Opioid addiction continues to be a serious crisis in the United States, harming individuals, families, and entire communities.
Every year, tens of thousands of people die from opioid overdoses, many involving powerful synthetic drugs like fentanyl.
But even when people survive an overdose and are treated in emergency rooms, they often do not receive follow-up care that could save their lives.
A major study led by researchers at the University of Michigan reveals that only a very small number of overdose patients receive proven medications that treat opioid addiction. These medications, known as MOUD (medications for opioid use disorder), include drugs like buprenorphine, methadone, and extended-release naltrexone.
The study looked at data from over 249,000 emergency department visits from patients aged 15 to 64 across all 50 states and Washington, D.C., using Medicaid records between 2016 and 2020. Medicaid is the biggest payer for addiction treatment in the U.S., so this data offers an important picture of what’s happening nationwide.
The results were disappointing. Only 6% of patients received any MOUD within 30 days after being treated for an overdose—just 1 out of every 16 patients.
This means that most people left the hospital without the support they needed to manage their addiction and avoid another overdose. This is especially concerning because the risk of a fatal overdose is much higher in the months following a nonfatal overdose.
The study found troubling differences in who received treatment. White patients were more likely to get MOUD, with 7.3% receiving medications.
In comparison, only 4.3% of Black patients, 5.2% of Asian patients, 5.4% of American Indian and Alaska Native patients, and 4.9% of Hispanic patients received MOUD. The gap between Black and white patients grew wider over the study period, even though overdose rates have been rising faster in Black communities.
The researchers also examined which drugs were used. Buprenorphine was prescribed most often, with 4.7% of patients receiving it. Methadone was used in 1% of cases, and extended-release naltrexone in 0.8%.
Patients in the Northeast had the highest rate of treatment at 8.6%, while the West had the lowest at 5%. The gap between Black and white patients was smallest in the West. There wasn’t a large difference between urban and rural patients.
Dr. Thuy Nguyen, the study’s lead author, says that emergency rooms offer a critical chance to start people on addiction treatment. But many barriers stand in the way. Some doctors may not be trained to treat opioid addiction or may not have time during a busy shift.
There’s also still stigma around addiction that can stop both doctors and patients from discussing treatment. Race and ethnicity may also affect whether someone gets treatment, possibly reflecting deeper issues like bias or unequal access to care.
The study makes it clear that more needs to be done. Emergency departments can help prevent future overdoses, save lives, and reduce stress on the healthcare system by starting addiction treatment right after an overdose.
Nguyen says that helping patients in this way could reduce repeat visits to the ER and help hospitals care more effectively for people who often lack a regular doctor.
Importantly, the study reminds us that starting medication is only the first step. Patients need support to stick with treatment and overcome other barriers like cost, transportation, and lack of follow-up care.
This research shows that improving care after overdoses could make a big difference. Giving more people access to life-saving medication—regardless of their race or where they live—could prevent deaths and help communities heal from the effects of the opioid crisis.
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The study is published in Health Affairs.
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