Long-Term Treatment of Opioid Use Disorder with Medications

Abstract Opioid use disorder (OUD) is a chronic, relapsing, and remitting medical disease. This principle guides the most widely accepted and evidence-based paradigm of OUD treatment, which is the long-term treatment of OUD with medications. Ongoing treatment has been shown to have clinical outcomes that include improved retention in addiction treatment, increased OUD remission, reduced opioid overdose, and reduced all-cause mortality along with numerous positive patient-centered, medical, psychiatric, and psychosocial outcomes. These outcomes are observed with methadone, buprenorphine, and extended-release naltrexone and remain for as long as the medication is continued, with an increased risk for negative outcomes when these medications are discontinued. Similar to other chronic medical diseases, OUD is best treated according to a chronic disease paradigm.