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In Reply Dr Stoddard notes that our Viewpoint on the stigma associated with the treatment of opioid use disorder did not discuss naltrexone. In 2010, the US Food and Drug Administration approved the extended-release formulation of naltrexone for relapse prevention of opioid use disorder based on evidence of efficacy against placebo.
The omission in our Viewpoint was intentional. Our goal was to confront the common, inaccurate, and dangerous assertion that long-term therapy with methadone or buprenorphine (both agonist medications) is merely substituting one addiction for another. This misconception inhibits physicians from providing and patients from seeking needed, effective, and compassionate care. As an antagonist medication usually used for less than 6 months, naltrexone does not face the same degree of misunderstanding.
Olsen Y, Sharfstein J. Treatment for Opioid Use Disorder—Reply. JAMA. 2014;312(7):751. doi:10.1001/jama.2014.8432