Many people addicted to opioids are undergoing short-term detoxification, instead of receiving long-term maintenance treatment, according to a new report. In the journal Health Affairs, eight experts write this means many people are not receiving adequate opioid addiction treatment.
Dr. Bohdan Nosyk and seven other experts note that excessive regulation in the United States prevents many people addicted to opioids from receiving long-term maintenance treatment with methadone. Instead, many people undergo short-term detox, which lasts from three to 12 weeks, and is focused on achieving abstinence from opioids.
He told PBS NewsHour, “We’ve known for decades that detox is ineffective in getting, and keeping people off of opioids. This is true even in youths who don’t inject and had relatively little experience with opioids before entering treatment.” He said the treatment is extremely dangerous, because people addicted to opioids are at highest risk of death in the first two weeks of treatment and in the two weeks after treatment ends. “That means a three-week detox regimen exposes addicts to an extremely high risk of death for four out of five consecutive weeks. So, aside from being ineffective, it’s extremely dangerous.”
In the United States, methadone is only available in specialized treatment centers, not in regular doctors’ offices, Dr. Nosyk explained. He said another opioid addiction treatment, buprenorphine, can be prescribed in physicians’ offices. “Methadone is a more effective, and considerably cheaper medication, and may therefore provide better value for money while further expanding access to treatment,” he said. He called for eliminating restrictions on office-based methadone prescribing in the United States.
In Health Affairs, Dr. Nosyk wrote that fewer than 10 percent of all people dependent on opioids in the United States are receiving treatment with methadone or buprenorphine. The proportion may increase as more people receive health insurance through the Affordable Care Act, he said.