Medical providers often exhibit stigma related to patients with opioid addiction, too, making it difficult for patients to trust the treatment community. So, medications to treat this disease should be the first-line treatment, as we know that it is extremely difficult to quit on one’s own. The current research around addiction has suggested that addiction is a chronic disease–just like high blood pressure and diabetes.
People feel that they are “still addicted” if they use opioid-based medications like buprenorphine as treatment, and prefer to try to stop on their own through meetings and groups. When it comes to patients, there is still a lot of stigma around medications used to treat opioid use disorder. Q &A With Payel Roy and Michael Stein The Brink: Why do so few individuals with opioid use disorder have access to medications like buprenorphine in the first place?
Roy and Stein spoke with The Brink to tell us more about why they think behind-the-counter buprenorphine could make a difference for people who are suffering from opioid withdrawal and don’t want to relapse to using drugs like heroin or fentanyl or painkillers like oxycodone. Stein, chair of BU’s School of Public Health department of health law, policy and management, provides primary care and buprenorphine treatment at a clinical practice in Rhode Island, which in 2003 was the first clinic in the state to start prescribing buprenorphine. Roy, a Boston University School of Medicine addiction medicine fellow and an internist at Boston Medical Center, sees patients every day who are struggling with opioid use disorder. But what if treatment was within reach without a visit to the doctor’s office? Boston University addiction experts Payel Roy and Michael Stein argue in a new editorial published in JAMA that lives could be saved by making one of these three medications, buprenorphine, more accessible to patients as a behind-the-counter drug monitored and administered by pharmacists. Methadone, naltrexone, and buprenorphine are all opioid-based medications and require a prescription for use, which can make them difficult to obtain for people who urgently need them to avoid relapse. As of now, there are only three medications approved by the Food and Drug Administration to treat opioid use disorder, a disease affecting an estimated two million individuals in the United States.
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