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How Federal and State Laws Have Hindered Access to OUD Treatment

A recent review published by Pew Charitable Trusts found that federal and state laws, predominantly not evidence-based, have hindered access to opioid use disorder (OUD) treatment.

The opioid epidemic has persisted over the past few decades. Exacerbated by the pharmaceutical industry, this epidemic has left many struggling with opioid use disorder (OUD). Effective treatments for OUD are essential for proper recovery. However, a recent analysis conducted by Pew Charitable trusts found that most federal and state laws have hindered access to OUD treatment.

According to the analysis, “opioid treatment programs (OTPs) are the only healthcare facilities that can offer patients all three forms of FDA-approved medication for opioid use disorder (OUD): methadone, buprenorphine, and injectable extended-release naltrexone. But Pew found that nearly all states have rules governing OTPs that are not based on evidence and in turn limit access to care or worsen the patient experience.”

The publication found that a quarter of the population in the United States did not have access to OTPs, meaning approximately 80% of US counties do not have OTPs. Part of the reasoning behind that is the restrictions in each state. About 19 states and DC have limitations involved in opening an OTP. These limitations may include a certificate of need, a moratorium, and a cap on the number of facilities.

The analysis highlights additional barriers to opening OTPs. A pharmacy license or registration is required in 16 states, and 15 require a pharmacist on the OTP staff.

Beyond the limitations in opening an OTP, some regulations prevent patients from accessing existing OTPs. Across the US, eight states require patients to have a valid government ID to access treatment. Additional difficulties include inflexible counseling schedules, limitations on take-home medications and medication dosage, discontinued care, and other drug screenings.

“As overdose deaths continue to climb, state policymakers should review these rules and make changes so that more people get the lifesaving treatment provided in these settings,” recommended the Pew Charitable Trust in their analysis.

Clinicians and researchers are urged to advocate to the federal government and their individual state governments for widened access to OTP. 

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