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Opioid Epidemic: Medication-Assisted Treatment Need Significantly Exceeds Capacity


U.S Department of Health & Human Services (HHS.gov)

June 11, 2015

A new study published today in the American Journal of Public Health indicates that increased access to methadone or buprenorphine-based medication-assisted treatment (MAT) is critical to fully address the epidemic of opioid abuse and dependence in the United States. MAT is a comprehensive approach to address substance use disorders that combines the use of medication with counseling and behavioral therapies. Despite an increase in medication-assisted treatment capacity nationwide in the past decade, the rate of past-year opioid abuse or dependence significantly exceeded treatment capacity each year, increasing from 634.1 per 100,000 in 2003 to 891.8 per 100,000 in 2012.

The study "National and State Treatment Need and Capacity for Opioid Agonist Medication-Assisted Treatment," conducted by researchers at the Food and Drug Administration, the Substance Abuse and Mental Health Services Administration, and the Centers for Disease Control and Prevention, looked at the discrepancy between the need for MAT and the capacity of treatment programs to provide MAT.

The study shows that in 2012, the number of people who abused opioids or were dependent, had increased to an estimated 2.3 million people; however, the maximum number of people who could access opioid-agonist based MAT was approximately 1.4 million - a gap of nearly 1 million people. Nationally, 82 percent of federally regulated Opioid Treatment Programs reported operating at 80 percent capacity or more.

"Opioid drug abuse is a devastating epidemic facing our nation," said Richard Frank, assistant secretary for planning and evaluation, whose office is coordinating the Department's opioid initiative. "Each day more than 60 people die from an opioid-related overdose. MAT has been shown to increase treatment retention and reduce opioid use, effectively treating opioid use disorders. Connecting people in need to the right treatment is critical to saving lives and addressing the opioid epidemic."

The study concludes a number of actions that can be taken to address the treatment gap, including:

Expanding the addiction professionals workforce and the existing pool of MAT providers will increase access to opioid treatment programs;
Creating clinical practice and reimbursement environments to facilitate clinician provision of MAT services;

Supporting programs that use onsite mentors and access to experienced clinicians to help provide the skills needed to implement office-based MAT;

Adopting remote forms of behavioral therapy to make existing trained professionals more accessible to those in underserved or isolated communities;

and coupling strategies that expand access to MAT with interventions that target the underlying drivers of the problem-inappropriate opioid pain reliever prescribing and use-such as implementation of opioid prescribing guidelines and education programs, development of real-time, interoperable state prescription drug-monitoring programs, and implementation of laws, regulations, or policies that better monitor and regulate providers who might be indiscriminately prescribing opioids.

HHS Secretary Sylvia M. Burwell has made addressing opioid abuse, dependence, and overdose a priority and work is underway within HHS on this important issue. The Secretary's evidence-based initiative focus on three promising areas: informing opioid prescribing practices, increasing the use of naloxone - a drug that reverses symptoms of a drug overdose, and using medication-assisted treatment to slowly move people out of opioid addiction.

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