Medication-Assisted Treatment for Opioid Use Disorder

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The opioid crisis in the United States has come about because of excessive use of these drugs for both legal and illicit purposes and unprecedented levels of consequent opioid use disorder (OUD). More than 2 million people in the United States are estimated to have OUD, which is caused by prolonged use of prescription opioids, heroin, or other illicit opioids. OUD is a life-threatening condition associated with a 20-fold greater risk of early death due to overdose, infectious diseases, trauma, and suicide. Mortality related to OUD continues to escalate as this public health crisis gathers momentum across the country, with opioid overdoses killing more than 47,000 people in 2017 in the United States. Efforts to date have made no real headway in stemming this crisis, in large part because tools that already exist—like evidence-based medications—are not being deployed to maximum impact.

To support the dissemination of accurate patient-focused information about treatments for addiction, and to help provide scientific solutions to the current opioid crisis, this report studies the evidence base on medication assisted treatment (MAT) for OUD. It examines available evidence on the range of parameters and circumstances in which MAT can be effectively delivered and identifies additional research needed.

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174 pages · 6 x 9 · paperback
ISBN Paperback: 0-309-48648-3
ISBN Ebook: 0-309-48649-1
DOI: https://doi.org/10.17226/25310

Suggested citation

National Academies of Sciences, Engineering, and Medicine. 2019. Medications for Opioid Use Disorder Save Lives. Washington, DC: The National Academies Press.

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Alan I. Leshner

Alan I. Leshner, Ph.D., (Chair) (NAM) is Chief Executive Officer, Emeritus, of the American Association for the Advancement of Science (AAAS) and former Executive Publisher of the Science family of journals. Before joining AAAS, Dr. Leshner was Director of the National Institute on Drug Abuse at the National Institutes of Health. He also served as Deputy Director and Acting Director of the National Institute of Mental Health, and in several roles at the National Science Foundation. Before joining the government, Dr. Leshner was Professor of Psychology at Bucknell University. Dr. Leshner is an elected fellow of AAAS, the American Academy of Arts and Sciences, the National Academy of Public Administration, and many others. He is a member and served on the governing Council of the National Academy of Medicine (formerly the Institute of Medicine) of the National Academies of Sciences, Engineering and Medicine. He served two terms on the National Science Board, appointed first by President Bush and then reappointed by President Obama. Dr. Leshner received Ph.D. and M.S. degrees in physiological psychology from Rutgers University and an A.B. in psychology from Franklin and Marshall College. Dr. Leshner has received many honors and awards, including the Walsh McDermott Medal from the National Academy of Medicine and seven honorary Doctor of Science degrees.

Huda Akil

Huda Akil, Ph.D., (NAS/NAM) is the Gardner Quarton Distinguished University Professor of Neuroscience and Psychiatry and co-Director of the Molecular & Behavioral Neuroscience Institute at the University of Michigan. Research in the Akil laboratory is focused on understanding the brain biology of emotions, including pain, anxiety, depression and substance abuse. Her early work provided the first physiological evidence for a role of endogenous opioids in the brain, and demonstrated that endorphins are activated by stress to block pain, a phenomenon termed Stress-Induced Analgesia. She and her colleagues demonstrated that genes that encode the natural opioids produce multiple products in the brain, and these products act coordinately to modify a wide range of behaviors including the control of feeding and the response to stress, pain and drugs of abuse.

Dr. Akil collaborated with Dr. Stanley J. Watson in a series of studies including the cloning of two types of opioid receptors, and the extensive characterization of the brain anatomy of the opioid peptides and receptors. Her group conducted extensive structure-function analyses defining the molecular basis of selectivity and high affinity binding of endorphins and opioid drugs at the different subtypes of opioid receptors.

A major focus of her current research program is on establishing animal models to uncover the genetic and developmental bases of temperament, and the implications of these inborn differences for vulnerability to clinical depression and to substance abuse disorders.

