How Do I Know if I Need Long-Term Treatment for OUD?

Some patients with Opioid Use Disorder (OUD), particularly those with minor or mild symptoms can be treated with medications - either methadone or suboxone -  for a short period of time while they detox from substances over a few days or weeks.

However, the majority of patients with more serious or severe addictions may require “long term” treatment, usually on the order of months to years.  Some patients may even require or prefer life-long treatment.

The two most common medications for OUD are Methadone and Suboxone. Using either of these medications is called being on medication for addiction treatment (MAT).

Research clearly shows that people on MAT have better success in recovery when they stay on MAT for 24 months or longer.[1]

Most addiction experts recommend long term or even potentially lifelong treatment with MAT for those who feel it is important in helping them maintain abstinence from opioids.[3] 

Benefits of Long-Term Addiction Care

Medications like buprenorphine treat chemical brain imbalances caused by drug misuse. People in long-term treatment have:[4]

• Fewer withdrawal symptoms
• Lower pain levels
• Improved quality of life
• Low levels of depression
• Higher employment levels

Those who stay in treatment for up to 18 months are less likely to need an emergency room visit when compared to those who discontinue Suboxone.[3]

People who quit their medications have a higher early death rate when compared to those who keep taking their medications.[5]

Talk to Your Doctor 

As explained above, most doctors recognize the fact that OUD is a life-long chronic disease, and may require life-long treatment with MAT. If you do feel like you need long term or even indefinite treatment for OUD, talk to your doctor and advocate for your ability to stay on this medication long term. Conversely, if you do decide to try decreasing or discontinuing your MAT, it is likewise important to talk to your doctor: some of these medications can cause side effects if stopped abruptly. You and your doctor can discuss a plan for slow and safe discontinuation

Sources

1. Optimal Minimum Length of Treatment in Opioid Dependence with Buprenorphine. Value in Health. https://www.valueinhealthjournal.com/article/S1098-3015(16)01415-7/pdf. 2016. Accessed August 2022.
2. Trends in Buprenorphine Treatment in the United States, 2009 to 2018. JAMA. https://jamanetwork.com/journals/jama/fullarticle/2758992. January 2020. Accessed August 2022.
3. Discontinuing Buprenorphine Treatment of Opioid Use Disorder: What Do We (Not) Know? American Journal of Psychiatry. https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2019.19121245. February 2020. Accessed August 2022.
4. Recovery From Opioid Use Disorder (OUD) After Monthly Long-Acting Buprenorphine Treatment: 12-Month Longitudinal Outcomes from RECOVER, an Observational Study. Journal of Addiction Medicine. https://journals.lww.com/journaladdictionmedicine/fulltext/2020/10000/recovery_from_opioid_use_disorder__oud__after.27.aspx. February 2020. Accessed August 2022.
5. Treatment of Opioid Use Disorder with Buprenorphine and Buprenorphine/Naloxone. North Carolina Department of Health and Human Services. https://files.nc.gov/ncdhhs/BuprenorphineGuidance.pdf. July 2019. Accessed August 2022. 
6. The ASAM National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use. American Society of Addiction Medicine. https://www.asam.org/docs/default-source/practice-support/guidelines-and-consensus-docs/asam-national-practice-guideline-pocketguide.pdf?sfvrsn=35ee6fc2_0. 2015. Accessed August 2022.