There is a massive treatment gap across the United States impacting people living with opioid use disorder (OUD), according to a new study from the International Journal of Drug Policy.
OUD addiction and fatalities are on the rise—drug overdose deaths increased significantly during the pandemic, and CDC data shows that opioids were responsible for the majority of drug overdose deaths in the last year, the study said.
But at the same time, despite a decade of work within the field to increase treatment capacity across the U.S., proven medical treatment for opioid addiction has failed to reach the vast majority of people who need it, said the study. led by researchers at the New York University Grossman School of Medicine, along with collaborators from Columbia University, and the National Center for Injury Prevention and Control .
“More than 70 percent of residential treatment programs across the country do not offer (medications for) OUD (*MOUD),” said Noa Krawczyk, PhD, an assistant professor in the Department of Population Health, a member of the Center for Opioid Epidemiology and Policy at NYU Langone.
“Other ways to expand access to MOUD could include removing special waiver requirements so that more physicians can prescribe buprenorphine, as well as expanding the deployment of MOUD by mobile health clinics and community-based organizations, and within the criminal justice system.”
Researchers estimated that of over 7.6 million people with opioid use disorder in the U.S., just over 1 million people received medications for opioid use disorder (MOUD). That leaves 86.6 percent of people with OUD untreated by medications that may help them.
A 2021 investigation for the Journal of the American Medical Association reviewing and analyzing mortality data for people with opioid dependence found that treatment with MOUD decreased overdose risk by over 50 percent.
These medications can be tough to access when you need them.
FDA-approved MOUD include methadone, buprenorphine and extended-release naltrexone. Each has its own limitations – methadone can only be dispensed by opioid treatment programs and buprenorphine can be prescribed by providers but only under waivers issued by application through the Substance Abuse and Mental Health Services Administration.
Naltrexone can be more widely prescribed and administered, but since it is predominantly used for treating alcohol use disorder it’s hard to track its impact on people with OUD. Naltrexone treatment is excluded from the Langone data.
MOUD treatment did increase over 100 percent between 2010 to 2019, but with the surge in opioid addiction, that increase failed to close the gap and the percentage of people with OUD receiving MOUD grew by just 8.5 percent in a decade.
“Improving initial access to MOUD is only the first step – our research and health systems have a long way to go in addressing the needs of people with OUD to support retention in treatment and services to effectively reduce overdose and improve long-term health and well-being,” authors of the study concluded.
Audrey Nielsen is a TCR Justice Reporting intern.