Clinical Report: Ongoing Management of Opioid Use Disorder Medications

Overview

Recent findings indicate a significant increase in the use of medications for opioid use disorder (MOUD) among Medicaid beneficiaries, rising from 60.0% to 69.1% between 2019 and 2023. However, the continuity of treatment for at least 180 days declined from 62.6% to 57.6%, highlighting a critical gap in treatment retention.

Background

The ongoing opioid crisis necessitates effective management strategies for opioid use disorder (OUD). Understanding treatment patterns and retention rates among Medicaid beneficiaries is crucial for improving care quality and outcomes. Recent policy changes aimed at expanding access to MOUD have shown mixed results, particularly concerning treatment continuity.

Data Highlights

Key Findings

• MOUD treatment rates increased by over 9 percentage points from 2019 to 2023.
• 180-day retention in MOUD treatment declined by approximately 5 percentage points during the same period.
• States with low initial MOUD treatment rates saw the most significant increases, with some states tripling their rates.
• Policy changes, including the removal of prior authorization and telehealth provisions, have aimed to improve access to MOUD.
• The relationship between policy changes and treatment retention remains unclear, with no consistent patterns observed across states.

Clinical Implications

Healthcare providers should focus on not only increasing the initiation of MOUD but also enhancing strategies to improve treatment retention. Understanding the factors influencing continuity of care is essential for optimizing outcomes for patients with OUD.

Conclusion

The increase in MOUD treatment usage is a positive development; however, the decline in treatment retention underscores the need for targeted interventions to improve continuity of care for individuals with opioid use disorder.

References

1. Lu et al, Medicaid Studies, 2023 -- Ongoing Management of Opioid Use Disorder Medications
2. SAMHSA, 2024 -- 42 CFR Part 8 Final Rule
3. JAMA Network, 2025 -- Comparison of Extended-Release Buprenorphine Doses
4. The ASCO Post — EXPECT QUESTIONS ABOUT THE RISK OF OPIOID ADDICTION
5. Frontiers in Psychiatry — Immediate Action Required to Tackle the Overdose Crisis Linked to Stimulants and Fentanyl
6. The ASCO Post — An Educational Program for Safe Handling of Opioids
7. The ASCO Post — ASCO Addresses New Policies That Threaten Access to Opioids ASCO Principles for Opioid Access
8. Expect Questions About the Risk of Opioid Addiction
9. Immediate Action Required to Tackle the Overdose Crisis Linked to Stimulants and Fentanyl
10. An Educational Program for Safe Handling of Opioids
11. 42 CFR Part 8 Final Rule | SAMHSA
12. Comparison of Extended-Release Buprenorphine Doses for Treating High-Risk Opioid Use: A Randomized Clinical Trial | Pharmacy and Clinical Pharmacology | JAMA Network Open | JAMA Network
13. Journal of Addiction Medicine