Considerable gaps seen in provision of effective treatment for opioid addiction

There are considerable gaps in provision of effective treatments for opioid use disorders (OUD) at U.S. substance use disorder (SUD) treatment facilities, according to a study published online July 11 in the JAMA.

Tae Woo Park, M.D., from the University of Pittsburgh, and colleagues conducted a cross-sectional study of specialty outpatient SUD treatment facilities that treat OUD. The prevalence of available treatments individually and combined was reported. Treatments offered in federally certified opioid treatment program (OTP) and non-OTP facilities were compared.

Overall, 17,353 representatives from SUD facilities were surveyed. OUD treatment was offered at 12,060 outpatient facilities: 1,925 and 10,135 OTPs and non-OTPs, respectively. The researchers found that 99.4 and 55.1% of OTP and non-OTP facilities offered medications for OUD (MOUD), respectively, and 35.2% of facilities offered psychosocial treatments only.

Of the facilities that offered MOUD, a higher proportion of OTPs versus non-OTPs offered any MOUD plus contingency management (53.3 versus 41.6%), and a lower proportion of OTPs offered any MOUD, any psychosocial treatment, other SUD treatment, and mental health services (16.7 versus 33.5%).

Overall, 62.2, 45.6, and 2.0% of facilities offered at least one, at least two, and all four MOUD types, respectively. A lower proportion of non-OTPs offered sublingual and injectable buprenorphine compared with OTPs (49.7 versus 83.4%; 22.4 versus 26.4%); injectable naltrexone was offered at similar rates. OTPs offered contingency management more frequently than non-OTPs (54.1 versus 40.2%).

"Substance use treatment facilities reported significant gaps in provision of effective treatments for OUD," the authors write.

One author reported ties to relevant organizations.

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