By Michelle Jaffee
When treating a physician or pharmacist who has developed a substance use disorder, historically there has been some controversy in including certain medications designed for addiction treatment that are commonly prescribed in the general population.
Now, new research led by MBI investigator Lisa Merlo, Ph.D., M.P.E., has found that using FDA-approved medications for addiction treatment for specified periods was not associated with worse outcomes or additional impairment among participants in Florida’s physician health program.
Published in the Journal of Addiction Medicine, the study is an analysis of treatment records over 30 years involving the use of methadone, buprenorphine or naltrexone. The analysis included records of 45 physicians and 37 pharmacists in Florida’s physician health program, which aims to help medical professionals recover from their disease.
While the sample size wasn’t large enough to be definitive, the research team suggested that extended-release formulations may be particularly helpful in this population, and this could be an area of future study.
“For cases where it is deemed appropriate by the treatment team, using medications for addiction treatment should be allowed,” Merlo said. “Physician health programs that allow individuals to use these medications should preferably continue monitoring beyond discontinuing the medication, to maintain a wraparound safety net and prevent return-to-use and overdose.”
After considering variables such as co-occurring pain disorders, demographics, type and length of monitoring and results of neurocognitive testing, researchers concluded that medications for addiction treatment should be considered on an individual basis for participants of physician health programs.
The findings could help advance patient-centered, evidence-based care, Merlo said.
“The current position of the Federation of State Physician Health Programs is that no one should be denied medication when their treatment provider and the patient agree it is in their best interest,” she said. “And if they’re going to use these medications, the physician health program can support them to make sure they’re doing it safely.”