The Opioid Epidemic is the deadliest drug overdose crisis in United States history, claiming almost 800,000 lives since 1999.

As the epidemic expanded to include every American demographic and subgroup, physicians and researchers adjusted their views of opioid abuse, replacing the idea of addiction with the clinical term 鈥渙pioid use disorder.鈥�

An opioid use disorder (OUD) is a problematic pattern of opioid use that is often characterized by physical and/or psychological dependence on opioids, a drug class including heroin and many prescription painkillers.

Not only has the terminology evolved, the treatment has as well. The most promising development in OUD treatment is the use of medication combined with behavioral therapy to aid recovery. This is called 鈥渕edication treatment鈥� or MT.

Medications like buprenorphine, naltrexone, and methadone all work differently in the body, easing cessation through some combination of silencing cravings, blocking the euphoric effects of opioids, and/or combatting withdrawal symptoms. Silencing the physical aspects of OUD helps patients develop the capacity to deal with the psychological elements, which they cultivate in MT-required therapy.

Organizations such as the U.S. Substance Abuse and Mental Health Services Administration (SAMSA) and the National Institutes of Health (NIH) publically attest the benefits of MT. But for many it remains inaccessible.

In a recent article in Health Services Research, 快猫短视频 Professors Amanda Abraham and David Bradford evaluated the accessibility of MT for people who receive medical services through Medicare.

The 快猫短视频 pair collaborated with public health colleague Grace Adams (PhD 鈥�12) and recent graduate Ashley Bradford (MPA 鈥�18). Together the group assessed the availability of MT by county, across the U.S.

They sought to identify geographic, demographic, and economic characteristics associated with access to two types of MT that are covered under Medicare Part D, buprenorphine and naltrexone.

Although MT is becoming more widely available, in more than half of the country, patients could not receive MT in their county. 鈥淲hile we found an overall increase in county-level access to OUD prescribers in Medicare Part D from 2010 to 2015, approximately 60% of counties did not have access to a buprenorphine prescriber and more than 75% of counties did not have access to an oral naltrexone prescriber in 2016,鈥� Abraham explained.

Additionally, the researchers found that access to MT prescribers is largely concentrated in urban counties. This means many people living in rural areas have to travel great distances or be left without life-saving access to MT medication.

Abraham concluded, 鈥淏y 2030, one in five Americans will be Medicare eligible. With rates of opioid use disorder increasing among older adults, our results indicate that targeted efforts are needed to improve access to OUD treatment medications for Medicare enrollees.鈥�

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Financial incentives provided by pharmaceutical companies may be changing the way doctors prescribe opioids. As 快猫短视频 Professor David Bradford’s shows, there is a high correlation between doctors receiving money from an opioid manufacturer and writing more prescriptions.

Bradford, in collaboration with two researchers at the University of Indiana, studied the prescription data of nearly 900,000 U.S. physicians who prescribed medications through Medicare. Bradford and his team found that the doctors studied received over $50 million in payments from opioid manufacturers between 2014 and 2016.

The study revealed that doctors who receive direct payments from opioid manufacturers, on average, tend to prescribe more opioids than doctors who receive no such payments. Those who were paid, prescribed over 8,784 daily doses of opioids per year more than their unpaid colleagues. Overall, receiving a 1 percent increase in payment was associated with an increase of 50 daily doses of opioid prescription.

As the nation grapples with the worst opioid epidemic in American history, research like this becomes increasingly important. Examining the factors that motivate doctors to prescribe more opioids could potentially lead to policy change that reduces opioid addiction.

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Since the beginning of 2018, Abraham has co-authored eight publications, including two for which she was the principal researcher.

In 鈥淕eographic disparities in availability of opioid use disorder treatment for Medicaid enrollees,鈥� Abraham and her co-authors found that there are several clusters of counties in the U.S. that see higher rates of opioid use disorder and yet have a lower than average amount of opioid treatment providers that accept Medicaid. These county clusters occur most frequently in the Southeast, including Arkansas, Kentucky, Louisiana, Mississippi, and Tennessee.

This disparity between the rate of opioid use disorder and opioid treatment providers results in a treatment gap for Medicaid enrollees. Because of this, Abraham and her co-authors are encouraging policymakers to consider strategies that will increase access to opioid treatment for Medicaid enrollees.

Abraham鈥檚 other article, 鈥淪tate-Targeted Funding and Technical Assistance to Increase Access to Medication Treatment for Opioid Use Disorder,鈥� discusses a way that policy makers may be able to increase access to opioid use disorder medications. Abraham and her co-authors show that state-targeted funding was associated with an increase in the availability of naltrexone and buprenorphine, two medications that have been proven to reduce opioid use, withdrawal and craving, infectious disease transmission, and treatment dropout.

Abraham has been studying the substance use disorder treatment system since completing a postdoc at UGA funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Dr. Abraham hopes to continue doing research to reduce the stigma of addiction and improve care for people who suffer from substance use disorder.

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