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Ideas and Opinions |16 January 2018

Evaluating Slow-Release Oral Morphine to Narrow the Treatment Gap for Opioid Use Disorders

M. Eugenia Socías, MD, MSc; Evan Wood, MD, PhD

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
This article was published at Annals.org on 26 December 2017.
  • From University of British Columbia and British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada.

    Acknowledgment: The authors thank Jennifer Navin for her administrative assistance and Leo Beletsky for his legal advice.

    Financial Support: Dr. Wood is a Tier 1 Canada Research Chairholder. Dr. Socías is supported by postdoctoral fellowship awards from the Michael Smith Foundation for Health Research and the Canadian Institute for Health Research.

    Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-2373.

    Requests for Single Reprints: Evan Wood, MD, PhD, British Columbia Centre on Substance Use, 608-1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada; e-mail, bccsu-ew@cfenet.ubc.ca.

    Current Author Addresses: Drs. Socías and Wood: British Columbia Centre on Substance Use, 608-1081 Burrard Street, Vancouver, British Columbia V6Z 1Y6, Canada.

    Author Contributions: Conception and design: M.E. Socías, E. Wood.

    Analysis and interpretation of the data: M.E. Socías, E. Wood.

    Drafting of the article: M.E. Socías.

    Critical revision for important intellectual content: M.E. Socías, E. Wood.

    Final approval of the article: M.E. Socías, E. Wood.

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North America is in the midst of an unprecedented public health crisis of opioid-related morbidity and mortality, fueled by the increasing contamination of the drug supply with illicitly manufactured fentanyl and related analogues (1). It is estimated that more than 2.5 million Americans have an opioid use disorder (OUD) and that more than 33 000 died from an opioid-related overdose in 2015—quadrupling the rates from 1999 (1). The scale and trajectory of the opioid overdose epidemic in North America underscore the need for an urgent scale-up and evaluation of science-driven solutions (2). Lessons drawn from the response to the HIV epidemic and, more recently, the Ebola virus outbreak show that prompt identification of and access to effective interventions are cornerstone elements in responding to any public health emergency (3, 4).
Fortunately, evidence-based treatments for OUD exist. However, despite the proven individual- and community-level benefits of opioid agonist therapy (OAT)—with buprenorphine or methadone (5, 6)—several health system and regulatory barriers to this treatment persist throughout North America, significantly undermining the population-level effect of these programs (6). In addition, buprenorphine and methadone may not be effective for all patients, with some studies indicating that fewer than 50% of persons who begin OAT with these medications are still receiving treatment at 6 months (7). The barriers to successful uptake and long-term engagement with OAT in the United States have resulted in a large unmet treatment need, leaving...
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Socías ME, Wood E. Evaluating Slow-Release Oral Morphine to Narrow the Treatment Gap for Opioid Use Disorders. Ann Intern Med. 2018;168:141–142. [Epub ahead of print 26 December 2017]. doi: https://doi.org/10.7326/M17-2373

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Published: Ann Intern Med. 2018;168(2):141-142.

DOI: 10.7326/M17-2373

Published at www.annals.org on 26 December 2017

©
2017 American College of Physicians
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