Why Patients Struggle to Access Mental Health and Addiction Treatment Medications

Pharmacy Times interviews Allison Burns, PharmD, RPh, the CEO of End Mass Overdose (EMO) Health to discuss why patients struggle to access mental health and addiction treatment medications.

Burns discussed the logistical and system-level barriers that can prevent patients in correctional, detoxification, rehabilitation, and congregate care settings from accessing appropriate mental health and substance use disorder medications. According to Burns, while some states have expanded access to medications for opioid use disorder within correctional facilities, availability remains inconsistent across institutions.

One significant challenge is that not all correctional facilities offer medications such as methadone or buprenorphine. Burns noted that individuals entering correctional settings may already be receiving these therapies and can experience withdrawal if treatment is interrupted. In facilities where certain medications are unavailable, clinicians must carefully consider treatment transitions, as initiating alternative therapies before opioids have fully cleared from a patient's system may trigger severe withdrawal symptoms.

Beyond medication availability, Burns emphasized the operational requirements necessary to support treatment programs in correctional facilities. Medications must be included on approved formularies, facilities must maintain adequate inventory, and systems must be in place to securely store and manage medications. Without these resources, patient access can be limited regardless of clinical need.

In congregate care and rehabilitation settings, Burns explained that barriers often stem from medication management and coordination challenges. Many facilities do not have an on-site pharmacy, requiring medications to be delivered from outside pharmacies or supplied by patients themselves. As a result, facilities must establish policies, medication storage procedures, and safeguards to ensure medications are properly handled and administered. Accurate medication identification and adherence to established medication administration practices are particularly important when managing large numbers of patients receiving similar therapies.

Burns also highlighted continuity of care as a persistent concern. Patients transitioning between treatment settings may lose access to prescribers or face delays in obtaining prescriptions after discharge. Ultimately, Burns noted that many of the most significant barriers are logistical in nature, including securing prescribers, obtaining medications, coordinating delivery, and ensuring patients can continue therapy as they move through different levels of care.