Neuromusculoskeletal Institute at Rowan University School of Osteopathic Medicine, Stratford, NJ, USA.
J Osteopath Med. 2022 Mar 14;122(7):367-374. doi: 10.1515/jom-2021-0163.
The American opioid epidemic has necessitated the search for safe and effective means of treatment for opioid use disorder (OUD). Medication-assisted treatment (MAT) encompasses select medications that are proven effective treatments for OUD. Understanding the mechanisms of action, indications, and implementation of MAT is paramount to increasing its availability to all individuals struggling with opioid addiction.
This review is based on an educational series that aims to educate healthcare providers and ancillary healthcare members on the use of MAT for the treatment of OUD.
The database PubMed was utilized to retrieve articles discussing the implementation of MAT. Boolean operators and Medical Subject Headings (MeSHs) were applied including: MAT and primary care, MAT and telehealth, methadone, buprenorphine, naltrexone, MAT and osteopathic, MAT and group therapy, and MAT and COVID-19.
Three medications have been approved for the treatment of OUD: methadone, naltrexone, and buprenorphine. Identifying ways to better treat and manage OUD and to combat stigmatization are paramount to dismantling barriers that have made treatment less accessible. Studies suggest that primary care providers are well positioned to provide MAT to their patients, particularly in rural settings. However, no study has compared outcomes of different MAT models of care, and more research is required to guide future efforts in expanding the role of MAT in primary care settings.
The coronavirus disease 2019 (COVID-19) pandemic has led to changes in the way MAT care is managed. Patients require a novel point-of-care approach to obtain care. This review will define the components of MAT, consider the impact of MAT in the primary care setting, and identify barriers to effective MAT. Increasing the availability of MAT treatment will allow for greater access to comprehensive treatment and will set the standard for accessibility of novel OUD treatment in the future.
美国阿片类药物流行促使人们寻找安全有效的阿片类药物使用障碍（OUD）治疗方法。药物辅助治疗（MAT）包括经证实对 OUD 有效的几种药物。了解 MAT 的作用机制、适应证和实施方法对于增加所有阿片类药物成瘾患者获得治疗的机会至关重要。
本综述基于一个教育系列，旨在向医疗保健提供者和辅助医疗成员传授 MAT 治疗 OUD 的使用方法。
利用 PubMed 数据库检索讨论 MAT 实施的文章。使用了布尔运算符和医学主题词（MeSH），包括：MAT 和初级保健、MAT 和远程医疗、美沙酮、丁丙诺啡、纳曲酮、MAT 和骨科、MAT 和团体治疗以及 MAT 和 COVID-19。
有三种药物已获准用于治疗 OUD：美沙酮、纳曲酮和丁丙诺啡。确定如何更好地治疗和管理 OUD 并消除污名化至关重要，这有助于打破使治疗变得更难获得的障碍。研究表明，初级保健提供者非常适合为患者提供 MAT，特别是在农村地区。然而，没有研究比较过不同 MAT 护理模式的结果，需要更多的研究来指导未来在初级保健环境中扩大 MAT 作用的努力。
2019 年冠状病毒病（COVID-19）大流行改变了 MAT 护理的管理方式。患者需要一种新的即时护理方法来获得护理。本综述将定义 MAT 的组成部分，考虑 MAT 在初级保健环境中的影响，并确定有效 MAT 的障碍。增加 MAT 治疗的可及性将使更多人能够获得全面治疗，并为未来新型 OUD 治疗的可及性设定标准。
