Date of Award

Spring 2021

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

ToriAnne Yetter

Abstract

Opioid Use Disorder is patterns of opioid use leading to withdrawal, giving up important life events in order to use opioids, and excessive time spent using opioids, to name a few diagnostic criteria. The clinical progression of the disorder involves periods of acute exacerbation and remission that are cyclic in nature. Treatment is most effective when it includes both pharmacological and psychosocial modalities, referred to as medication assisted therapy (MAT). Three drugs used commonly in MAT-based treatment for OUD from oldest to newest include Methadone, Buprenorphine-naloxone, and Naltrexone. Treatment program models that prioritize total abstinence from the addictive substance attached to the disorder see low retention rates that lead to extremely high relapse, overdose, and mortality rates. Longer term maintenance therapy in with these drugs is possible with newer formulations, and may lead to better outcomes for many patients facing OUD. This review will examine whether buprenorphine-naloxone (e.g. Suboxone) or extended release naltrexone injections (e.g. Vivitrol) are a more effective treatment in terms of initiation, retention, and long-term outcomes over 3-, 6-, and 12- months.

Additional Files

OUD Capstone Poster References.docx (16 kB)
Capstone OUD.mp4 (184218 kB)

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Opioid Use Disorder: The Timeline for Medication Assisted Therapy

Opioid Use Disorder is patterns of opioid use leading to withdrawal, giving up important life events in order to use opioids, and excessive time spent using opioids, to name a few diagnostic criteria. The clinical progression of the disorder involves periods of acute exacerbation and remission that are cyclic in nature. Treatment is most effective when it includes both pharmacological and psychosocial modalities, referred to as medication assisted therapy (MAT). Three drugs used commonly in MAT-based treatment for OUD from oldest to newest include Methadone, Buprenorphine-naloxone, and Naltrexone. Treatment program models that prioritize total abstinence from the addictive substance attached to the disorder see low retention rates that lead to extremely high relapse, overdose, and mortality rates. Longer term maintenance therapy in with these drugs is possible with newer formulations, and may lead to better outcomes for many patients facing OUD. This review will examine whether buprenorphine-naloxone (e.g. Suboxone) or extended release naltrexone injections (e.g. Vivitrol) are a more effective treatment in terms of initiation, retention, and long-term outcomes over 3-, 6-, and 12- months.