Amy Kennalley, MBS First Year Medical Student Department of Medical Education Geisinger Commonwealth School of Medicine

20 Dec New Geisinger Study Finds That While US Drug Overdoses Increased, the Distribution of Methadone Decreased

Posted at 18:48h in Author Interviews by

MedicalResearch.com Interview with:

Amy Kennalley, MBSFirst Year Medical Student Department of Medical Education Geisinger Commonwealth School of Medicine

Amy Kennalley

Amy Kennalley, MBS
First Year Medical Student
Department of Medical Education
Geisinger Commonwealth School of Medicine

MedicalResearch.com: What is the background for this study?

Response:   Opioid use disorder (OUD) is a major public health crisis in the United States. Despite the availability of effective treatments, including the medication-assisted treatment (MAT) with methadone, many individuals with OUD do not receive the care they need. Over the COVID-19 pandemic, there were several policy changes related to take-home doses of methadone, which may have impacted access to this lifesaving medication.

The Drug Enforcement Administration’s (DEA)’s Automated Reports and Consolidated Ordering System (ARCOS) is a database that tracks the distribution of controlled substances, including methadone distributed to opioid treatment programs (OTPs). This data can be used to assess trends in methadone distribution over time. Additionally, the Medicaid State Drug Utilization Data (SDUD) database provides comprehensive information on methadone prescribing to Medicaid patients.

By analyzing data from both ARCOS and SDUD, we aimed to provide a comprehensive picture of methadone distribution for OUD treatment in the United States. These findings1 are important because drug overdose deaths, primarily involving opioids, increased substantially (49%) from 2019 (70,980) to 2021 (~106,000).2

MedicalResearch.com: What are the main findings?

Response:   Our research revealed a significant increase in methadone distribution for OUD over the past decade, with an average state increase of +96.96% from 2010 to 2020. This surge in methadone distribution was significant in OTPs, where we observed a 61.0% increase from 2010 to 2020 and a 26.2% increase from 2015 to 2020. However, we also found that methadone distribution to OTPs declined from 2019 to 2021 by -5.2%.

Our findings also highlight considerable state-level variation in methadone prescribing to Medicaid patients, with four states having no prescriptions at all which may reveal an underlying issue within the SDUD database.

MedicalResearch.com: What should readers take away from your report?

Response:   The key takeaways from our study are twofold.

First, we have documented a substantial significant increase in methadone distribution for OUD treatment over the past decade, demonstrating the growing recognition of methadone as an effective treatment modality. However, this increase was not maintained in 2021.

Second, our findings underscore the disparities in access to OTPs across the United States, particularly in rural and western states. This variation highlights the need for targeted interventions to ensure equitable access to methadone treatment for all individuals with OUD. Due to the annual escalation in overdoses involving opioids,2 maximizing availability of methadone should be a public-health priority.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response:   Our study has uncovered several areas for future research. Firstly, it is crucial to determine which patient subgroups were most impacted by the observed trends in methadone distribution. Additionally, given the recent decline in the number of pharmacies nationally distributing buprenorphine (-4.7%) from 2019 to 2021, further research should evaluate whether both methadone and buprenorphine continue to be underutilized in the post-COVID-19 pandemic period. Understanding these utilization patterns is essential for guiding policy and practice efforts to ensure that all individuals with OUD have access to effective and evidence-based MAT options.

Citations:

  1. Kennalley et al. Trends in methadone utilization for Opioid Use Disorder treatment in the United States during the COVID-19 pandemic. BMJ Open 2023: 13(11): e074845. https://bmjopen.bmj.com/content/13/11/e074845.long
  2. https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates#:~:text=Overall%2C%20drug%20overdose%20deaths%20rose,overdose%20deaths%20reported%20in%202021.

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Last Updated on December 20, 2023 by Marie Benz MD FAAD

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