Ramin Mojtabai (
Christine Mauro is an assistant professor of biostatistics at the Mailman School of Public Health, Columbia University, in New York City.
Health Aff (Millwood). 2019 Jan;38(1):14-23. doi: 10.1377/hlthaff.2018.05162.
Medication treatment (MT) is one of the few evidence-based strategies proposed to combat the current opioid epidemic. We examined national trends and correlates of offering MT in substance use treatment facilities in the United States. According to data from national surveys, the proportion of these facilities that offered any MT increased from 20.0 percent in 2007 to 36.1 percent in 2016-mainly the result of increases in offering buprenorphine and extended-release naltrexone. Only 6.1 percent of facilities offered all three MT medications in 2016. Facilities in states with higher opioid overdose death rates, facilities that accepted health insurance overall (and, more specifically, those that accepted Medicaid in states that opted to expand eligibility for Medicaid), and facilities in states with more comprehensive coverage of MT under their Medicaid plans had higher odds of offering MT. The findings highlight the persistent unmet need for MT nationally and the role of expansion of health insurance in the dissemination of these treatments.
药物治疗（MT）是目前为数不多的被提出的基于证据的策略之一，旨在对抗当前的阿片类药物泛滥。我们研究了美国物质使用治疗机构提供 MT 的国家趋势和相关因素。根据全国性调查的数据，提供任何 MT 的这些机构的比例从 2007 年的 20.0%增加到 2016 年的 36.1%——主要是因为丁丙诺啡和纳曲酮延长释放制剂的增加。2016 年，只有 6.1%的机构提供所有三种 MT 药物。在阿片类药物过量死亡率较高的州的机构、总体上接受健康保险的机构（更具体地说，在选择扩大医疗补助资格的州接受医疗补助的机构），以及其医疗补助计划对 MT 覆盖范围更全面的州的机构，提供 MT 的可能性更高。这些发现突出表明全国范围内对 MT 的需求仍然未得到满足，以及医疗保险的扩大在这些治疗方法的传播中所起的作用。