Colleen Barry

Colleen Barry, Ph.D., is the Fred and Julie Soper Professor and Chair of the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health. She has a joint appointment in the Department of Mental Health. Professor Barry's research focuses on how health and social policies can affect a range of outcomes for individuals with mental illness and substance use disorders, including access to medical care and social services, care quality, health care spending, financial protection and mortality. She is involved in numerous research studies examining the implications of health insurance expansions and health care delivery system reform efforts on the treatment of mental illness and substance use disorders. She also conducts empirical research to understand how communication strategies influence public attitudes about opioid addiction, mental illness, gun policy, and obesity and food policy. One focus of this work is to identify evidence-based approaches to reducing stigma. She has authored over 150 peer-reviewed articles on these topics. Dr. Barry is founding co-Director (with Elizabeth Stuart) of the Johns Hopkins Center for Mental Health and Addiction Policy Research and is a core faculty member in the Johns Hopkins Center for Gun Policy and Research. Professor Barry received her Ph.D. in health policy from Harvard University and her Masters degree in public policy from the John F. Kennedy School of Government at Harvard.

Kathleen M. Carroll

Kathleen Carroll, Ph.D., is the Albert E. Kent Professor of Psychiatry; at the Yale University School of Medicine. She graduated summa cum laude from Duke University, received her Ph.D. in clinical psychology in 1988 from the University of Minnesota, and completed her pre-doctoral training at the Yale University School of Medicine’s Division of Addictions, where she was promoted to Professor in 2002. She is Principal Investigator of the Center for Psychotherapy Development at Yale, NIDA’s only Center devoted to behavioral therapies research, and since 1999 she has been Principal Investigator of the New England Consortium Node of the National Institute on Drug Abuse’s Clinical Trials Network (merging with Dr. Roger Weiss’s Northern New England in 2008). Dr. Carroll is the author of over 300 peer-reviewed publications as well as numerous chapters and books. Her research has focused on the development and evaluation of behavioral treatments and combinations of behavioral therapies and pharmacotherapies, with an emphasis on improving the quality and rigor of clinical efficacy research in the addictions. Dr. Carroll received a NIH MERIT (Method to Extend Research in Time) in 2003 for her work on developing web-based cognitive-behavioral therapy.

Chinazo Cunningham

Chinazo Cunningham, M.D., is a professor at the Albert Einstein College of Medicine. Since 1998, Dr. Cunningham has been providing care, developing programs, and conducting research focused on people who use drugs. She has collaborated with community-based organizations to develop unique and innovative programs. Parallel with program development, her research has focused on improving access to care, utilization of health care services, and health outcomes. Dr. Cunningham has published over 100 articles and has been the principal investigator on numerous grants funded by the NIH, CDC, HRSA, foundations, and local and state Departments of Health. Dr. Cunningham has served on numerous national advisory committees, including serving as the Chair of NY State Department of Health’s Substance Use Guidelines Committee; a member and Chair of the NIH’s Behavioral and Social Consequences of HIV/AIDS Study Section; and a member of the CDC's Board of Scientific Counselors of the National Center for Injury Prevention and Control. Dr. Cunningham’s husband is employed by and owns stock in Quest Diagnostics.

Walter P. Ginter

Walter Ginter is the Project Director of the Medication Assisted Recovery Support (M.A.R.S.) Project. The M.A.R.S. Project is funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT). It is the only federal project designed to provide peer recovery support to persons whose recovery from opiate addiction is assisted by medication. It is in collaboration with the Division of Substance Abuse, Albert Einstein College of Medicine, Yeshiva University and the National Alliance for Medication Assisted (NAMA) Recovery. He was formerly the Board of Directors of Faces and Voices of Recovery (FaVoR). Mr. Ginter is the Director of Training and Certification at the National Alliance for Medication Assisted (NAMA) Recovery. He is a Planning Partner for National Recovery Month and a member of the Methadone Treatment Advisory Group of the New York State Office of Alcoholism and Substance Abuse Services (OASAS) and the NYS OASAS Recovery Implementation Team.

