Medications for opioid use disorder (MOUD) help reduce or block the euphoric effects of illicit opioids, decrease opioid craving, and help individuals engage more fully in work and social roles. Studies have found that buprenorphine and methadone are associated with a 53 percent reduction in all-cause mortality, with significant reductions in suicide, drug-related, and alcohol-related deaths. But despite the evidence on the effectiveness of MOUD, myths persist around the medications and their use by patients.
Dr. John Winhusen is the Vice Chair of Addiction Studies at the University of Cincinnati College of Medicine and a leading expert on effective opioid use disorder treatments. In a recent Ask the Expert video series from the HEALing Communities Study and Addiction Policy Forum, Dr. Winhusen helps to dispel misconceptions about MOUD.
Are medications for opioid use disorder substituting one drug for another?
Dr. Winhusen responded to this common question about MOUD: “No, we are not just replacing one drug with another. Methadone and buprenorphine have very different pharmacology that helps to stabilize the brain and produce positive public health outcomes.”
Dr. Winhusen also explains the difference between MOUD utilization versus heroin or fentanyl use: “Both heroin and fentanyl have short half-lives and produce euphoria and encourage compulsive use since the drug leaves the body relatively quickly. In contrast, once a steady state is achieved, euphoria is not experienced with methadone or buprenorphine because they both stay bound at the mu-opioid receptor, they decrease craving and withdrawal, and they both work to block the effects of the heroin and fentanyl. In a nutshell, drugs like fentanyl and heroin encourage compulsive use and place people at a heightened risk for dying, while methadone and buprenorphine are safe and effective treatments that give individuals a chance to pursue healthy and productive lives.”
The HEALing Communities Study is a multi-site research study to test the integration of prevention, overdose treatment, and medication-based treatment in select communities hard hit by the opioid crisis. HEALing Communities is funded by the National Institutes of Health (NIH) Helping to End Addiction Long-term (HEAL) Initiative®.
Access the Ask the Expert interview with Dr. Winhusen here.