The Supply of Authorized Providers for Medication-Assisted Treatment in Ohio

Ariana Pitcher,Wendy Yi Xu

doi:10.18061/ojph.v4i2.8439

Abstract

Background: Ohio experiences among the highest drug overdose rates nationally. The Drug Addiction Treatment Act (DATA) of 2000 permits qualified clinicians to use medication-assisted treatment (MAT) to treat opioid dependency. This study characterizes clinicians authorized to perform MAT and examines whether these clinicians are geographically collocated in areas with higher opioid burdens. Methods: Data of DATA providers in 2019 came from the Substance Abuse and Mental Health Administration. Opioid overdose mortality rates were extracted from the County Health Rankings and Roadmaps to represent disease burdens in local areas. The DATA provider density is represented by the number of DATA-waivered providers per 100 000 population for each county. We used Pearson correlational tests to examine the correlations between the local DATA provider density and the opioid mortality rate.Results: Most of the DATA providers were physicians (57%), followed by nurse practitioners (27%) and physician assistants (4%). The average waivered provider density was 13.90 per 100 000 population. The local density of DATA providers and local opioid overdose death rates are moderately correlated (P < 0.001).Conclusion: Physicians still represent most waivered providers in Ohio. While DATA providers were located in some areas with high needs for opioid treatments, our data suggest that other areas with high opioid burdens likely have an inadequate workforce supply to reduce opioid burdens. Without an adequate DATA workforce, policies that focus on MAT care access to address the opioid epidemic may be in vain.

Highlights

Today, Ohio stands among the top 5 states for the highest mortality rates due to drug overdoses.[1]
While Drug Addiction Treatment Act (DATA) providers were located in some areas with high needs for opioid treatments, our data suggest that other areas with high opioid burdens likely have an inadequate workforce supply to reduce opioid burdens
Without an adequate DATA workforce, policies that focus on medication-assisted treatment (MAT) care access to address the opioid epidemic may be in vain

Summary

Introduction

Ohio stands among the top 5 states for the highest mortality rates due to drug overdoses.[1] In the last 2 decades, the overall drug overdose rate in Ohio increased 9-fold compared to the national average increase of 3-fold.[2] To help tackle the opioid crisis, local and state governments pushed to expand medicationassisted treatment (MAT) with evidence of its ability to reduce drug overdose deaths.[3] Medication-assisted treatment utilizes medications, such as methadone, buprenorphine, and naltrexone, alongside counseling and behavioral therapies to treat substance use disorders, including opioid and alcohol use disorders.[1,4] Under the Drug Addiction Treatment Act of 2000 (DATA 2000), certain clinicians can obtain a waiver to prescribe MAT with buprenorphine or naltrexone outside of opioid treatment programs.[5] The DATA 2000 first only allowed physicians to be eligible for the waiver. The DATA waiver was later extended to other qualified clinicians under the Comprehensive Addiction and Recovery Act of 2016, such as nurse practitioners (NPs) and physician assistants (PAs), to provide MAT.[6]. The Drug Addiction Treatment Act (DATA) of 2000 permits qualified clinicians to use medication-assisted treatment (MAT) to treat opioid dependency. This study characterizes clinicians authorized to perform MAT and examines whether these clinicians are geographically collocated in areas with higher opioid burdens

Methods

Results

Discussion

Conclusion