How Fentanyl Is Forcing Providers to Go Rogue

TO MEDICATE OR MEDITATE? –

by Claire Wilcox

Dec. 12, 2022 – “It was very confusing in the beginning,” says Rifka Stern, community addiction treatment physician in New Mexico and member of the Bernalillo County Addiction Treatment Advisory Board. She said that providers would initiate patients on buprenorphine using old protocols and put them into precipitated withdrawals. “We just didn’t understand what was going on,” says Stern.

For providers like Stern, there has been nowhere to turn for answers. The evidence base has not had time to catch up.

“It’s like the wild west again,” says Snehal Bhatt, Division Chief, Addictions Psychiatry, University of New Mexico. “For a long time, we knew exactly what to do and now it’s … like we’re all just trying things.”

Overwhelming evidence indicates that opioid use disorder is best treated with medications—often taken for months or years—which prevent craving and relapse back to use, instead of therapy alone. These medications reduce mortality and help people get back to their lives.