Medication Treatment For Opioid Use Disorders In Substance Use Treatment Facilities

Abstract

Medication treatment (MT) is one of the few evidence-based strategies proposed to combat the current opioid epidemic. We examined national trends and correlates of offering MT in substance use treatment facilities in the United States. According to data from national surveys, the proportion of these facilities that offered any MT increased from 20.0 percent in 2007 to 36.1 percent in 2016—mainly the result of increases in offering buprenorphine and extended-release naltrexone. Only 6.1 percent of facilities offered all three MT medications in 2016. Facilities in states with higher opioid overdose death rates, facilities that accepted health insurance overall (and, more specifically, those that accepted Medicaid in states that opted to expand eligibility for Medicaid), and facilities in states with more comprehensive coverage of MT under their Medicaid plans had higher odds of offering MT. The findings highlight the persistent unmet need for MT nationally and the role of expansion of health insurance in the dissemination of these treatments.

Predicting high-risk opioid prescriptions before they are given

“…However, it faces two significant hurdles. First, MAT is not widely available to those with opioid use disorders; only 36% of substance abuse treatment facilities offer one of three different kinds of medication treatment (41). Second, even when those suffering from opioid use disorders can be connected to treatment, the costs associated with treatment are high and recovery from an opioid use disorder is challenging.…”

Comparative Effectiveness of Different Treatment Pathways for Opioid Use Disorder

“…[10][11][12][13][14][15] Many parts of the United States lack access to buprenorphine prescribers, and only a few addiction treatment programs offer all forms of MOUD. [16][17][18] This lack of access has resulted in a treatment gap of an estimated 1 million people with OUD untreated with MOUD annually. 19 Nationally representative, comparative effectiveness studies of MOUD compared with nonpharmacologic treatment are limited.…”

Opioid agonist treatment and fatal overdose risk in a state‐wide US population receiving opioid use disorder services

“…Compared to detoxification alone or behavioral treatments that do not involve medications, treatments with opioid agonists increase retention, reduce illicit opioid use and prevent infectious disease transmission [6,7]. However, in many care settings in the United States these medications are underutilized: approximately 70% of people entering specialty treatment for OUD throughout the United States do not receive opioid agonist medications [8], and most specialty treatment programs do not offer such medications [9,10]. Instead, most treatment programs offer behavioral services such as counseling, substance use screening and assessments, drug testing, outreach and case management, skill development, mentoring/peer support, education and mental health services [11].…”