A Glossary of Some Important MOUD Terms

In In the News, Uncategorized by marietta

 

 

By RCORP-TA

Being new to the world of medications for opioid use disorder (MOUD) can feel a bit overwhelming. Whether you are getting oriented yourself or are orienting others, this article gives you a quick rundown of the key terms and concepts that everyone needs to be familiar with to engage effectively around MOUD.

Basics

  • Group – Mutual aid groups provide socially supporting communication and the exchange of skills through shared experience. Mutual aid groups like Narcotics Anonymous and Medication Assisted Recovery Anonymous are free resources that help people build their recovery. You can read more about this in the Best Practice of the Month featured in the February 2021 RCORP-TA Newsletter.
  • Opioid use disorder (OUD) – OUD is a problematic pattern of opioid use leading to problems or distress. It may be mild, moderate, or severe depending on the number of symptoms present. A person may have OUD even if they are not dependent on opioids and have not developed tolerance to them. For more on how OUD is diagnosed, visit the American Psychiatric Association’s page on Opioid Use Disorder.
  • Psychostimulant – Psychostimulants are substances that excite the central nervous system. Their use has increased dramatically in recent years, especially in rural areas, and they’re often used with opioids. Even though there is not yet a medication for treating psychostimulant use, people who use stimulants will benefit from harm reduction.
  • Recovery – Recovery is a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. Check out the Recovery Reader to learn more.
  • Zero tolerance – Zero-tolerance policies have been shown to be ineffective in schools and may create or perpetuate disparities.

Harm Reduction

  • Injection – People who use drugs by injection can do so more safely if they can wash their hands, clean their skin, and use a new, sterile syringe for each injection. These simple steps can help reduce abscesses and endocarditis.
  • Naloxone – Naloxone is the antidote to opioid poisoning. When a person is overdosing on an opioid, prompt administration of naloxone can restore breathing and save the person’s life.
  • Test strips – Fentanyl test strips are an important tool for people who use drugs. These simple paper strip allow a person can check if fentanyl is present in the drug before they use it. This information helps people make informed decisions that improve their safety. You can read more about this in the Best Practice of the Month featured in the June 2021 RCORP-TA Newsletter.

Medications

  • Agonist – An agonist is a medication that works by attaching to a receptor on the outside of a cell, activating it. In the case of MOUD, the receptor targeted by agonists is the mu opioid receptor, which is found in the brain, nervous system, and digestive tract. Methadone and most opioid pain relievers are agonists.
  • Antagonist – An antagonist is a medication that, like agonists, works by attaching to a receptor on the outside of a cell; however, instead of activating the receptor, it blocks the receptor and keeps it from working as normal. Naltrexone is an antagonist.
  • Buprenorphine – Buprenorphine is a medication used to treat OUD. It attaches to the opioid receptors and keeps other opioids from using it, but the effect it produces is limited; this makes it a partial agonist. It is available as a generic medication but is also part of the name-brand medications Bunavail, Suboxone, Zubsolv, and Sublocade.
  • Methadone – Methadone, a mu opioid full agonist medication, has been used to treat OUD for more than 50 years. In the U.S., it can only be provided by a certified opioid treatment program (OTP), which is a one-stop shop for opioid addiction treatment. They always provide counseling. Often, they provide buprenorphine and naltrexone and treat other addictions. You can find out if there is an OTP in your community here.
  • Naltrexone – Naltrexone is an opioid agonist, blocking the effects of opioids. It should be provided in a monthly long-acting injection called Vivitrol. There is an oral form of naltrexone that can be used while waiting to get the shot. However, the pill doesn’t work very well long-term because people just stop taking it; so, stick with the shot.

Substance Use and Risks to Health

  • Endocarditis – Endocarditis occurs when parts of the heart get inflamed; it is easy to miss because, until the person is very sick, it usually only causes fatigue and a fever. People who inject drugs are at risk for endocarditis. You can help prevent endocarditis by making sure people have a new sterile syringe for every injection.
  • Fentanyl – Fentanyl is a highly potent opioid that is in most opioids people buy on the street and is also often found in methamphetamine and cocaine. Fentanyl is a fast killer. Its strength and being blended with other drugs – often without either the people who sell or use drugs knowing – is why people should not use drugs alone.
  • Hepatitis and HIV – HIV and many forms of hepatitis are contagious, and people who use drugs need to be tested for both viruses and treated. People who inject drugs or do sex-work should receive Preexposure Prophylaxis (PReP) to prevent HIV infection. PReP reduces the risk of getting HIV from injection drug use by 74%. MOUD reduces the risk of HIV and hepatitisinfection and improves treatment outcomes for both.
  • Xylazine – Xylazine is an animal sedative found in some overdose fatalities, and is one of many drugs may be added to illicit substances of all kinds, whether by accident or design. Some of these drugs, like xylazine, increase the sedation and respiratory depression of opioids, while others have toxic side effects that can cause serious health problems.

Treatment

  • Detoxification – People who are dependent on alcohol or benzodiazepines often need detoxification, sometimes under the care of a physician in the hospital. Detoxification is the medical management of acute withdrawal due to physiological dependence on a substance. People with OUD need detoxification if they want to use naltrexone to treat their condition. “Detoxification is not treatment”, is highlighted in the Best Practice of the Month featured in the January 2021 RCORP-TA Newsletter
  • Justice-involved – Treatment for OUD in jail reduces the likelihood of justice involvement after release. There are quite a few resources for jails, prisons, and communities to use to start people on MOUD while they are incarcerated.
  • Quality – Quality measures are standards for measuring the performance of healthcare providers’ care for patients and populations. Quality measures can identify important aspects of care like safety, effectiveness, timeliness, and fairness. The Chartbook on Rural Healthcare published by the Agency for Healthcare Research and Quality (AHRQ) reports on health care quality and disparities, including for substance use disorder, in rural areas.
  • Urine testing – Urine drug testing or toxicology is the most widely used way to objectively determine what drugs a person has used recently and verify use of prescribed MOUD. Best practices dictate that urine or other forms of drug testing be used only as one of several clinical tools to guide treatment decisions. People should never be penalized for drug test results. You can read more about this topic in the March 2021 and April 2021 Best Practices of the Month in the RCORP-TA Newsletter.

 

**Drug Free Ozarks would like to thank RCORP-TA for the permission to post this story.  For more great info, visit https://www.rcorp-ta.org/