ORN Summer 2025 - Opioid Overdoses and Opioid Use Disorder Treatment Access-2025-08-20

Video Transcription

Video Summary

In this AOA webinar, Dr. Benjamin Howell presents an in-depth overview of the opioid overdose crisis, opioid use disorder (OUD) treatment options, barriers to treatment access, and subsequent clinical outcomes. He highlights the ongoing surge in opioid overdose deaths driven by waves involving pharmaceutical opioids, heroin, fentanyl, and polysubstance use, emphasizing the lethality of fentanyl contamination.<br /><br />Dr. Howell reviews FDA-approved pharmacotherapies for OUD: methadone (a full opioid agonist), buprenorphine (a partial agonist), and naltrexone (an antagonist). Methadone has the strongest evidence for reducing overdose risk and improving retention but requires daily clinic visits, posing access challenges. Buprenorphine is safer with less overdose risk, available by prescription, but induction is complex in the fentanyl era due to precipitated withdrawal risk. Naltrexone has limited effectiveness because of high induction barriers.<br /><br />Non-medication treatments like detox and inpatient rehab show low long-term efficacy and relapse rates. The presenter underscores that medication-based treatments, especially methadone and buprenorphine, substantially reduce repeat overdoses.<br /><br />He highlights significant treatment access barriers, including stigma, regulatory restrictions, financial hurdles, and logistical issues like transportation challenges, particularly in rural areas where opioid treatment programs are sparse and bus access is poor. Analysis of Connecticut data shows only about one-third of overdose survivors engage with medication treatment, with methadone linked to the greatest reduction in subsequent overdose risk.<br /><br />Dr. Howell calls for policy and clinical interventions to expand medication access, address barriers, and integrate addiction treatment with broader healthcare, emphasizing patient-centered approaches and continued research to improve outcomes amid evolving drug supply dynamics.

Keywords

opioid overdose crisis

opioid use disorder

OUD treatment options

fentanyl contamination

methadone therapy

buprenorphine induction

naltrexone effectiveness

treatment access barriers

medication-based treatments

opioid treatment programs