New KFF Analysis Examines Rapidly Evolving Federal Policies For Substance Use Disorder Treatment for the Opioid Epidemic

A new KFF analysis unearths that 24 p.c extra buprenorphine, a medicine to regard opioid use dysfunction, used to be distributed in 2022 than in 2019, the 12 months ahead of the pandemic introduced a surge of opioid overdose deaths – and a focal point on methods to enlarge get right of entry to and remedy.

This upward development in buprenorphine distribution, already in movement ahead of the pandemic, persisted right through the COVID public well being disaster, suggesting persisted enhancements in get right of entry to to remedy even because the pandemic raised different boundaries to well being care. Alternatively, it’s unclear whether or not those steps to toughen get right of entry to to buprenorphine are attaining other folks with top wishes, together with communities of colour.

KFF tested 5 key federal insurance policies governing substance use dysfunction remedy, the adjustments they’ve gone through all the way through the pandemic, and the consequences for get right of entry to and remedy for opioid use dysfunction. Knowledge display a steep build up in opioid overdose deaths all the way through the pandemic, essentially pushed by means of the artificial opioid fentanyl. From 2016 to 2021, opioid overdose deaths just about doubled, from 42,249 to 80,411. The rise has been specifically top amongst other folks of colour and younger other folks.

The important thing findings come with:

• Coverage adjustments all the way through the pandemic greater get right of entry to to care by means of making it imaginable to begin buprenorphine remedy by way of telehealth, with out an in-person consult with. Even though federal officers have thought to be finishing that flexibility, it’s been prolonged quickly based on public considerations over the most likely affect on get right of entry to to remedy.
• Past due remaining 12 months, federal law got rid of the extra boundaries to buprenorphine prescribing for OUD remedy, the so-called X-waiver, opening the doorways to a considerable build up in approved suppliers. However analysis signifies that many prescribers nonetheless would possibly not prescribe buprenorphine and considerable disparities in get right of entry to to remedy might stay.
• A short lived pandemic-era coverage has allowed opioid remedy methods to offer some sufferers with as much as 28 days of take-home doses of methadone, a transformation that can turn out to be everlasting beneath a proposed rule. This shift used to be designed to ease the load for sufferers and build up get right of entry to to remedy for the ones residing further from remedy facilities.
• Fresh Meals and Drug Management approval of over the counter naloxone – a nasal spray to opposite opioid overdose – lets in the life-saving drug to be bought with no prescription, even though its kind of $50 value might stay a barrier. Accessibility of fentanyl check strips, which will assist customers resolve if medication were blended with fentanyl, stays restricted, even though federal price range can now be used to pay for them beneath sure grant methods.
• As of June 2023, 14 states have submitted Phase 1115 waivers in the hunt for exemption from federal regulation that prohibits the usage of federal Medicaid bucks for well being care services and products for inmates, together with opioid use dysfunction remedy. Just about two-thirds of jail inmates have a substance use dysfunction, and their possibility of opioid overdose after being launched is 10 occasions upper in comparison to most of the people.

Regardless that new and proposed federal insurance policies have the prospective to extend get right of entry to to care, ongoing demanding situations, corresponding to behavioral well being staff shortages, low prescribing of buprenorphine by means of suppliers, and remedy gaps by means of race/ethnicity, may restrict the effectiveness of recent federal methods.

For extra knowledge and analyses concerning the opioid epidemic, visit kff.org.

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