Use of Medication for Addiction Treatment Among Physicians and Pharmacists Monitored for Substance Use Disorder by One State Physician Health Program.

Abstract

This study explored the utilization of medication for addiction treatment (MAT) by participants in one state physician health program (PHP) over the course of 30 years, and reviewed patterns of use and monitoring outcomes. Data were extracted from the PHP records of 45 physicians and 37 pharmacists with substance use disorder (SUD), with or without co-occurring pain disorder, who used opioid [partial] agonist or antagonist medication, with or without other MAT. Variables of interest included demographics, type/length of monitoring, use of medications during monitoring, results of neurocognitive testing, and monitoring outcomes. Descriptive statistics were used to characterize PHP participants. χ2 tests, Fisher exact test, and t tests were used for group comparisons. Findings demonstrated positive outcomes among the PHP participants, regardless of MAT use status, with over 70% graduating monitoring or currently in good standing. A minority completed their initial monitoring but returned to the PHP due to return-to-use (n=4, 4.9%), discontinued monitoring against recommendations (n=4, 4.9%), or were turned over to the licensing board due to noncompliance with monitoring (n=4, 4.9%). There were 5 deaths (unrelated to substance use). Periods of MAT use were not associated with worse outcomes or additional impairment. All FDA-approved MAT should be considered for physicians and pharmacists monitored by a PHP, on an individual basis, when deemed clinically appropriate. Extended-release formulations may be particularly helpful for this population. Results may help clarify misunderstandings and controversies surrounding the use of MAT for PHP participants, while also advancing patient-centered, evidence-based care.