Barely 25% of people with opioid use disorder (OUD) get the medicines proven to treat it, buprenorphine or methadone, a new study found. Almost half get no medicine at all. The rest get other drugs. That treatment gap helps explain why OUD deaths are not falling as fast as they should.
Summary: Less than 4% of people prescribed opioids may need treatment for opioid use disorder (OUD). But a new study shows that barely 25% of them get buprenorphine or methadone for OUD. Almost half get no medicine at all, and the rest get other medicines. That may explain why so many people with OUD are still dying. The study found several reasons for this.
The opioid epidemic is a major problem in the US. It causes more than 80,000 deaths each year. Luckily, deaths from opioid use disorder (OUD) are falling. Sadly, they are not falling as fast as expected. A new study suggests one cause: many people simply do not get medicine to manage OUD.
Opioids are still among the strongest painkillers. Many painful conditions are best treated with opioids. Only a small number of people prescribed opioids develop OUD. So OUD is no reason to stop opioid use completely. Millions of people benefit from opioids, with better pain control and quality of life.
For the small number of people with OUD, it is key to diagnose it early and give proper care or medical treatment, like telehealth addiction treatment. But many people with OUD simply do not get the right treatment. That leads to poor results.
This new study was published in one of the CDC’s weekly reports. It looked at a large body of data on OUD treatment.
In this new study, researchers looked at data from the 2022 National Survey on Drug Use and Health (NSDUH). About 3.7% of all people who use opioids need treatment for OUD. But barely 25% of those who need OUD treatment get their medicine.
That is not all. They also found gaps by race. Black patients were even less likely than white patients to get medicine for OUD.
OUD is treated with medicines like buprenorphine and methadone. Both are milder, safer opioids. But the data makes clear that doctors are slow to prescribe them.
The study found that almost half of all patients were treated without medicine. The rest got medicines, but not buprenorphine or methadone, the two proven to work and save lives. All this leads to poor treatment and harm.
Most doctors seem too worried that their patients might start abusing the treatment drugs too. They seem to judge their patients too harshly. Researchers say doctors need a nonjudgmental approach to build trust with patients.
Many doctors also believed that using certain medicines for OUD is the same as promoting illegal drug use. But there are also rules that get in the way. Methadone can only be given out by an opioid treatment program (OTP) certified by the Substance Abuse and Mental Health Services Administration. Many counties have no OTP, so doctors have no choice.
Buprenorphine is easier to get. But many pharmacies do not stock it, for various reasons. There are also some legal hurdles to prescribing it. Many doctors simply cannot prescribe it, have too little experience or have many concerns.
Put simply, OUD affects a small number of people prescribed opioids for chronic pain. Many OUD deaths could be prevented by giving OUD medicine to more patients.
Source:
Dowell, D. (2024). Treatment for Opioid Use Disorder: Population Estimates — United States, 2022. MMWR. Morbidity and Mortality Weekly Report, 73. https://doi.org/10.15585/mmwr.mm7325a1
Related reading: Buprenorphine Treatment Gaps Raise Overdose Risk · Chronic Pain and Opioid Use Disorder · New Approach to Addiction Treatment · Opioid Addiction Treatment in St. Louis