By Heather Saunders & Nirmita Panchal | July 11, 2023
Opioid overdose deaths, primarily driven by fentanyl, have surged during the pandemic, exposing significant gaps in access to and availability of treatment. From 2016 to 2021, opioid overdose deaths nearly doubled, from 42,249 to 80,411. By 2021, these deaths accounted for 75% of all fatal drug overdoses, up from 66% in 2016. Rises in overdose deaths have been particularly sharp among people of color and young people. Policy efforts have focused on enhancing access to medications for Opioid Use Disorder (OUD) treatment, which can substantially reduce overdose and mortality rates. Yet, approximately 75% of people with OUD do not receive the recommended treatment, and treatment rates are generally lower among people of color and adolescents.
Currently, three medications are approved for OUD treatment: methadone, buprenorphine, and naltrexone. Buprenorphine and methadone, both controlled substances, have unique administration requirements. Buprenorphine can be prescribed and picked up from a pharmacy, while methadone must be dispensed through licensed opioid treatment programs.
Federal policies governing substance use disorder treatment have undergone rapid changes during the pandemic; however, the extent to which these changes can address the surge in opioid overdose deaths is unclear. Some of these policy adjustments are permanent, while others could revert to pre-pandemic regulations. In this brief, we examine the following 5 key federal policies and implications for access and treatment for OUD:
- Access to buprenorphine medication via telehealth
- Changes to dispensing methadone
- Changes to provider regulations for the prescribing of buprenorphine
- Changes in access to opioid overdose prevention and reversal methods
- Guidance to leverage Medicaid for pre- and post-release from prison access to OUD treatment services