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Opioid Medications Reach Just 20% of U.S. Opioid Strugglers – Study

The persistent and troubling U.S. opioid abuse epidemic remains a critical issue, as overdose deaths continue to soar. Despite the availability of potentially life-saving medications like methadone, buprenorphine, and naltrexone, a recent study reveals that only 1 in 5 individuals grappling with opioid addiction actually receives these essential treatments. This alarming revelation underscores the urgent need to bridge the gap between medical interventions and the individuals who desperately require them.

Dr. Wilson Compton, the study’s author and deputy director of the U.S. National Institute on Drug Abuse, emphasizes the effectiveness of medications like methadone, buprenorphine, and naltrexone in addressing opioid addiction. These medications are capable of managing both prescription opioids like hydrocodone and oxycodone, as well as illicit street opioids such as fentanyl and heroin. Despite their potential to counteract the devastating impact of opioid misuse, the study indicates that a vast majority of people grappling with opioid use disorder remain without access to these critical medications.

The research, based on an analysis of data from the 2021 National Survey on Drug Use and Health, highlights the severity of the crisis. Approximately 2.5 million adults aged 18 and above struggled with opioid use disorder in the previous year, and tragically, nearly 107,000 individuals lost their lives to drug overdoses in 2021, with opioids involved in a staggering 75% of those fatalities. Despite these grim statistics, the survey found that merely 36% of those affected received any form of substance use treatment, and only 22% had access to medications designed to tackle opioid use disorder.

Disturbing disparities emerge when examining certain demographics. Certain groups, including Black adults, women, unemployed individuals, and those residing in nonmetropolitan areas, faced significant barriers to accessing medications for opioid use disorder. The study revealed that white adults were 14 times more likely to receive these medications compared to their Black counterparts, while men were six times more likely than women to have access.

Furthermore, the severity of one’s opioid use disorder also played a role in determining access to medication. Individuals with more severe opioid use disorder were five times more likely to be prescribed these medications compared to those with milder forms of the disorder.

The consequences of not addressing this disparity are dire. Without timely intervention and access to appropriate medications, individuals struggling with opioid addiction remain at risk of fatal overdoses. During the COVID-19 pandemic, the federal government took steps to ease certain regulations surrounding telemedicine, leading to improved access to medications for opioid use disorder. Notably, individuals who received substance use treatment through telehealth were remarkably more likely to gain access to medications for opioid use disorder, about 38 times more likely compared to those not utilizing telehealth for treatment. This shift towards telemedicine has proved beneficial in widening access to these crucial medications and presents an opportunity to optimize the use of telehealth for controlled substances, as highlighted by Dr. Wilson Compton, the study’s author.

Beyond telemedicine, there are additional strategies to overcome barriers to medication access. One such strategy is increasing funding for states, a pivotal approach that can enhance access to medication-assisted treatment. Mobile methadone clinics, which bring medications to areas most in need, have demonstrated their potential to enhance access as well. An encouraging development is the elimination of the X-waiver requirement, which allows doctors to prescribe buprenorphine without needing a specific waiver. This change is expected to further facilitate access to this important medication for treating opioid use disorder.

Dr. Compton emphasizes the importance of having naloxone (Narcan) readily available for those with loved ones affected by opioid use disorder. Naloxone is an antidote that can reverse opioid overdoses and will soon be accessible without a prescription.

Dr. Sarah Wakeman, the medical director for substance use disorder at Mass General Brigham in Boston, finds the study’s results unsurprising. She points out that despite the severity of the ongoing overdose epidemic and the availability of effective medications, a significant number of individuals still do not receive the necessary treatments for opioid use disorder. Dr. Wakeman highlights several factors contributing to this issue, including the stigma associated with medication use, inadequate education and training among healthcare providers, and varying state laws that can act as barriers.

To enhance access to these medications, Dr. Wakeman suggests a multifaceted approach. While removing the X-waiver is a positive step, efforts should encompass a range of strategies. Timely availability of treatment upon seeking help is crucial. Special considerations need to be taken for pregnant women, as buprenorphine is considered safe during pregnancy. However, legal implications in some states might discourage women from seeking this treatment due to concerns about child abuse reporting.

The study underscores the importance of addressing these barriers and disparities in medication access for opioid use disorder. Combining efforts such as telemedicine expansion, financial support for states, and broader education and awareness initiatives can help create a comprehensive solution to tackle the ongoing opioid epidemic and improve the lives of those affected by this crisis.


Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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