38. Rehab vs. Meds vs. No Treatment

38. Rehab vs. Meds vs. No Treatment

This episode of the Addiction Medicine Journal Club dives into a critical discussion on the effectiveness of different treatments for opioid use disorder. Dr. John Keenan and Dr. Sonia del Tredici dissect a study comparing inpatient treatment, medication, and no treatment at all. They reveal some surprising findings about relapse rates and the impact of various treatments on reducing fatal overdoses. The conversation extends to the stigma faced by patients with opioid use disorder, especially those needing surgery for endocarditis.

They also touch on the historical context of opioid addiction in America, dating back to the Civil War, and current debates around banning menthol cigarettes. The hosts share personal anecdotes and reflections, adding depth to the clinical data. For instance, Dr. del Tredici recounts a New England Journal of Medicine essay about bias against treating injection drug users with endocarditis.

This anecdote highlights the broader issue of withholding care from patients who aren't 100% abstinent, challenging listeners to rethink their biases. You'll also hear about the role of medication like methadone and buprenorphine in reducing opioid overdose deaths. The hosts argue that these medications should be more accessible, as they have a proven track record of saving lives.

They discuss the challenges doctors face, including fear of being labelled as a 'pill mill' by the DEA, which can deter them from prescribing life-saving medications. This episode is a must-listen for anyone interested in addiction medicine, offering a mix of clinical insights, historical context, and personal stories. It challenges you to think critically about treatment options and the stigma surrounding opioid use disorder. Don't miss out on this enlightening conversation that could reshape your understanding of addiction treatment.