Studies Show Underuse of Medications to Treat Opioid Use Disorder in Adults and Adolescents


Medications are often underused to treat opioid use disorder, recent research indicates. A new study in JAMA Network Open has found in 2021, only one in five people aged 18-years or older in the U.S. with an opioid use disorder (OUD) in the past year, an estimated 2.5 million people, received medication, such as buprenorphine, methadone, and naltrexone, to treat it. There were disparities across groups for OUD treatment, with Black adults, women, the unemployed, and those residing outside metropolitan areas significantly less likely to receive medication. These findings are consistent with another recent study in JAMA that found buprenorphine, the only FDA approved drug for treating OUD in people aged 16-18, is offered in only one in four residential treatment facilities serving adolescents under 18-years old in the U.S., with only one in eight offering it for ongoing treatment.

Both studies were recently featured in press releases[1-2] from The National Institute on Drug Abuse, and highlight the vast underutilization of evidence-based medications to treat people with OUD, despite their safety and effectiveness. In 2021, approximately 107,000 people died of drug overdose, with two-thirds of those involving an opioid. Additionally, overdose deaths among young people aged 14-18 have increased dramatically in recent years. Medications are the most effective treatment option for preventing both overdose deaths and return to opioid use in people with OUD. This research demonstrates the substantial need to expand access to evidence-based treatment for OUD in a variety of populations and settings. Recent efforts to expand medication for OUD, such as removal of the X-waiver in the U.S. in 2023, may help to close the treatment gap; future research should assess the impact of these policy and practice changes.  

The integration Academy offers a Medication-Assisted Treatment (MAT) for Opioid Used Disorder Playbook that provides practical guidance for implementing MAT in primary care and other ambulatory care settings. For additional studies on MAT for OUD, visit the Academy’s literature collection.

[1] National Institutes of Health: National Institute on Drug Abuse. Only 1 in 5 U.S. adults with opioid use disorder received medications to treat it in 2021. NIDA News Releases, 2023. Accessed August 11, 2023.

[2] National Institutes of Health: National Institute on Drug Abuse. Only 1 in 4 adolescent treatment facilities offer buprenorphine for opioid use disorder. NIDA News Releases, 2023. Accessed August 11, 2023.