A new study by the University of Michigan suggests that emergency departments (EDs) may be missing vital opportunities to curb opioid addiction and overdose fatalities.
Researchers led by Thuy Nguyen of U-M’s School of Public Health found that less than 20% of Medicaid patients treated for opioid overdoses in emergency departments were prescribed FDA-approved medications for opioid use disorder (OUD), such as buprenorphine, methadone, and extended-release naltrexone, despite their proven efficacy.
The Scale of the Crisis and Missed Opportunities
The opioid crisis continues to grip the U.S., with a record 81,000 overdose deaths in 2021. Nguyen points out, “There are nearly 2 million opioid-related visits to emergency departments in the U.S. each year.”
The low rate of medication initiation for OUD suggests a significant gap in the current approach to treatment.
Barriers to Effective Treatment
The study identified several obstacles that contribute to the low rate of medication initiation for OUD, including:
- Limited availability of healthcare providers offering such treatments in the community.
- Lack of adequate training and resources for healthcare providers on OUD medications.
- Poor referral systems between emergency departments and outpatient treatment facilities.
Regional Differences Show Room for Improvement
Interestingly, eight states in the U.S.—Massachusetts, Rhode Island, Vermont, New Hampshire, Maine, Connecticut, Pennsylvania, and Maryland—had higher rates of initiation (between 20%-34%) of OUD medications following ED visits for opioid overdose.
This variation indicates that “better performance is possible,” according to Nguyen.
Implications for Policy and Healthcare
If EDs can overcome these barriers, they have the potential to play a crucial role in mitigating the opioid crisis.
Increasing the initiation of FDA-approved medications for OUD during or after emergency department visits could significantly reduce the risk of subsequent overdoses and fatalities.
Nguyen suggests that insights from better-performing states could guide future policy strategies aimed at boosting treatment access following ED visits.
A Multi-Disciplinary Approach
The study included experts from various fields, including Pediatrics, Health Management and Policy, Anesthesiology, and General Medicine.
This diverse team reflects the complexity of the opioid crisis and suggests that a multi-disciplinary approach will be key to tackling it effectively.
The Way Forward
While the study shines a light on a glaring gap in the current response to the opioid crisis, it also provides a roadmap for improvement.
Policymakers and healthcare providers should consider these findings as they seek innovative solutions to a complex and ongoing public health crisis.
By leveraging the unique position of emergency departments as first points of contact, there is an opportunity to make a significant impact on the opioid epidemic.
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