Traci Green

Traci Green, Ph.D., M.Sc. is an Associate Professor, Emergency Medicine and Community Health Sciences, at Boston University Schools of Medicine and Public Health, Deputy Director of the Boston Medical Center Injury Prevention Center, and an Adjunct Associate Professor of Emergency Medicine at the Warren Alpert Medical School of Brown University. Dr. Green is an epidemiologist whose research focuses on drug use, opioid addiction, and drug-related injury. Specifically, the areas in which she is most interested and to which she has contributed include the intersecting worlds of HIV infection and drug use, non-medical use of prescription drugs, corrections health, drug policy, and opioid overdose prevention and intervention. She earned a Master of Science in Epidemiology and Biostatistics from McGill University and a Ph.D. in Epidemiology from Yale University where she was both a Center for Interdisciplinary Research on AIDS pre-doctoral fellow and an individual Kirschstein-National Research Services Award pre-doctoral fellow. She helped design the ASI-MV®, a real-time illicit and prescription misuse surveillance system developed by Inflexxion, Inc. Dr. Green helped co-found www.prescribetoprevent.org for prescribers and pharmacists and its companion site www.prevent-protect.org for families, patients, and community organizations. She serves as an advisor to the Rhode Island Governor on addiction and overdose, and consults for the Center for Disease Control and Prevention and the High Intensity Drug Trafficking Areas on public health and public safety opportunities. She served on the Board of Scientific Counselors for the CDC’s National Center for Injury Prevention and Control and on the National Academy of Sciences, Engineering, and Medicine’s Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse. Her research is supported by the CDC, the National Institute on Drug Abuse, the Agency for Healthcare Research and Quality, the Patient Centered Outcomes Research Institute, the Bloomberg American Health Initiative, and the Department of Justice.

Yasmin L. Hurd

Yasmin Hurd, Ph.D., (NAM) is the Ward-Coleman Chair of Translational Neuroscience and the Director of the Addiction Institute at Mount Sinai. Dr. Hurd's multidisciplinary research investigates the neurobiology underlying addiction disorders and related psychiatric illnesses. A translational approach is used to examine molecular and neurochemical events in the human brain and comparable animal models in order to ascertain neurobiological correlates of behavior. Her basic science studies are complemented by human clinical laboratory investigations in patients with substance use disorders focused on the development of new treatment interventions.

Alan M. Jette

Alan Jette, PT, Ph.D., MPH, FAPTA, (NAM) is Professor of Rehabilitation Science in the Ph.D. in Rehabilitation Sciences program and in the Department of Physical Therapy at the MGH Institute of Health Professions. Dr. Jette is also Professor and Dean Emeritus at Boston University. Dr. Jette is a physical therapist and an internationally recognized expert in the measurement of function and disability. He has developed numerous instruments that assess function and disability and has published numerous articles on these topics in the rehabilitation, geriatrics, and public health literature.
Over the past 30 years, Dr. Jette has received a total of 54 grants and fellowships from such agencies as National Institutes of Health (multiple divisions), Robert Wood Johnson Foundation and the National Arthritis Foundation. His current research interests include the measurement, epidemiology, and prevention of disability, and the development and dissemination of contemporary outcome measurement instruments to evaluate the quality of health care. He also has applied his research to randomized clinical trials to reduce disability in older adults using cognitive-behavioral strategies, exercise training, and programs to reduce fear of falling. He furthermore developed and tested innovative strategies to disseminate these programs to the wider community.

From 2005-2007 Dr. Jette chaired the Institute of Medicine's (IOM) Project, The Future of Disability in America. Building on the 1991 landmark IOM report, Disability in America, the IOM Panel updated developments since that report's publication and highlighted future priorities for the nation. The panel's report was released in 2007. In 2013, Dr. Jette was elected to the National Academy of Medicine. He currently serves as Editor-in-Chief of the journal, PHYSICAL THERAPY.

Laura R. Lander

Laura R. Lander, M.S.W., is an Associate Professor, Social Work Section Chief and Addiction Therapist in the Department of Behavioral Medicine & Psychiatry, and Department of Neuroscience, at West Virginia University, School of Medicine. She graduated with a Masters in Social Work from Columbia University, and currently holds licensure as an Independent Clinical Social Worker under the West Virginia Board of Social Work Licensure. She previously served as the Clinical Coordinator of the Child Outpatient Clinic at McLean Hospital in Belmont, MA, and was Director of Adult Mental Health Services at the Pederson Krag Center, Smithtown, NY. She is a member of the National Association of Social Work and the National Association of Addiction Professionals.

David Patterson Silver Wolf

David Patterson Silver Wolf, Ph.D., is an Associate Professor at Washington University. He has over 15 years of experience providing clinical services in the substance use disorder treatment field. Patterson Silver Wolf investigates how empirically supported interventions are implemented in community-based services, specifically as it relates to therapist and organizational characteristics. He is the director of the Community-Academic Partnership on Addiction, which works with several St. Louis-based organizations to bring science to addiction services.

