National roadmap on state-level efforts to end the nation’s drug overdose epidemic

American Medical Association

Publications

National roadmap on state-level efforts to end the nation’s drug overdose epidemic

9 January 2021

By the American Medical Association

As with any condition, it is critical that people with a substance use disorder have access to medically appropriate care, taking into account their individual needs and circumstances. More than eight in ten people with a substance use disorder (82.6%) who need treatment do not receive it. Moreover, among those with an opioid use disorder, many still do not receive MOUD even though evidence is clear that MOUD helps save lives and has numerous benefits; the US surgeon general continues to emphasize that MOUD is the “gold standard” of treatment for OUD. Patients who use MOUD remain in therapy longer and are less likely to use illicit opioids. The result is that SUD treatment helps decrease overdose deaths, reduces the transmission of infectious diseases, including HIV and hepatitis C, and leads to reduced recidivism and other benefits to society, including lower rates of crime.

Despite the evidence base for MOUD, barriers to it persist, including inconsistent coverage of all US Food and Drug Administration (FDA)-approved forms of MOUD, inadequate provider networks, stigma that keeps some individuals and providers from using MOUD, lack of provider education and comfort with providing MOUD, high cost sharing for MOUD, and prior authorization requirements. These barriers can make the difference between a person being willing to pursue treatment or continuing to misuse opioids and risking death by overdose.