57 28TH ANNUAL CRIME PREVENTION GUIDE Medications approved for the treatment of opioid abuse are underutilized and often not delivered in an evidence based manner. • Fewer than half of private sector treatment programs offer these medications • of patients in those who may benefit, only half actually receive it • many people suffering with opioid addiction do not seek treatment How to Address Challenges • Identifying the need and engaging them in treatment is an essential element of addressing the opioid crisis • Overcoming the misunderstandings and other barriers that prevent wider spread adoption of these treatments is crucial for tackling the opioid crisis For treatment to be effective • Methadone and Buprenorphine must be given at a sufficiently high dose o Some prescribers who are warry of using methadone or buprenorphine have prescribed lower doses for short treatment durations, leading to treatment failure and the mistaken conclusion that the medication is ineffective • Some programs and insurance provider limit the duration of treatment a patient may receive o Opioid addiction is a chronic condition and many patients will need ongoing treatment for many years • It will be important to develop sustainability strategies to ensure that patients do not lose access to these life-saving medications when a particular funding program is discontinued •While users seeking treatment are on wait list they generally continue to engage in opioid use and this may contribute to failure to enter treatment when a slot becomes available o Research has shown that providing interim treatment with medications while patients are waiting admission to a treatment program increases the likelihood that they will engage in treatment • At home buprenorphine is not allowed under interim regulations currently o Urine testing call backs and a special medicine dispensing devise are used to prevent diversion SOURCE: Research on the Use and Misuse of Fentanyl and Other Synthetic Opioids.Wilson M. Compton, M.D. Deputy Director, National Institute on Drug Abuse (NIDA).March 21, 2017 TREATMENT CHALLENGES