December 6, 2017

Of the 2.5 million Americans 12 years of age or older who abused or were physically dependent on opioids in 2012, fewer than 1 million received MAT.[1] Despite their benefits, MATs have been adopted in less than half of private treatment programs. Even in programs that do offer MAT options, only about a third of patients receive them.[2]

Why is MAT underused?
  • Reasons for this gap between treatment need and delivery include lack of access to opioid maintenance programs,[3] lack of training for providers (especially in rural areas),[4] stigma, expense, and negative attitudes toward agonist maintenance in some minority communities.[5]
  • Medication-assisted treatment has saved many lives, but it is still not often accepted by the public. Patients seeking MAT for opioid use disorder sometimes find that their healthcare providers may have a negative opinion of MAT despite medical evidence of its many benefits.[6]
  • Some treatment programs and insurance companies have placed many limits and regulations on who can be prescribed MAT and for what duration. These policies are often intended to ensure that MAT is the best course of treatment for their patients, but they can make it harder for patients to find the care they need.[7] Some of these programs and insurance plans provide too low of a dose or too short of a course of MAT. Use of too low of a dose of MAT may lead to increased risk of relapse, and may shake patient’s and their medical provider’s trust in MAT unnecessarily.[8]

[1]Substance Abuse and Mental Health Services Administration, Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-46, HHS Publication No. (SMA) 13-4795. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013.

[2]Knudsen HK, Abraham AJ, Roman PM. Adoption and implementation of medications in addiction treatment programs. J Addict Med 2011;5:21-7.

[3] Cicero, T. J., Surrat, H., Inciardi, J. A., & Munoz, A. (2007.) Relationship between therapeutic use and abuse of opioid analgesics in rural, suburban, and urban locations in the United States. Pharmacoepidemiol Drug Saf. Aug;16(8), 827-40.

[4] Knudsen, H.K., Ducharme, L.J., & Roman, P. M. (2007.) Research network involvement and addiction treatment center staff: counselor attitudes toward buprenorphine. Am J Addict. Sep-Oct;16(5), 365-71.

[5] Zaller, N. D., Bazazi, A. R., Velazquez, L., & Rich, J. D. (2009). Attitudes toward methadone among out-of-treatment minority injection drug users: implications for health disparities. Int J Environ Res Public Health. Feb;6(2), 787-97.

[6]Knudsen HK, Abraham AJ, Roman PM. Adoption and implementation of medications in addiction treatment programs. J Addict Med 2011;5:21-7.

[7]Clark RE, Baxter JD. Responses of state Medicaid programs to buprenorphine diversion: doing more harm than good? JAMA Intern Med 2013;173:1571-2.

[8]Volkow, N. D., et al. (2014.) Medication-Assisted Therapies – Tackling the Opioid-Overdose Epidemic. New England Journal of Medicine 370(22), 2063-2066.