"The fentanyl made me feel like I needed more methadone”: changes in the role and use of medication for opioid use disorder (MOUD) due to fentanyl

Original research
by
Bolshakova, Maria et al

Release Date

2024

Geography

USA

Language of Resource

English

Full Text Available

Yes

Open Access / OK to Reproduce

Yes

Peer Reviewed

Yes

Objective

Fentanyl and fentanyl analogues have disrupted the illegal drug supply through contamination of other substances (i.e., methamphetamine and cocaine) and replacement of heroin in illegal markets. Increasingly, they are contributing to opioid-toxicity related deaths. We sought to examine how the changing opioid market and growing fentanyl availability influences the role and use of medication for opioid use disorder (MOUD).

Findings/Key points

The following themes related to fentanyl use and MOUD emerged: (1) Use of deviated MOUD to address fentanyl contamination, (2) Changing perception of the effectiveness of MOUD on fentanyl, and (3) Regulatory limitations of MOUD for fentanyl use disorder. PWUD described several repertoires for adjusting to changes in the illicit market of opioids. Clinicians treating PWUD should ask about recent fentanyl use prior to starting MOUD to account for increased tolerance to opioids. 

Design/methods

Semi-structured qualitative interviews were conducted with a community recruited sample of people who use drugs (N = 22) in Los Angeles, California between September 2021 and April 2022. Interviews examined opioid use history, current opioid use behaviors and consumption patterns, and MOUD experiences and perceptions. 

Keywords

About PWUD
Barriers and enablers
Clinical guidance
Harm reduction
Illegal drugs
Injecting drugs
Substitution/OAT
Withdrawal