suggest that primary care providers are well positioned to provide MAT to their patients, particularly in rural settings. However, no study has compared outcomes of different MAT models of care, and more research is required to guide future efforts in expanding the role of MAT in primary care settings. Conclusions The coronavirus disease 2019 (COVID-19) pandemic has led to changes in the way MAT care is managed. Patients require a novel point-of-care approach to obtain care. This review will define the components of MAT, consider the impact of MAT in the primary care setting, and identify barriers to effective MAT. Increasing the availability of MAT treatment will allow for greater access to comprehensive treatment and will set the standard for accessibility of novel OUD treatment in the future.
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阿片类药物使用障碍的药物辅助治疗综述
美国阿片类药物的流行使得寻求安全有效的治疗阿片类药物使用障碍(OUD)的方法成为必要。药物辅助治疗(MAT)包括经证实有效治疗OUD的精选药物。了解MAT的作用机制、适应症和实施对于增加所有与阿片类药物成瘾作斗争的个体的可获得性至关重要。本综述基于一个教育系列,旨在教育医疗保健提供者和辅助医疗保健成员使用MAT治疗OUD。方法利用PubMed数据库检索讨论MAT实施的文章。采用布尔算子和医学主题标题(MeSHs),包括MAT与初级保健、MAT与远程医疗、美沙酮、丁丙诺啡、纳曲酮、MAT与整骨疗法、MAT与团体治疗、MAT与COVID-19。结果三种药物已被批准用于治疗OUD:美沙酮、纳曲酮和丁丙诺啡。确定更好地治疗和管理OUD以及消除污名化的方法对于消除使治疗难以获得的障碍至关重要。研究表明,初级保健提供者能够很好地为患者提供MAT,特别是在农村地区。然而,没有研究比较不同MAT模式的护理结果,需要更多的研究来指导未来扩大MAT在初级保健环境中的作用。结论2019冠状病毒病(COVID-19)大流行导致MAT护理管理方式发生变化。患者需要一种新颖的即时护理方法来获得护理。本综述将定义MAT的组成部分,考虑MAT在初级保健环境中的影响,并确定有效MAT的障碍。增加MAT治疗的可获得性将允许更多地获得综合治疗,并将为未来新型OUD治疗的可及性设定标准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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