During the last several decades, opioid use disorders (OUD) have been considered one of the most serious public health concerns among the citizens of the United States. It is not only necessary to prevent misuse of these drugs but also to be prepared to treat patients and deal with physical dependence. The theme of medications for opioid use disorders (MOUDs) is thoroughly discussed in the article written by Nora Volkow and Carlos Blanco for the Journal of Clinical Investigation. The authors pay attention to the characteristics of OUDs and investigate the differences between opioid withdrawal and dependence in order to explain the worth of the most effective MOUDs for patients (Volkow and Blanco 10). Treatment for OUD patients consists of a variety of steps, and awareness of medications cannot be ignored because of potential negative outcomes and expected improvements. Although the article lacks statistical data, its qualitative information serves as a solid background for future studies on a similar topic. In this paper, the analysis of the article by Volkow and Blanco will be developed to clarify the primary clinical and pharmacological considerations of MOUD-based treatment.
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Characteristics of OUD
Taking into consideration the major requirements for writing academic papers, the authors of the article under analysis follow the necessary rules. First, they clearly introduce the chosen topic and explain its importance as “one of the most challenging public health crises in the US” (Volkow and Blanco 10). Then, they focus on the distinctions between OUD withdrawal and dependence. Finally, the evaluation of MOUDs is developed to understand them as an efficient part of a treatment program. According to Volkow and Blanco, it is important to know the difference between OUD and opioid physical dependence (10). Physical dependence has a tendency to develop rapidly among patients who take medications repeatedly, and OUD is observed in 10% of cases with impairment and distress presence (Volkow and Blanco 10). Withdrawal and dependence lead to different disorders, and to diagnose OUD at its early stage, the assessment developed by a clinical is required. There are specific brain mechanisms that have to be taken into consideration to control the consequences of treatment and physical dependence.
Medications for OUD Patients
Another important part of the article includes the discussion of medications that are appropriate for OUD patients. Volkow and Blanco defined MOUD as the standard of care for patients with OUD symptoms (11). The major goals of treatment approved by the US Food and Drug Administration (FDA) are the reduction of risks of overdose deaths, opioid-related infections, and criminal behaviors. Among well-known MOUDs, Volkow and Blanco identify methadone, buprenorphine, and naltrexone (11). On the one hand, the authors admit that doses and frequency of medication use are defined by the level of opioid impact on the human brain. It is said that MOUDs are usually taken orally or in other slow-released forms in order to slow down the rate of brain entry. On the other hand, there are no specific examples with clear statistics about how to use drugs, and when their application is not appropriate for patients. Therefore, it remained unclear what doses of MOUDs can be dangerous for patients, and what ways of differentiating between MOUDs are effective.
MOUDs Pros and Cons
The choice of MOUDs for treating patients is a highly debatable topic. Some researchers support the idea that medication choice depends on patients’ responses to previous forms of treatment, and some experts recommend focusing on the level of physical dependence and coexisting diseases (Volkow and Blanco 11). However, there are also situations when the reaction to MOUD is hard to predict, and certain results are observed during the treatment process. For example, methadone is appropriate for patients who reject other medications and need the drug as a part of a daily behavioral treatment program full of other central nervous depressants (Volkow and Blanco 11). Buprenorphine is a relatively new drug for OUD patients who usually need a waiver. The required dose for this drug is proved to be from 8 mg to 24 mg, and the expected outcome is the possibility to avoid respiratory complications. Finally, naltrexone, as an antagonist drug, contributes to mood improvement among patients with alcohol dependence as an example.
In general, the article by Volkow and Blanco contains a number of educative issues about OUD patients and pharmacological treatment options available for them. Despite the evident shortage of the study like the absence of statistics or real-life examples, the authors manage to create descriptive research about OUD and its medications. In this article, three major drugs are specified as an effective means of health improvement. They include methadone, buprenorphine, and naltrexone with specific doses and recommendations. However, the list of mods is large, and new interventions can be discussed within the frames of future studies. There is an opportunity to control the opioid crisis in the USA, and Volkow and Blanco present the conditions under which MOUD treatment plans are developed, including positive and negative outcomes and contributions.
Volkow, Nora D., and Carlos Blanco. “Medications for Opioid Use Disorders: Clinical and Pharmacological Considerations.” The Journal of Clinical Investigation, vol. 130, no. 1, 2020, pp. 10-13.