TY - JOUR
KW - Addiction
KW - buprenorphine
KW - clinic
KW - narcotic
KW - Opiate
KW - primary care
KW - substance
KW - Therapy
AU - M. Deyo-Svendsen
AU - Cabrera Svendsen
AU - J. Walker
AU - A. Hodges
AU - R. Oldfather
AU - M. P. Mansukhani
A1 - 
AB - Opioid use disorder (OUD) is a cause of significant morbidity and mortality in the United States. Although efforts are being made to limit access to prescription opioids, the use of heroin and synthetic opioids as well as death due to opioid overdose has increased. Medication-assisted treatment (MAT) is the pairing of psychosocial intervention with a Food and Drug Administration (FDA)-approved medication (methadone, buprenorphine plus naltrexone) to treat OUD. MAT has resulted in reductions in overdose deaths, criminal activity, and infectious disease transmission. Access to MAT in rural areas is limited by shortages of addiction medicine-trained providers, lack of access to comprehensive addiction programs, transportation, and cost-related issues. Rural physicians express concern about lack of mentorship and drug diversion as reasons to avoid MAT. The prescribing of MAT with buprenorphine requires a Drug Enforcement Agency (DEA) waiver that can easily be obtained by Family Medicine providers. MAT can be incorporated into the outpatient practice, where patient follow-up rates and number needed to treat to effect change are similar to that of other chronic medical conditions. We describe a case of opioid overdose and a suggested protocol for the induction of MAT with buprenorphine/naloxone (Suboxone) for OUD in a rural family medicine outpatient practice. Treatment access is facilitated by utilizing the protocol, allowing office staff work to the extent allowed by their licensure, promoting teamwork and minimizing physician time commitment. We conclude that improved access to MAT can be accomplished in a rural family medicine outpatient clinic by staff that support and mentor one another through use of a MAT protocol.
AD - Mayo Clinic Health System-Northwest Wisconsin, Eau Claire, WI, USA.; Mayo Clinic Health System-Northwest Wisconsin, Eau Claire, WI, USA.; Mayo Clinic Health System-Northwest Wisconsin, Eau Claire, WI, USA.; Mayo Clinic Health System-Northwest Wisconsin, Eau Claire, WI, USA.; University of Minnesota Medical School, Minneapolis, MN, USA.; Mayo Clinic Rochester, Rochester, MN, USA.
BT - Journal of primary care & community health
C5 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
DO - 10.1177/2150132720931720
JF - Journal of primary care & community health
LA - eng
M1 - Journal Article
N2 - Opioid use disorder (OUD) is a cause of significant morbidity and mortality in the United States. Although efforts are being made to limit access to prescription opioids, the use of heroin and synthetic opioids as well as death due to opioid overdose has increased. Medication-assisted treatment (MAT) is the pairing of psychosocial intervention with a Food and Drug Administration (FDA)-approved medication (methadone, buprenorphine plus naltrexone) to treat OUD. MAT has resulted in reductions in overdose deaths, criminal activity, and infectious disease transmission. Access to MAT in rural areas is limited by shortages of addiction medicine-trained providers, lack of access to comprehensive addiction programs, transportation, and cost-related issues. Rural physicians express concern about lack of mentorship and drug diversion as reasons to avoid MAT. The prescribing of MAT with buprenorphine requires a Drug Enforcement Agency (DEA) waiver that can easily be obtained by Family Medicine providers. MAT can be incorporated into the outpatient practice, where patient follow-up rates and number needed to treat to effect change are similar to that of other chronic medical conditions. We describe a case of opioid overdose and a suggested protocol for the induction of MAT with buprenorphine/naloxone (Suboxone) for OUD in a rural family medicine outpatient practice. Treatment access is facilitated by utilizing the protocol, allowing office staff work to the extent allowed by their licensure, promoting teamwork and minimizing physician time commitment. We conclude that improved access to MAT can be accomplished in a rural family medicine outpatient clinic by staff that support and mentor one another through use of a MAT protocol.
PY - 2020
SN - 2150-1327; 2150-1319; 2150-1319
SP - 2150132720931720
T1 - Medication-Assisted Treatment for Opioid Use Disorder in a Rural Family Medicine Practice
T2 - Journal of primary care & community health
TI - Medication-Assisted Treatment for Opioid Use Disorder in a Rural Family Medicine Practice
U1 - Education & Workforce; Healthcare Disparities; Opioids & Substance Use
U2 - 32507023
U3 - 10.1177/2150132720931720
VL - 11
VO - 2150-1327; 2150-1319; 2150-1319
Y1 - 2020
Y2 - Jan-Dec
ER -