August 22, 2023

Utilization of Opioid Use Disorder Medications

The Journal of the American Medical Association (JAMA) published a new study that examines the use of medication for opioid use disorder (OUD) among adults in 2021.

Previous research has noted that only 27.8% of individuals with OUD received medication for OUD, indicating a significant gap in treatment, especially as the CDC does not recommend opioid detoxification without medications because of increased risk for resuming drug use, overdose, and death.

The study utilized data from the 2021 National Survey on Drug Use and Health, which involved 47,291 adults aged 18 or older, selected to reflect a national representation of the US civilian. The analysis of the JAMA study focused on adults with past-year OUD based on DSM-V diagnostic criteria.

In 2021, an estimated 2.5 million adults had past-year OUD. Among them:

  • 52.5% were men
  • 67.4% were aged 35 or older
  • 60.6% were non-Hispanic white
  • 52% lived in large metropolitan areas

Among adults with past-year OUD, only 35.6% received past-year substance use treatment, and only 22.3% received medication for OUD. Among those who received medication for OUD:

  • 58.5% were men
  • 61.7% were aged 35 or older
  • 67.1% were non-Hispanic white
  • 57.7% lived in large metropolitan areas

Among adults with past-year OUD, increased odds of receiving medication for OUD were seen in adults:

  • With severe past-year OUD vs mild OUD
  • Who received substance use treatment via telehealth in the past year
  • Those with family income less than $20,000 and those with family income between $20,000 and $49,999

Lower odds of receiving medication for OUD were found among women, non-Hispanic black adults, the unemployed, those living in nonmetropolitan areas, and those with past-year cannabis use disorder.

The numbers reported by JAMA are liable to change in the coming years, as access to medications for OUD, such as buprenorphine, could increase.

Efforts from a JAMA Opioid Taskforce increased the number of healthcare professionals certified to prescribe buprenorphine in office to over 85,000 – an increase of nearly 50,000 – from 2017 to 2020.

However, the passage of the Consolidated Appropriations Act of 2023 removed the federal requirements for practitioners to submit a Notice of Intent (have a waiver) to prescribe medications, like buprenorphine, for the treatment of opioid use disorder (OUD).

While more providers can prescribe buprenorphine and other OUD medications than ever before, The New York Times reports that medical schools have historically tended not to incorporate opioid addiction in their curriculum, which could mean that there is still a knowledge gap on how to approach patients suffering from OUD.

How the utilization of OUD medications changes in the next few years remains to be seen.

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