Many Medicaid Patients with Opioid Use Disorder Lack Treatment

Many Medicaid Patients with Opioid Use Disorder Lack Treatment

The Untapped Potential: Improving Access to Medication for Opioid Addiction


“Medicaid is uniquely positioned to achieve these goals, given that the program is estimated to cover almost 40% of non-elderly adults with opioid use disorder.” – U.S. Department of Health and Human Services

In the battle against opioid addiction, medications that can help reduce cravings have been proven effective. However, a recent report from the U.S. Department of Health and Human Services revealed a troubling statistic – nearly a third of Medicaid recipients dealing with opioid addiction are not receiving these life-changing medications.

The report, based on 2021 enrollment, eligibility, and claims data, highlights significant disparities in who has access to medication, based on factors such as age, race, and state of residence. With Medicaid covering approximately 40% of non-elderly adults with opioid use disorder, improving access to these treatments is crucial.

Medications for addiction, including methadone, buprenorphine, and naltrexone, have been shown to be effective in assisting individuals struggling with opioid addiction. Yet, the report reveals that over half a million Medicaid recipients with opioid use disorder did not receive these medications.

Dr. Bradley Stein, director of the RAND Opioid Policy Center, expressed surprise at the numbers, asserting that the actual percentage of individuals not receiving treatment could be even higher. He emphasizes the need to address this inequity, stating, “Things are not where they need to be, and I’m asking: Are the successes things we’re going to be able to sustain or not?”

The report further highlights the disparities among different demographic groups. In the 15 states with available data on race and ethnicity, only 53% of Black patients with opioid use disorder received medication compared to 70% of their white counterparts. This discrepancy is especially concerning in light of the significant increase in overdose deaths among Black individuals.

Age also plays a role in access to opioid addiction medication. Only 11% of those under 19 received the necessary treatment, while 70% of those aged 19 to 44 were fortunate enough to access these medications. The statistics are similarly disheartening for individuals aged 65 and above, with less than half receiving the medications they need.

State policies regarding medication coverage vary widely, contributing to the unequal distribution. For instance, Rhode Island and Vermont boast coverage rates of nearly 90%, whereas Illinois and Mississippi fall behind with coverage rates of less than 40%. This discrepancy emphasizes the urgent need for consistent and equitable access to treatment across all states.

Additionally, specific states face significant challenges, as over half of their Medicaid-covered individuals with opioid use disorder did not receive necessary medications. Notable examples include populous states like Texas and New York.

The urgency to address this issue becomes even more apparent when considering that opioid overdoses claimed the lives of over 80,000 individuals in 2021 alone, reflecting a 17% increase compared to previous years.

Several barriers contribute to the inadequate access to treatment. Stigma around addiction, difficulty finding providers willing to prescribe medication, and a lack of awareness among patients create significant hurdles. To address these challenges, the report recommends that the U.S. Centers for Medicare and Medicaid Services (CMS) launch a social media campaign and create informative fact sheets.

However, some experts find these recommendations inadequate. Dr. Ayana Jordan, an associate professor of psychiatry at NYU Grossman School of Medicine, specializing in race and addiction research, criticizes the suggestions as merely encouraging action without concrete plans for resolving medication shortages in pharmacies serving minority communities. She suggests incentivizing healthcare providers to collaborate with churches and other community organizations to increase prescribing.

Dr. Jordan passionately states, “They ‘encourage, encourage, encourage’ action – what does that mean? Nothing. It is not enough… How can the federal government be involved in actually holding states accountable?” She is tired of witnessing the loss of countless patients to addiction.

The issue of inadequate access to medication for opioid addiction highlights the urgency for legislative action. Dr. Jordan reflects on the intense sorrow that accompanies addressing a crisis with limited legislative support, craving a more comprehensive and effective approach to combating addiction.

Moving forward, it is essential for policy-makers, healthcare providers, and communities to work together to ensure all individuals battling opioid addiction have access to the medications they need. Addressing disparities in access by age, race, and state of residence is crucial for achieving long-term success in the fight against opioid addiction.



QUESTION What are opioids used to treat? SOURCE: MedicineNet

Answer: Opioids are used to treat pain.