Individuals with opioid use disorder (OUD) are much more likely to take buprenorphine or methadone if their treatment center offers these medications onsite, according to an analysis appearing in Psychiatric Services in Advance.
“In July 2018, Philadelphia became the first U.S. municipality to mandate the availability of medications for opioid use disorder (MOUD) in publicly funded substance use disorder treatment agencies,” wrote Rebecca E. Stewart, Ph.D. of the University of Pennsylvania Perelman School of Medicine, and colleagues. However, treatment agencies could either provide medications onsite or have a documented plan to refer patients to external MOUD providers.
The researchers reached out to the leaders of all 53 public OUD treatment agencies in Philadelphia between March and July 2020 to ask whether their site provides medications onsite or coordinates with external providers. Forty-five leaders responded, of whom 34 reported providing methadone and/or buprenorphine onsite. Stewart and colleagues then used Medicaid data to calculate how many patients of these 45 sites received methadone or buprenorphine.
Overall, 43% of the patients who went to an onsite provider received an MOUD, compared to 28% of patients at referral agencies. The researchers noted that only two of the 11 referral agencies contacted said they provided naltrexone (an OUD medication that works differently on opioid receptors than methadone or buprenorphine), so the lower prescription rate at these centers was not because they were offering an alternative.
“Agencies that coordinate with external MOUD providers may be creating barriers that impede uptake, or the clients of these agencies may be less motivated to engage with MOUD treatment,” Stewart and colleagues concluded. “Regardless, these findings highlight the need for MOUD mandates specifying how care is provided at substance use disorder treatment agencies, as well as for efforts to build the capacity of these agencies to provide MOUD onsite.”
To read more about this topic, see the Psychiatric News article “Rutgers Grad Students RIOT for Opioid Education.”
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