Patterson Silver Wolf is a faculty scholar in the Washington University Institute for Public Health, a faculty affiliate in the Center for Violence and Injury Prevention, and serves as training faculty for two NIH- funded (T32) training programs at the Brown School, including the Transdisciplinary Training in Addictions Research program of the National Institute on Drug Abuse.

Patterson Silver Wolf also studies factors that improve underrepresented minority college students’ academic success. He is specifically interested in American Indian/Alaska Native health and wellness, particularly issues related to college retention. At the Brown School he teaches substance abuse courses, chairs the American Indian and Alaska Native concentration in the Master of Social Work program, and works closely with Kathryn M. Buder Center Scholars.

Seun Ross

Seun Ross, D.N.P, MSN, CRNP-F, NP-C, NEA-BC, is the Director of Nursing Practice & Work Environment at the American Nurses Association (ANA). Dr. Ross is a published author, and lecturer on many topics within her research interests, which include evidence based practice, workforce management, RN work environment, competency and developing/mentoring the novice RN. In her clinical experience as a hospital administrator and clinician, she worked with pregnant women where medication assisted therapy was part of the treatment regimen. She is currently the President of IMBUEfoundation and the immediate Past President of the Chi Zeta Chapter of Sigma Theta Tau Nursing Honor Society, a member of the Academy of Healthcare Executives and holds certifications as a family nurse practitioner and Nurse Executive-Advanced.

Scott Steiger

Scott Steiger, M.D., is Associate Clinical Professor of Medicine and Psychiatry at UCSF, board certified in both Internal Medicine and Addiction Medicine. Currently serving as Deputy Medical Director of the Opiate Treatment Outpatient Program at San Francisco General, where he helps direct the "medication-assisted" treatment of ~600 patients with OUD, over half of whom are experiencing homelessness. He has extensive clinical and teaching experience in the treatment of OUD with all FDA-approved medications in the safety net primary care, acute care hospital, and specialty licensed Opiate Treatment Program settings.

David Vlahov

David Vlahov, Ph.D., (NAM) is Associate Dean for Research and Professor at the Yale School of Nursing with a joint appointment in Epidemiology and Public Health. He is also the Co-Director of the National Program Office for the Robert Wood Johnson Foundation’s Culture of Health: Evidence for Action Program.

Dr. Vlahov’s research and practice have been focused on advancing health in urban settings which has been funded by NIDA, NIMHD, CDC, Robert Wood Johnson Foundation, Rockefeller Foundation, Gates Foundation. He was the founding President of the International Society for Urban Health. He has been a Visiting Professor at the Medical School in Belo Horizonte, Brazil to develop their programs in urban health, and served as expert consultant to the WHO’s Urban Health Center in Kobe, Japan; the Istituto Superiore d’ Sanita in Rome and the Municipal Health Service in Amsterdam. Dr. Vlahov is the editor-in-chief of the Journal of Urban Health, has edited three books on urban health and published over 650 scholarly papers.

He served on the New York City Board of Health, the NIH National Advisory Board on Drug Abuse, the NIH Advisory Board for the Office of AIDS Research, the Board of Directors for the American Association of Colleges of Nursing, and HRSA’s National Advisory Board on Nursing Education and Practice.

In 2011 Dr. Vlahov was both elected to the National Academy of Medicine, currently serving on the Institute’s Board of Global Health. In 2015, he was inducted into the Johns Hopkins University Society of Scholars. He is a Fellow of the American Academy of Nursing and the New York Academy of Medicine.

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Medication-Assisted Treatment for Opioid Use Disorder

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Medication-Assisted Treatment for Opioid Use Disorder

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Featured publication

Medications for Opioid Use Disorder Save Lives

Description

Collaborators

Committee

Sponsors

Staff

Major units and sub-units

Contact

Contact us

Provide feedback

Request materials

More like this

Modernizing Mathematics Education for Grades 9-14

Health Care Financing to Improve Availability of Affordable Contraception: Identifying Promising Practices

Review of Methods in the Report on Carcinogens Handbook

National Cooperative Highway Research Program

Transit Cooperative Research Program

Modernizing Mathematics Education for Grades 9-14

Response to the Centers for Medicare & Medicaid Services CY 2025 Advanced Primary Care Hybrid Payment Request for Information

Response to the “Pay PCPs [Primary Care Providers] Act of 2024” Request for Information

Clinical Trials of Far UV to Reduce Indoor Transmission of Respiratory Infections