Bradley D. Stein MD PhD Senior Physician Policy Researcher Pittsburgh Office Rand Corporation

More Medicaid Enrollees Receiving Treatment for Opioid Use Disorder, But Disparities Remain Interview with:

Bradley D. Stein MD PhD Senior Physician Policy Researcher Pittsburgh Office Rand Corporation

Dr. Stein

Bradley D. Stein MD PhD
Senior Physician Policy Researcher
Pittsburgh Office
Rand Corporation What is the background for this study?

Response: Increasing use of medication treatment for individuals with opioid use disorders, with medications like methadone and buprenorphine, is a critical piece of the nation’s response to the opioid crisis. Buprenorphine was approved by the FDA in 2002 for treatment of opioid use disorders, but there was little information about to what extent buprenrophine’s approval increased the number of Medicaid-enrollees who received medication treatment in the years following FDA approval nor to what extent receipt of such treatment was equitable across communities. What are the main findings? 

Response: We found that from 2002 to 2009, there was a substantial increase in the number of adult Medicaid-enrollees receiving medication treatment, with the bulk of the increase coming from individuals receiving buprenorphine. Over that period, buprenorphine substantially increased the likelihood that residents of rural counties would receive medication treatment, although rural counties continued to lag behind urban counties in residents receiving medication treatment. We also learned that residents of counties with a low poverty rate and low percentage of individuals of color were significantly more likely to receive buprenorphine than residents of all other types of counties. What should readers take away from your report?

Response: The increase in Medicaid-enrollees receiving medication treatment in the years following buprenorphine’s approval is encouraging, but it is concerning that increases in medication treatment were substantially lower in counties with populations that historically have been disadvantaged with respect to health care access and quality. What recommendations do you have for future research as a result of this work?

Response: Future research with more recent data is needed to understand if the disparities in use of medication treatment persist, but based on our findings, concerted efforts are needed to ensure that access to medication treatent is equitably distributed across society and available to disadvantaged individuals who may be at higher risk of experiencing opioid use disorders. 

No disclosures


Bradley D. Stein, Andrew W. Dick, Mark Sorbero, Adam J. Gordon, Rachel M. Burns, Douglas L. Leslie & Rosalie Liccardo Pacula (2018) A population-based examination of trends and disparities in medication treatment for opioid use disorders among Medicaid enrollees, Substance Abuse, DOI: 10.1080/08897077.2018.1449166

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Last Updated on June 26, 2018 by Marie Benz MD FAAD