Utilizing Decision Analysis to Assess the Safety of Providing Medication for Addiction Treatment to Professionals With Substance Use Disorder

Care models for professionals with substance use disorder (SUD), such as those for physicians, attorneys, military personnel and commercial pilots, currently do not have a standard method to determine whether to allow medication for addiction treatment (MAT) in profession-specific treatment plans. The decision to endorse the use of MAT involves a tradeoff between maximizing SUD relapse prevention and minimizing MAT-related adverse effects that might impact safety. We propose a decision analysis process to facilitate an objective and evidence-based use of MAT in these circumstances. Already implemented in high-reliability sectors such as aviation, decision tree analysis of quantifiable hazards and mitigating variables can be used to calculate an evidence-based risk for the number of bad outcomes with one alternative versus another. Greater data transparency from and increased resource availability to professional care models are necessary to conduct and disseminate these analyses.