National and State Treatment Need and Capacity for Opioid Agonist Medication-Assisted Treatment

Abstract

Significant gaps between treatment need and capacity exist at the state and national levels. Strategies to increase the number of OA-MAT providers are needed.

CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016

“…Recent studies among patients with prescription opioid dependence (based on DSM-IV criteria) have found maintenance therapy with buprenorphine and buprenorphinenaloxone effective in preventing relapse (216,217). Treatment need in a community is often not met by capacity to provide buprenorphine or methadone maintenance therapy (218), and patient cost can be a barrier to buprenorphine treatment because insurance coverage of buprenorphine for opioid use disorder is often limited (219). Oral or long-acting injectable formulations of naltrexone can also be used as medicationassisted treatment for opioid use disorder in nonpregnant adults, particularly for highly motivated persons (220,221).…”

Inpatient Management of Opioid Use Disorder: A Review for Hospitalists

“…As of 2012, there were an estimated 2.3 million individuals with OUD; however, more than 1 million of these individuals do not have access to treatment. 44 As a result, many addiction treatment programs have wait lists that can last months or even years. 45 These shortages are especially apparent in rural areas, where individuals with OUD are particularly reliant upon buprenorphine treatment because of prohibitive travel times to urban-based programs.…”

Increasing Access to Medication-Assisted Treatment for Opioid Use Disorders: Estimating Costs, Supply, and the Effects of Insurance Expansions

“…Buprenorphine is a cost-effective evidence-based MAT that reduces morbidity, mortality, hospitalizations and emergency visits associated with relapse, and increases retention in treatment among those with an opioid use disorder, Doran, Shanahan, Mattick et al, 2003;Manhapra, Rosenheck, & Fiellin, 2017;Mattick, Ali, White et al, 2003;Mattick, Kimber, Breen, & Davoli, 2008;Sordo et al, 2017). Despite its proven effectiveness, the supply of these medications did not keep pace with the increase in people with OUD in America (C. M. Jones et al, 2015;Pacula, Gordon, Dick et al, 2015;Volkow, Frieden, Hyde, & Cha, 2014). Because people diagnosed with an OUD may need to pay for these medications for an extended period, as is the case for patients with other chronic diseases, financial costs may be one of the most important barriers to treatment.…”