Opioid Use Disorder Treatment Gap Shrank Slightly Between 2010 and 2019, but Vast Majority of Patients Still Do Not Receive Standard of Care

This study investigated whether the gap between the number of persons with opioid use disorder (OUD) and the number who receive medications for opioid use disorder (MOUD) has narrowed over the last decade in the US. Researchers adjusted data from the National Survey on Drug Use and Health to estimate OUD prevalence in the US, and estimated MOUD receipt from other national data for each year between 2010 and 2019.

• Adjusted national estimates of OUD prevalence decreased from 9,448,532 persons in 2010 to 7,631,804 in 2019.
• Over the study period, the number of individuals receiving MOUD at opioid treatment programs (OTPs) increased from 294,491 to 442,741, while those dispensed buprenorphine at pharmacies increased from 167,556 to 581,218.
• The percentage of persons with OUD who did not receive MOUD improved from 95 percent in 2010 to 87 percent in 2019.

Comments: Despite efforts to increase access, the vast majority of persons with OUD in the US still do not receive MOUD. In 2023, the federal requirement for practitioners to obtain a waiver to prescribe buprenorphine was removed, which may improve MOUD access. However, methadone is only available at licensed OTPs, which are strictly regulated. The US healthcare system is failing to deliver first-line treatment to persons with OUD. Increasing access to MOUD will require more ambitious regulatory, financing, and workforce changes.

Aaron D. Fox, MD

Reference: Krawczyk N, Rivera BD, Jent V, et al. Has the treatment gap for opioid use disorder narrowed in the US?: A yearly assessment from 2010 to 2019. Int J Drug Policy. 2022;110:103786.