Why do so few doctors treat people with opioid addictions?

STAT_LogoDear Doctor,

Please help me understand why so few of you have chosen to treat people with opioid addictions.

I’ve been following the topic of opioid addiction for years. It is one of the most common themes for First Opinion submissions. Authors routinely point to the importance of medication-assisted therapy, the standard of care for individuals with opioid addiction (a term that those in the know tell me I should replace with opioid use disorder). That means treatment with methadone, buprenorphine, naltrexone, or combinations of these — medications you could prescribe if you wanted to.

The surgeon general’s report, “Facing Addiction in America,” says that medication-assisted therapy is effective in treating opioid use disorder, but is vastly underused. FDA Commissioner Scott Gottlieb has called medication-assisted therapy “one of the major pillars of the federal response to the opioid epidemic in this country.”

Yet 95 percent of you don’t prescribe these medications.

Why is that?

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