Only 1 in 5 adults with an opioid use disorder received medication to treat it in 2021

As drug overdose deaths reached record levels in the United States, evidence-based treatments for substance use remained significantly underutilized, a new study found.

The vast majority of drug overdose deaths involve opioids, and rates have surged in recent years. In 2021, more than 80,000 people died from a drug overdose involving opioids, according to data from the US Centers for Disease Control and Prevention.

But only about a third of adults with opioid use disorder received any type of treatment for substance use, and only about 1 in 5 received medication to treat opioid use disorder, according to the new study by researchers at the National Institute on Drug Abuse and the National Center for Injury Prevention.

An estimated 2.5 million adults in the US have an opioid use disorder, and the US Food and Drug Administration has approved various drugs to treat the condition – including buprenorphine, methadone, and naltrexone – which can help with reducing cravings for the drugs or blocking the effects of them.

“Medications for opioid use disorder are safe and effective. They help sustain recovery and prevent overdose deaths,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse. “Failing to use safe and lifesaving medications is devastating for people denied evidence-based care. What’s more, it perpetuates opioid use disorder, prolongs the overdose crisis, and exacerbates health disparities in communities across the country.”

The study, published Monday in JAMA Network Open, also found vast disparities in who received medication to treat opioid use disorder.

Men with opioid use disorder were six times more likely than women to receive medication to treat it, and White adults were 14 times more likely to receive the medication than Black adults. Unemployed adults and those living in non-urban areas were also less likely to receive the medication.

During the Covid-19 pandemic, the US Drug Enforcement Administration granted flexibilities that allowed certain controlled medications – including those used to treat opioid use disorder – to be prescribed through telehealth. Those flexibilities have been extended through at least mid-November.

“These medications, including those used to treat opioid use disorder, are a vital form of care for millions of Americans who have come to rely on safe and effective telemedicine appointments,” Dr. Bobby Mukkamala, chair of the American Medical Association’s Substance Use and Pain Care Task Force said in a statement when the extension was announced. “Patients being treated with these medications often have challenges securing and traveling to in-person appointments.”

And the new study supports previous research that has found telehealth to improve rates of treatment. Those receiving substance use treatment via telehealth were nearly 40 times more likely to receive medications for opioid use disorder than those who did not receive telehealth treatment, the researchers found.

Data from the new study is based on a nationally representative sample of more than 47,000 adults who participated in the 2021 National Survey on Drug Use and Health, which is sponsored by the US Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration.

“Everyone should have the opportunity to be as healthy as possible and our goal is to help reduce health disparities and save lives,” said Christopher M. Jones, a study author and the director of the National Center for Injury Prevention and Control.