Research: Educating the Community About the Opioid Epidemic and Medications for Opioid Use Disorder
Author: Jill Williams, MD, et al.
Abstract/Extract: Graduate students in health sciences are being trained to successfully teach the public about the opioid crisis and the usefulness of medications for opioid use disorder. To date, 120 students at Rutgers University have participated and delivered 59 presentations to more than 1,065 community members. Students named the program RIOT (Rutgers Interdisciplinary Opioid Trainers).
The program has had a significant impact on the knowledge of community members, say researchers. Importantly, there has been a statistically significant increase in community members taking part in the program who endorse that medications are often necessary for successful treatment of opioid use disorders. Most have felt more positive about such medications as a result of attending the students’ presentations. 20% of attendees had a family member with an opioid use disorder.
“Despite overwhelming evidence of benefit, medications for opioid use disorder remain stigmatizing and more efforts are needed to educate health care professionals and the general public,” say the research team.
Importance: Drug overdose deaths in the US have risen to historic levels, with more than 93,331 deaths in 2020, and 700,000 in the last 20 years. The federal response has included changing prescriber behavior to use fewer opioid medications, distributing naloxone to the general public for overdose reversal, and supporting the increased use of medications for opioid use disorder.
Medications for opioid use disorder (MOUD) refers to the use of Food and Drug Administration-approved medications for the maintenance treatment of opioid use disorder and includes methadone, buprenorphine, and naltrexone.
But the use of MOUD remains stigmatizing. Patients, families and health care providers can have negative attitudes and beliefs about MOUD, which may be worse for methadone and buprenorphine treatments that have the potential for misuse. An abstinence-only approach (counseling without medication) is not recommended for opioid use disorder, yet negative attitudes persist even among substance abuse treatment providers and individuals in recovery.
Less than half of individuals with opioid use disorder who are eligible ever receive MOUD. Long-term compliance with treatment is poor, with more than half of individuals discontinuing treatment within six months, contributing to relapse and death. Discontinuation of MOUD even after extended treatment periods (18 months) is associated with a high risk for adverse effects including emergency department visits, hospitalizations, and drug overdose.
“By mobilizing a large group of students, we could hope to have a broader reach,” say the researchers. “It is imperative that we educate future health care professionals how to treat patients with opioid use disorder and RIOT is a model that can be implemented at other universities.”
Availability: Pre-publication in The American Journal on Addictions.