Category:MAT for opioid use disorder: Difference between revisions
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A ''' | A '''medicine for opioid use disorder''' (MOUD; the older term "medication-assisted treatment" or MAT is the historical-clinical phrase, retained for recognition) is one used to treat [[wikipedia:Opioid use disorder|opioid use disorder]], with the goal of stabilising the patient, reducing illicit-opioid use, reducing overdose mortality, and supporting recovery and social reintegration. The category is small but exceptionally consequential: three medicines (methadone, buprenorphine, extended-release naltrexone) are approved in the United States for the indication, and they are among the most-studied medicines in clinical pharmacology for any indication, with substantial mortality-reduction data that has driven a generational shift in addiction-medicine practice and a major regulatory loosening of access. | ||
The conceptual founding event of MOUD was the 1965 study by [[wikipedia:Vincent Dole|Vincent Dole]] and [[wikipedia:Marie Nyswander|Marie Nyswander]] at the Rockefeller Hospital in New York, who established the metabolic-disease model of opioid addiction and showed that daily oral [[Methadone|methadone]] stabilised heroin-using patients into productive lives without ongoing illicit use.<ref name="dole1965">Dole VP, Nyswander M. A medical treatment for diacetylmorphine (heroin) addiction. A clinical trial with methadone hydrochloride. ''JAMA''. 1965 Aug 23;193(8):646-650. PMID 14321530.</ref> The Dole-Nyswander framework reframed opioid use disorder as a chronic medical condition treatable with daily long-term medicine, in deliberate contrast to the contemporary abstinence-based and morally framed treatment of addiction. Methadone maintenance was operationalised through the federally licensed Opioid Treatment Programmes (OTPs, originally Narcotic Treatment Programmes) that became the standard delivery model in the U.S. from 1972 onward; the daily clinic visit for observed dosing, with progressively earned take-home doses for patients in stable recovery, has remained the basic structure of methadone-based MOUD. | The conceptual founding event of MOUD was the 1965 study by [[wikipedia:Vincent Dole|Vincent Dole]] and [[wikipedia:Marie Nyswander|Marie Nyswander]] at the Rockefeller Hospital in New York, who established the metabolic-disease model of opioid addiction and showed that daily oral [[Methadone|methadone]] stabilised heroin-using patients into productive lives without ongoing illicit use.<ref name="dole1965">Dole VP, Nyswander M. A medical treatment for diacetylmorphine (heroin) addiction. A clinical trial with methadone hydrochloride. ''JAMA''. 1965 Aug 23;193(8):646-650. PMID 14321530.</ref> The Dole-Nyswander framework reframed opioid use disorder as a chronic medical condition treatable with daily long-term medicine, in deliberate contrast to the contemporary abstinence-based and morally framed treatment of addiction. Methadone maintenance was operationalised through the federally licensed Opioid Treatment Programmes (OTPs, originally Narcotic Treatment Programmes) that became the standard delivery model in the U.S. from 1972 onward; the daily clinic visit for observed dosing, with progressively earned take-home doses for patients in stable recovery, has remained the basic structure of methadone-based MOUD. | ||
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== Notes on scope == | == Notes on scope == | ||
The boundary of this category is "medicine prescribed for the chronic treatment of opioid use disorder." The medicines used for opioid overdose reversal (naloxone in its various formulations) are cross-listed under [[:Category:Opioid_antagonists|opioid antagonists]] separately, although naloxone is foundational to the contemporary harm-reduction infrastructure of MOUD. The medicines used for treatment of substance use disorders other than opioid ([[wikipedia:Naltrexone|naltrexone]] and [[wikipedia:Acamprosate|acamprosate]] and [[wikipedia:Disulfiram|disulfiram]] for alcohol use disorder; bupropion and varenicline for tobacco use disorder; the absence of FDA-approved medicines for | The boundary of this category is "medicine prescribed for the chronic treatment of opioid use disorder." The medicines used for opioid overdose reversal (naloxone in its various formulations) are cross-listed under [[:Category:Opioid_antagonists|opioid antagonists]] separately, although naloxone is foundational to the contemporary harm-reduction infrastructure of MOUD. The medicines used for treatment of substance use disorders other than opioid ([[wikipedia:Naltrexone|naltrexone]] and [[wikipedia:Acamprosate|acamprosate]] and [[wikipedia:Disulfiram|disulfiram]] for alcohol use disorder; bupropion and varenicline for tobacco use disorder; the absence of FDA-approved medicines for psychostimulant use disorder remains a current research focus) are listed under the respective substance-specific MAT pages. The medicines used in opioid withdrawal symptomatic management (clonidine, lofexidine, the antiemetics, the antidiarrhoeals, the symptomatic comfort medicines) are listed under their primary mechanism categories. | ||
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