Substantially more people in the United States with opioid use disorder are receiving evidence-based treatment for the disease, but there are still considerable gaps in care along racial lines, a new study shows.
The results, the largest analysis to date of opioid use disorder among Medicaid recipients, provide insights that policymakers and medical providers can act on to improve access to quality care for opioid use disorder, one of the leading causes of death in the US.
“Medicaid plays an incredibly important role in our health system, and the population it serves overlaps with those most likely to have opioid use disorder. But Medicaid is 50-plus separate programs that can’t easily share data,” says co-author Julie Donohue, chair and professor in the health policy and management department in the Graduate School of Public Health at the University of Pittsburgh.
“For the first time, we’ve pooled a large part of that data, enabling us to draw powerful conclusions that could better enable our country to address the opioid epidemic, which has only grown more intense during the COVID-19 pandemic.”
The prevalence of opioid use disorder increased from 3.3% of enrollees in 2014 to 5% in 2018. Notably, the share of enrollees with opioid use disorder enrolled in Medicaid due to the ACA expansion grew from 27.3% to 50.7% in the same time period.
“This demonstrates that state Medicaid expansion provided access to care for a population that needed to be engaged in the health care system,” says Donohue. “Opioid use disorder can be treated, just like any other disease, but treatment is most successful when the patient has regular, unimpeded access to trained clinicians who can not only treat the disorder, but also oversee the rest of their health care.”
There are several medications—buprenorphine, methadone, and naltrexone—to treat opioid use disorder. These medications work best when taken continuously, so the MODRN team looked at several indicators of quality of care, including at least one period of 180 days of continuous medication, at least one order for a urine drug test and at least one claim for behavioral health counseling.
Read the full article about opioid addiction by Allison Hydzik at Futurity.
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