Benefits and Evidence Supporting MOUD
Medication for opioid use disorder (MOUD) is an evidence-based approach for treating opioid use disorder. Research has shown the following benefits of MOUD treatment:
- Reduced opioid use
- Reduced risk of death from opioid overdose
- Increased retention in treatment programs
- Decreased criminal behavior
- Increased ability to find work and maintain employment
- Improved maternal and infant health outcomes for pregnant women who use opioids
- Decreased risk of contracting infectious diseases such as HIV and hepatitis C
The three medications for opioid use disorder (OUD) — buprenorphine, methadone, and naltrexone — have been shown to improve the overall health and well-being of patients with OUD by blocking cravings and reducing or eliminating withdrawal symptoms.
Studies have shown MOUD works best for treating OUD when paired with supportive counseling and behavioral therapy services, such as case management, medication management, individual or group addiction counseling, and other mental health services. These mental health and addiction services, along with social services and supports, foster health and resilience and help people with OUD strive to reach their full potential. In addition, recovery supports — such as housing, employment, child care, and transportation — support MOUD retention and adherence. These services ensure the individual has a stable and safe place to live and the ability to conduct meaningful daily activities, giving them independence in society and motivation to pursue full recovery. In addition, supportive relationships with family and friends are key to a successful recovery process.
While there are benefits of pairing MOUD with behavioral health and counseling services, some rural programs debate whether it is appropriate to require patient participation in mental health services, as it may be a barrier to treatment. According to the Models for Medication-Assisted Treatment for Opioid Use Disorder, Retention, and Continuity of Care report, released by the U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) in 2020:
“Some providers feel very strongly that psychosocial treatment is a key component of [medication for opioid use disorder], whereas others feel that the most important thing is to get clients stabilized on medication, hoping that they will be receptive to psychosocial treatment as they move further into medication-supported recovery. The latter camp also often sees mandated psychosocial treatment as impeding retention for many people.”
Providers generally agree that the appropriate approach for OUD treatment is low threshold. A low threshold treatment approach is one that offers services and makes minimal requirements of patients, thus removing or reducing barriers to treatment and expanding access to care. In certain settings, such as opioid treatment programs, federal standards require patients receiving medication to also receive counseling for substance use disorder.
MOUD programs should also be patient-centered and “meet people where they are” with the ultimate goal of supporting full recovery. Every patient is different, with unique needs and varying length of treatment. This is consistent with the Stages of Change health promotion model, which supports patients in striving to reach their full potential. The Stages of Change model recognizes that patients have different levels of readiness for change — including readiness to enter OUD treatment, readiness to take medication, and readiness to sustain recovery. The Stages of Change model is a useful tool for working with patients to change behaviors and setting goals appropriate for the individual.