University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Addiction Medicine


Vickie Beloy, DMSc, PA-C


The increase in opioid use disorder has risen exponentially from the late 1990s into one of the most deadly and financially burdensome opioid crises in the United States. At the height of the COVID-19 pandemic, the CDC estimated that more than 110,000 deaths resulted from opioid addiction and abuse. As of 2022, approximately 3 million U.S. citizens are estimated to suffer from opioid use disorder (OUD). Patients with OUD are afflicted with a constant craving for these drugs, which can spiral into drug-seeking behaviors and heroin and fentanyl abuse. Optimizing patient outcomes involves early identification and intervention with medication-assisted treatment (MAT). Yet even with these best efforts, relapse is common in this vulnerable population and cultural stigma can often dissuade patients from treatment. The United States declared a public health emergency in 2017 and has since created new policies to eliminate the x-waiver for physicians, physician assistants (PAs), and nurse practitioners (NPs) in order to expand access to treatment for patients with OUD. MAT substitution therapy can reduce withdrawal symptoms, manage cravings, and maintain tolerance in case of relapse. Methadone has long been considered the standard of care for OUD. However, recent studies have supported buprenorphine-naloxone as an alternative option for OUD due to its safety, ease of use, and low risk of diversion. The benefits of providing MAT through primary care clinics increase access, reduce stigma, and enhance provider-patient relationships. Buprenorphine-naloxone offers many benefits for OUD treatment in an outpatient setting. Recent studies have provided exceptional clinical insight to help primary care providers treat opioid use disorder effectively.


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