CHI Health’s Addiction Specialist Rob Rymowicz Calls for Updated Evidence-Based Protocols in Opioid Use Disorder Treatment
Omaha, NE, 8th December 2025- As opioid-related morbidity continues to surge nationwide, Rob Rymowicz, D.O., addiction psychiatrist at CHI Health, is calling for a system-wide update to opioid use disorder (OUD) treatment protocols to better reflect modern neurobiological insights, patient-centered care models, and evolving medication-assisted treatment (MAT) strategies. Through his clinical leadership and educational work, Rob Rymowicz emphasizes that OUD is a chronic, relapsing medical condition requiring structured, science-driven frameworks rather than outdated or fragmented approaches.
The announcement comes at a critical time. New synthetic opioids, variable fentanyl analogs, and polysubstance use have reshaped the clinical landscape, making traditional detox-first or abstinence-only approaches insufficient for long-term recovery. Rob Rymowicz, known for his work bridging addiction neuroscience with front-line clinical practice, asserts that updated protocols are no longer optional—they are essential for patient safety and treatment efficacy.
A Science-Based Framework Designed for Modern Opioid Realities
Central to Rob Rymowicz’s call for updated protocols is the growing understanding of the opioid-altered brain. OUD profoundly affects reward circuits, stress pathways, pain processing, and emotional regulation. According to Dr. Rymowicz, any effective treatment model must address these changes through a combination of medication, behavioral therapy, and long-term support structures.
His proposed framework includes:
- Individualized Medication-Assisted Treatment
Matching patients to the most appropriate MAT option—buprenorphine, methadone, or naltrexone—based on neurobiological patterns, craving intensity, and relapse risk. - Craving-Mapping and Compulsion Interruption
Borrowing from models used in stimulant and behavioral addictions, Rob Rymowicz highlights structured craving identification, pattern mapping, and compulsion-interruption techniques to break the anticipatory reward cycle that fuels opioid use. - Emotional-Regulation–Focused Interventions
Addressing trauma histories, chronic stress, and dysregulated mood states that often precede opioid use or relapse. - Long-Term Maintenance and Relapse Prevention
Emphasizing ongoing care, continuous medication access, and predictable follow-up—not short-term crisis stabilization.
These components form a comprehensive model intended to reduce relapse rates and improve patient stability.
Updated MAT Protocols: A Cornerstone of Rymowicz’s Initiative
One of the most significant areas calling for revision, according to Rob Rymowicz, is medication-assisted treatment. Despite overwhelming evidence supporting MAT as the gold standard, variability in prescribing practices and adherence to outdated detox mandates continue to limit patient outcomes.
In the materials and clinical insights aligned with his professional work, Rob Rymowicz highlights several key recommendations:
- Ending “MAT Hesitancy” in Clinical Settings
Many patients encounter clinicians who remain resistant to prescribing buprenorphine or methadone, despite FDA-approved evidence. Dr. Rymowicz urges health systems to build clinician confidence through structured training, reducing stigma around these medications.
- Improved Buprenorphine Induction Pathways
Traditional induction models often fail in the era of high-potency fentanyl. Dr. Rymowicz supports micro-induction and tailored dosing strategies to minimize withdrawal, improve patient comfort, and increase retention.
- Sustained MAT Rather Than Premature Discontinuation
Dr. Rymowicz stresses that early medication tapering dramatically increases relapse and overdose risk. Updated guidelines should emphasize duration-based decision-making rather than arbitrary time limits.
- Integrating MAT With Neuroscience-Informed Behavioral Interventions
MAT stabilizes reward pathways but must be paired with cognitive-behavioral frameworks that address compulsive drug-seeking and emotional triggers.
Addressing Cravings: A Key Component of the Updated Protocol
A consistent theme in Rob Rymowicz’s work is the central role of cravings in relapse. Unlike pain or withdrawal, cravings activate anticipatory reward circuits that operate independently of physical symptoms. Dr. Rymowicz advocates for clearer tools that help both clinicians and patients understand, track, and disrupt cravings.
According to his framework, cravings emerge from:
- conditioned cues,
- stress-response activation,
- sensory reminders,
- emotional dysregulation, and
- reward anticipation loops.
Dr. Rymowicz encourages treatment teams to use “craving diaries,” trigger mapping, and structured interruption strategies—tactics widely recognized in the treatment of stimulant and gambling disorders, and well-reflected in the content he has authored and contributed to.
Addressing Polysubstance Use in Updated Protocols
Another urgent focus area identified by Rob Rymowicz is polysubstance use, particularly combined opioid-stimulant patterns. Traditional treatment silos fail to address the ways stimulants alter emotional states, increase impulsivity, and amplify opioid cravings.
His updated protocol recommendations include dual-track interventions that simultaneously treat:
- opioid-driven withdrawal and cravings,
- stimulant-related reward-circuit disruption, and
- emotional drivers common to both classes of substances.
Patient-Centered Philosophy at the Core
Despite the scientific depth of his approach, Rob Rymowicz consistently emphasizes compassion, patient dignity, and stigma reduction. OUD patients, he notes, are often navigating neurobiological and emotional challenges—not moral failures. Updated protocols must therefore humanize care and ensure that patients feel safe, understood, and supported.
“Effective opioid treatment requires recognizing the predictable patterns of the disorder and providing patients with clear, structured tools—not blame or judgment,” says Rob Rymowicz in clinical guidance materials.
A Call to Action for 2025
As the opioid epidemic evolves, so must the clinical frameworks used to treat it. Through his work at CHI Health and his ongoing contributions to addiction-focused education, Rob Rymowicz, D.O., is urging health systems, clinicians, and policymakers to adopt updated, evidence-based protocols that reflect the realities of modern opioid use.
His message is clear: OUD treatment must be scientific, structured, and deeply human. Without change, preventable overdose deaths will continue. With the right protocols, recovery becomes not only possible—but predictable.
