Treatment for Opioid Abuse Grows, but Many on Medicaid Don’t Receive It

MONDAY, July 2, 2018 — Approval of the drug buprenorphine led to a rise in the number of Medicaid patients getting medication to treat opioid addiction. But the rates were lower among poor, black and Hispanic patients, a new study says.

Methadone or buprenorphine are recommended treatments for opioid-abuse disorders. Methadone must be dispensed in special clinics and often requires daily visits, while buprenorphine can be prescribed by any specially certified physician, the researchers noted.

They analyzed Medicaid claims in 14 states between 2002, when buprenorphine was approved in the United States, and 2009. That period saw a 62 percent increase in Medicaid patients getting medication-aided treatment for opioid abuse.

By 2009, buprenorphine accounted for nearly one-third of medication-aided treatment, according to investigators at the RAND Corp., a nonprofit research organization.

Despite the overall increase, patients in counties with more poverty and higher percentages of blacks and Hispanics were much less likely to receive medication-aided treatment as of 2009.

While patients in urban counties were much more likely to get medication-aided treatment than those in rural counties, the gap narrowed during the study period.

Opioid abuse affects about 9 out of every 1,000 Americans, and opioid overdose-related deaths have quadrupled over the past 15 years. Medicaid is the payment source for more than one-third of all opioid treatment cases, according to the researchers.

“These findings highlight the good news that medication therapy is being used more widely to combat the nation’s opioid epidemic,” study lead author Dr. Bradley Stein said in a RAND news release.

“But it also raises concerns that there are racial/ethnic and income disparities that may prevent many individuals struggling with opioid addiction from receiving effective treatment,” said Stein, a senior physician scientist.

The expansion of medication-aided treatment appears to have created new health care disparities, he said.

“We need research using more current information to better understand whether the disparity is linked to the availability of medication-assisted therapy, differences in Medicaid eligibility or some other factor, and whether it has persisted,” Stein added.

States in the study included California, Connecticut, Florida, Georgia, Illinois, Louisiana, Massachusetts, Maryland, New York, Pennsylvania, Rhode Island, Texas, Vermont and Wisconsin. They account for almost half of the nation’s Medicaid recipients.

The findings were published online recently in the journal Substance Abuse.

More information

The U.S. National Institute on Drug Abuse has more about opioid addiction treatments.

Posted: July 2018

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