COMMENTARY

Commonly Prescribed Meds for Treating Addiction Also Reduce Crime and Suicide

Peter M. Yellowlees, MBBS, MD

Disclosures

February 06, 2019

This is the Medscape Psychiatry Minute. I'm Dr Peter Yellowlees.

The use of medication-assisted treatment for addictions is becoming increasingly common. However, we don't know whether there are associations between medications for alcohol and opioid use disorders (acamprosate, naltrexone, methadone, and buprenorphine) and suicidal behavior, accidental overdoses, and crime.

Now a team of investigators[1] from the University of Oxford, England, have investigated this question in a within-individual population cohort study of 21,281 individuals in Swedish registries who received treatment with at least one of these four medications between 2005 and 2013.

No significant associations were found for acamprosate, but for naltrexone there was a reduction in accidental overdoses. Buprenorphine was associated with reduced arrest rates for all crime categories, as well as a reduction in accidental overdoses. For methadone, there were significant reductions in the rate of suicidal behaviors as well as reductions in all crime categories. The authors concluded that medications currently used to treat alcohol and opioid use disorders also appear to reduce suicidality and crime during treatment.

Given the extent of our current opiate epidemic, these results are of great importance. They strongly support the increased use of medication-assisted treatments, which as a consequence should lead to more lives saved and reductions in emergency department visits for overdoses and in the criminal activities of addicts. While it is apparent that, as a profession, physicians have to accept some of the blame for the prevalence of opioid addiction, this study gives us more evidence to right some wrongs for our patients and ensure that we engage them with medication-assisted treatment as part of an overall biopsychosocial approach to treating addiction.

Thank you for listening to this Medscape Psychiatry Minute. Do continue to enjoy your practice.

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