NASEM Issues Report on Opioid Treatment Access and Barriers

On Wednesday, the National Academies of Sciences, Engineering, and Medicine (NASEM) issued a report on opioid use disorder (OUD) treatment options, finding that despite the fact that the three U.S. Food and Drug Administration (FDA)-approved medications are safe and effective, most individuals who could benefit from the treatments do not receive them. Further, the report determines that access to OUD medications is inequitable, particularly among certain subpopulations.

NASEM indicates that an estimated two million people in the United States are estimated to have an OUD, a life-threatening chronic condition associated with a twentyfold greater risk of death due to overdose, infectious disease, trauma, and suicide. In 2017, 47,000 Americans died as a result of opioid overdoses. While an increasing number of individuals have an OUD, major barriers to the use of approved medications exist; these barriers include:

  • Misunderstanding and stigma toward drug addiction;
  • Inadequate education and training of professionals responsible for working with people with OUD, including treatment providers, law enforcement, and criminal justice personnel;
  • Current regulations around methadone and buprenorphine, particularly as it relates to waiver policies, patient limits, and treatment setting restrictions;
  • A fragmented system of care for people with OUD and current financing and payment processes.

NASEM discusses in its report the current state of treatment access, finding that adolescents and young adults, people in rural areas, and racial and ethnic minorities are disproportionately impacted by access challenges. The report goes on to further examine overall effectiveness of medication treatment, population-specific considerations, and treatment setting challenges. The full NASEM report is available here.