Study on Medications for Opioid Use Disorder in Residential Treatment Facilities

Background of the Opioid Crisis

A recent study has explored the differences in the availability and utilization of medications for opioid use disorder (OUD) within residential treatment facilities. Opioids, a class of drugs primarily prescribed for pain management, saw a significant increase in prescriptions during the late 1990s. This surge led to widespread misuse and highlighted the addictive potential of these medications, culminating in a dramatic rise in overdose deaths. Between 1999 and 2017, approximately 400,000 individuals succumbed to opioid drug overdoses. The Centers for Disease Control and Prevention (CDC) reports that, on average, over 130 people die from opioid overdoses each day. In 2017, the Health and Human Services (HHS) declared the opioid crisis a public health emergency in the United States.

Research Objectives and Methodology

Many individuals grappling with opioid addiction seek help at residential addiction treatment centers. However, the extent of medication availability and its use for treating OUD in these facilities remains unclear. Researchers from Johns Hopkins University conducted a study to address this gap. Published in JAMA Network Open, the study analyzed data from 2,863 residential facilities and over 230,000 admissions across the United States in 2017. The research utilized publicly available databases, including the 2017 National Survey of Substance Abuse Treatment Services and the 2017 Treatment Episode Data Set–Admissions.

Key Findings

The study found that the availability and use of medications for OUD were notably low in most residential treatment facilities nationwide. In states that expanded Medicaid under the Patient Protection and Affordable Care Act, nearly 18 percent of patients admitted to these facilities utilized medications as part of their treatment plans. Conversely, only about 2 percent of patients accessed these medications in states that did not expand Medicaid.

The research also indicated that the use of medications for OUD was highest in states with Medicaid expansion and without prescriber restrictions for Medicaid reimbursement. In contrast, the lowest usage rates were observed in states that resisted Medicaid expansion and imposed restrictions on prescribers. These findings suggest that residential facilities located in states lacking Medicaid expansion or facing prescriber restrictions experienced reduced availability and use of medications for OUD.

Implications for Public Health Policy

The study highlights that various factors, including legal and regulatory barriers to prescribing opioids, may hinder residential treatment facilities from offering medications for OUD. The researchers advocate for public health and policy initiatives aimed at enhancing the availability and usage of these medications, which could lead to improved treatment outcomes for individuals with opioid addiction. They propose that expanding Medicaid and easing prescriber restrictions on Medicaid reimbursement could significantly increase the accessibility and utilization of medications for OUD in residential treatment settings.

References

Huhn AS, Hobelmann JG, Strickland JC et al. (2020). Differences in Availability and Use of Medications for Opioid Use Disorder in Residential Treatment Settings in the United States. JAMA Netw Open. doi: 10.1001/jamanetworkopen.2019.20843

What is the U.S. Opioid Epidemic? https://www.hhs.gov/opioids/about-the-epidemic/index.html

Opioid Overdose https://www.cdc.gov/drugoverdose/epidemic/index.html

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