Opioid use disorder (OUD) has been top of mind for many employers over the past several years. Good progress has been made in terms of changing prescribing patterns in physicians and dentists so that less people are exposed to opioids. There has also been progress in understanding the condition itself and employers have begun to address stigma so that people can come forward and get help sooner.
But as I discussed in an earlier post, the news on overdose deaths is not good. It is time to turn our attention to more effective strategies for treating those with OUD. One of the most cost-effective early interventions is medication-assisted treatment (MAT). This treatment is started right after an individual is safely detoxified from the drug. It provides a medication that reacts to the opioid receptors in a person but does not cause euphoria or cravings. There are several treatment protocols for suboxone, methadone and vivitrol that have all been shown to allow a person to stabilize their life and then participate fully in treatment and recovery as well as work and home life.
Optum analyzed the data on their population and found that those on MAT are 50% more likely to remain drug-free than those with detox and counselling alone. They have also found that there are significant savings starting at 90 days of treatment -- on the order of $4,000 per patient.
The Substance Abuse and Mental Health Services Administration recommends that MAT be readily available to those with OUD and that the medication be part of a comprehensive approach that includes counselling for best outcomes.
We have people who need help. We have good evidence that providing people with MAT and counselling is both clinically effective and cost effective. Unfortunately, there remain barriers to accessing this kind of help. It is important that employers require their health plans to have adequate networks of MAT providers, that the providers are adequately reimbursed for these services and that there are not financial barriers for the patients seeking care. But as this recent paper by the Pew Charitable Trust demonstrates, we are not there yet. There is no better way to move that needle than for employers to require access for their people!