“Beyond the False Dichotomy” Bridging the MOUD-Mutual Help Group Divide

Wayne Kepner, PhD, MPH
Stanford University

ABSTRACT:
A significant barrier to addressing the opioid crisis is the "false dichotomy" between two of our most effective strategies; medications for opioid use disorder (MOUD) and 12-step mutual help groups (MHG). MOUD is the most effective pharmacological treatment to reduce mortality, while MHGs provide invaluable access to peer-based recovery capital. A fragmented system of care exists despite evidence that combining these approaches yields superior outcomes. Facilities offering recovery support services are nearly eight times more likely to exclude MOUD patients, forcing individuals to navigate seemingly incompatible systems where they may be discouraged from MOUD use, increasing risks of treatment discontinuation and overdose.