In the U.S., approximately 20 million people have a diagnosable substance use disorder, including more than 2.1 million who are estimated to have an opioid use disorder (Dydyk, Jaine, & Gupta, 2020)—about the population of New Hampshire and Vermont combined. In 2018, the U.S. saw nearly 70,000 deaths due to drug overdose (NIDA, 2020)—almost half of which were attributed to opioids.
These numbers continue to grow and have been further exacerbated by the COVID-19 pandemic. Since March, opioid overdose death rates have risen across the country (CDC, 2020). Social distancing, pandemic stress and trauma, and disrupted drug supplies have all contributed to increased risk for overdose. Creating and ensuring access to effective treatment and recovery supports is paramount for all who struggle with addiction.
For individuals with an opioid use disorder, combining medications with counseling and recovery support services is a best practice according to the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA), Centers for Disease Control (CDC), and World Health Organization (WHO). Medication for Opioid Use Disorder (MOUD) plays a key role in treatment by normalizing brain chemistry, blocking euphoric effects of opioids, and relieving physiological cravings and withdrawal symptoms. MOUD improves outcomes for long-term recovery and prevents death from overdose. According to one study by the National Institute of Health (NIH), deaths from overdose decreased by 38% in those taking buprenorphine (Suboxone) and 59% in those taking methadone—two medications approved by the Food and Drug Administration (FDA) to treat opioid use disorder (NIH, 2018).
MOUD was first introduced in the 1960s. Decades of research have shown it to be safe and effective for individuals who are in or seeking recovery from opioid use disorder (SAMHSA, 2020). Despite this, people who choose MOUD experience stigma as misinformation and misunderstanding persists among the public, and in some cases, among substance use disorder treatment providers and recovery communities. Some of the stigma stems from beliefs that addiction is a moral problem rather than a medical condition or that using MOUD substitutes one drug for another rather than fostering long-term recovery.
These knowledge gaps and this persistent stigma create barriers to lifesaving treatment. We must work as change agents within our personal and professional networks to share research-based knowledge, dispel myths, and promote best practices for helping individuals to select and integrate MOUD as part of their personal treatment and recovery plan.
While therapy and recovery support services work to address factors that drive use—often in the form of unaddressed trauma and other behavioral health needs—MOUD plays an important role by allowing individuals a reprieve from overwhelming cravings and withdrawal symptoms which can derail interventions. Creating welcoming, equitable pathways to MOUD and recovery support services is crucial as we do the work necessary to address opioid and other substance use during and beyond the COVID-19 pandemic.