Dr. Amy Burns: Attention Spokane medical community: Treating opioid use disorder is the standard of care for all of us

Spokane is a community in crisis. Overdose deaths are declining across Washington state, but not in Spokane. According to County Health Insights, Spokane saw a 38% increase in opioid overdose deaths in 2024. Gaps in treatment for opioid use disorder have led to devastating impacts that trickle down to every member of the community, including families, first responders and local businesses.

While opioid use disorder results in numerous consequences, the truth is it’s also a medical illness. Like other illnesses, the most effective treatment is a medication. Medications for opioid use disorder, such as methadone and buprenorphine (also known as Suboxone), are a proven, evidence-based treatment. In fact, these medications are even more effective than sobriety alone at stabilizing people with opioid use disorder. These medications can be a crucial tool in treating the disorder and preventing overdose.

Medications are not just a medical solution to treat opioid use disorder – they are a lifeline to improve the health of our patients and our community. Medications are a safe and effective course of treatment that supports people who choose to reduce or stop their opioid use. Buprenorphine and methadone reduce cravings, treat withdrawal symptoms, support long-term recovery, and lower the risk of fatal overdose from opioids by 50%.

I’ve seen firsthand the power of using medications to treat opioid use disorder.

One of my patients came to me in crisis. She struggled with opioid use disorder while caring for her 5-year-old child. She desperately wanted stability but couldn’t get through the withdrawals long enough to begin rebuilding her life. When she started on buprenorphine, everything shifted. Her life stabilized and she began to thrive. Today, she works with Oxford House and has helped open six new Oxford Houses in Spokane the past year, creating more low-income housing options for our community.

Providers have the power to help patients with opioid use disorder. Methadone is still highly regulated, but with the elimination of the X-Waiver in 2023, anyone with a Drug Enforcement Agency license can prescribe buprenorphine. Yet, many health care providers fall short. Some are hesitant to prescribe medications because of uncertainty or common misconceptions, including the belief that abstinence is a better strategy due to stigma of being dependent on a medication. This isn’t true. Buprenorphine does not produce the high that opioids do, but it does directly address the cravings and debilitating withdrawal symptoms that come with stopping opioid use without medication. In every study, medications outperforms abstinence only or psychosocial treatments only.

The reality is that people in remission from opioid use are at risk of relapse and overdose for the rest of their lives. Treatment with medications has been proven to be the most effective at reducing risk of overdose compared to other treatments, including inpatient treatment.

Medications for opioid use disorder don’t just stabilize the patient, they stabilize the community. Using medications leads to fewer emergency room visits, reduces reliance on emergency medical services, decreases public intoxication and lowers public costs. Voluntary public health initiatives like University of Washington Medicine’s Telebuprenorphine Program or Boulder Care have come from outside of our community to provide medications. The gaps are closing, but we still have an opportunity to address our own public health crisis rather than rely on outsiders.

Change starts with the health care providers here in our community. We can do more and do better. The opioid crisis is treatable and I’m calling on my peers: When you treat a patient with opioid use disorder, lead with the right treatment. The process of making buprenorphine more accessible to patients starts with the health care providers here in our community being willing to offer it.

The good news is we have resources available to guide us to become better health care practitioners. New tools at ScalaNW.org/MOUD provide guidance on the benefits of MOUD and how to implement it into practice. UW’s Psychiatry Consultation Line offers a supportive network of providers who can advise on treatment for specific patients.

If you are a clinician who sees patients with opioid use disorder, I urge you to consider incorporating buprenorphine as a standard part of your care. It’s an opportunity to uplift the Spokane community and to help your patients thrive.

Amy Burns, M.D., is a dual board-certified psychiatrist and addiction medicine specialist working in Spokane.