A new study conducted by researchers at Oregon Health & Science University (OHSU) reveals significant discrepancies among US states in terms of effectively treating opioid use disorder among Medicaid recipients.
Despite the opioid overdose crisis being exacerbated by the surge of illicit fentanyl, many states are not providing adequate treatment to people with opioid use disorder covered by Medicaid.
Fewer than Half Treated
The study, which was published in the journal JAMA Health Forum, discovered that in numerous states, fewer than half of people diagnosed with opioid use disorder received evidence-based medications to treat it.
Lead author Stephan Lindner, Ph.D., an associate professor at the OHSU Center for Health Systems Effectiveness, expressed that we are failing people by not providing appropriate treatment.
Medication Should Be Universal Treatment
Co-author Dennis McCarty, Ph.D., a professor emeritus of public health at the OHSU School of Medicine and the OHSU-Portland State University School of Public Health, stated that evidence strongly suggests medication should be almost universally used to treat people with opioid use disorder.
Regional Disparities
The study documented a wide variability in access to medication for opioid use disorder.
In some Northeast states, up to 75% of Medicaid-covered patients diagnosed with the disorder received one of the three FDA-approved medications – buprenorphine, methadone, or naltrexone.
In contrast, fewer than 25% of Medicaid recipients diagnosed with opioid use disorder in the Midwest and the South received one of these medications.
Oregon was approximately in the middle, with a rate of 61%, slightly above the nationwide average of 55%. However, in some counties, the rate was less than 10%.
Quality of Care Problems
The wide variability suggests problems with the quality of care and reveals missed opportunities to intervene before fatal and nonfatal overdoses occur.
A record 109,000 people in the U.S. died of drug overdoses in 2022, according to provisional data released by the Centers for Disease Control and Prevention.
Study Limitations
Researchers conducted the study using a newly available set of Medicaid claims data, examining claims among individuals enrolled in Medicaid between 2016 and 2018 at the state and county level.
The study’s limitations include the quality of data across states and the fact that Medicaid claims records only capture people with opioid use disorder who are in contact with health care professionals.
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The study was published in JAMA Health Forum.
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