Study Results Show 86.6% of Individuals With OUD Do Not Receive Life-Saving Medication

Investigators from NYU’s Grossman School of Medicine sound alarm on treatment gap and suggest ways to remove barriers, as opioid overdoses soar to historic levels.

About 86.6% of individuals living with opioid use disorder (OUD) are not receiving medications that are proven to reduce opioid overdoses by more than 50%, including buprenorphine, extended-release naltrexone, and methadone, according to the results of a study by New York University’s Grossman School of Medicine.

The study, published online on August 4, 2022, in the International Journal of Drug Policy, examined the gap between new estimates of OUD prevalence and the use of medication to treat OUD. Investigators examined data on the national and state levels between 2010 and 2019.

“Our findings highlight the urgency of removing barriers to accessing medications to treat [OUD], while expanding the availability of these medications,” Noa Krawczyk, PhD, an assistant professor at the Center for Opioid Epidemiology and Policy in the Department of Population Health at NYU Langone, said in a statement.

“But what we have is way beyond a simple treatment capacity problem. We need to rethink how treatment for [OUD] is delivered, eliminate stigma, make it easier for people to enter and remain in treatment, as well as ensure that all treatment programs provide and encourage use of evidence-based medications that we know save lives,” Krawczyk said.

More than 70% of residential treatment programs across the country do not offer medication to treat OUD, she said.

Other ways to expand access to medications could include using special waivers so that more physicians can prescribe the medications and expanding the administration of these medications by community-based organizations and mobile health clinics, investigators said.

Additionally, making methadone less controlled and more accessible through avenues other than highly regulated opioid treatment programs would be beneficial and is long overdue, Krawczyk said.

The investigators used 2 different sources to determine the gap between individuals with OUD and those receiving medication: a private database of outpatient pharmacy claims that tracks prescriptions filled for buprenorphine and extended-release naltrexone and a publicly available database that tracks the dispensing of these medication by licensed methadone clinics .

They calculated the percentage change in national and state-specific rates of individuals receiving medication over the past decade and year, using rates per 100,000 individuals.

The investigators found that there was a 105.6% increase in the rate of medication receipt across the United States between 2010 until 2019. However, as of 2019, 86.6% of individuals with OUD were not receiving these medications.

The state-specific findings showed that a wide variation in past-year OUD prevalence and medication treatment gaps. They found that treatment rates were highest in Vermont at 1342.6 per 100,000 individuals and lowest in South Dakota at 66.1 per 100,000 individuals.

As of 2019, the largest treatment gaps were in Iowa at 97.3%, North Dakota at 96.1%, and Washington DC at 95.1%. The smallest treatment gaps were in Connecticut at 53.9%, Maryland at 58.1%, and Rhode Island at 58.6%.

Although all 50 states had increases in treatment rates, Washington DC had a decrease of 9.2% between 2018 and 2019.

Reference

Almost 90 percent of people with opioid use disorder not receiving life-saving medication, new study finds. News release. EurekAlert. August 4, 2022. Accessed August 8, 2022. https://www.eurekalert.org/news-releases/960588