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Methadone Matters: What the United States Can Learn from the Global Effort to Treat Opioid Addiction

  • S. L. CalcaterraEmail author
  • P. Bach
  • A. Chadi
  • N. Chadi
  • S. D. Kimmel
  • K. L. Morford
  • P. Roy
  • J. H. Samet
Perspective

Abstract

In the midst of an opioid epidemic, mortality related to opioid overdose continues to rise in the US. Medications to treat opioid use disorder, including methadone and buprenorphine, are highly effective in reducing the morbidity and mortality related to illicit opioid use. Despite the efficacy of these life-saving medications, the majority of people with an opioid use disorder lack access to treatment. This paper briefly reviews the evidence to support the use of medications to treat opioid use disorder with a specific focus on methadone. We discuss the current state of methadone therapy for the treatment of opioid use disorder in the US and present logistical barriers that limit its use. Next, we examine three international pharmacy-based models in which methadone dispensing to treat opioid use disorder occurs outside of an opioid treatment facility. We discuss current challenges and opportunities to incorporate similar methods of methadone dispensing for the treatment of opioid use disorder in the US. Finally, we present our vision to integrate pharmacy-based methadone dispensing into routine opioid use disorder treatment through collaboration between clinicians and pharmacies to improve local access to this life-saving medication.

KEY WORDS

methadone opioid use disorder opioids 

Notes

Acknowledgements

The authors would like to thank Lorraine Maden, B.Pharm., Lead Clinical Pharmacist, Addaction, North West UK for reviewing the “UK” section for accuracy.

Funding Sources

SL Calcaterra, P Bach, N Chadi, SD Kimmel, KL Morford, and P Roy participate in the Research in Addiction Medicine Scholars (RAMS) program funded by NIDA grant R25DA033211. JH Samet is partially supported by NIDA grant R25DA033211 (multiple PI).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.

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Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  • S. L. Calcaterra
    • 1
    Email author
  • P. Bach
    • 2
  • A. Chadi
    • 3
  • N. Chadi
    • 4
  • S. D. Kimmel
    • 5
  • K. L. Morford
    • 6
  • P. Roy
    • 7
  • J. H. Samet
    • 7
  1. 1.Division of General Internal Medicine, Department of MedicineUniversity of ColoradoAuroraUSA
  2. 2.British Columbia Centre on Substance UseUniversity of British ColumbiaVancouverCanada
  3. 3.Faculty of PharmacyMontreal UniversityMontrealCanada
  4. 4.Division of Developmental Medicine, Department of PediatricsHarvard Medical School and Boston Children’s HospitalBostonUSA
  5. 5.Section of Infectious Diseases and General Medicine, Department of MedicineBoston University School of MedicineBostonUSA
  6. 6.Section of General Internal Medicine, Department of Internal MedicineYale School of MedicineNew HavenUSA
  7. 7.Section of General Internal Medicine, Department of MedicineBoston University School of Medicine and Boston Medical CenterBostonUSA

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