Department of Medical Education, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA
Department of Medical Education, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA.
BMJ Open. 2023 Nov 16;13(11):e074845. doi: 10.1136/bmjopen-2023-074845.
Opioid use disorder (OUD) is a major public health concern in the USA, resulting in high rates of overdose and other negative outcomes. Methadone, an OUD treatment, has been shown to be effective in reducing the risk of overdose and improving overall health and quality of life. This study analysed the distribution of methadone for the treatment of OUD across the USA over the past decade and through the COVID-19 pandemic.
Retrospective observational study using secondary data analysis of the Drug Enforcement Administration and Medicaid Databases.
USA.
Patients who were dispensed methadone at US opioid treatment programmes (OTPs).
The primary outcomes were the overall pattern in methadone distribution and the number of OTPs in the USA per year. The secondary outcome was Medicaid prescriptions for methadone.
Methadone distribution for OUD has expanded significantly over the past decade, with an average state increase of +96.96% from 2010 to 2020. There was a significant increase in overall distribution of methadone to OTP from 2010 to 2020 (+61.00%, p<0.001) and from 2015 to 2020 (+26.22%, p<0.001). However, the distribution to OTPs did not significantly change from 2019 to 2021 (-5.15%, p=0.491). There was considerable state-level variation in methadone prescribing to Medicaid patients with four states having no prescriptions.
There have been dynamic changes in methadone distribution for OUD. Furthermore, pronounced variation in methadone distribution among states was observed, with some states having no OTPs or Medicaid coverage. New policies are urgently needed to increase access to methadone treatment, address the opioid epidemic in the USA and reduce overdose deaths.
阿片类药物使用障碍（OUD）是美国的一个主要公共卫生问题，导致高剂量用药和其他负面结果。美沙酮作为一种 OUD 治疗药物，已被证明能有效降低用药过量的风险，改善整体健康和生活质量。本研究分析了过去十年和 COVID-19 大流行期间美国各地美沙酮治疗 OUD 的分布情况。
使用药物执法管理局和医疗补助数据库的二次数据分析进行回顾性观察研究。
美国。
在美国阿片类药物治疗项目（OTPs）接受美沙酮治疗的患者。
主要结果是美沙酮分布的总体模式和美国每年的 OTP 数量。次要结果是医疗补助对美沙酮的处方。
过去十年中，治疗 OUD 的美沙酮的使用明显扩大，2010 年至 2020 年平均州增长率为+96.96%。从 2010 年到 2020 年，OTP 接受美沙酮的总体分布显著增加（+61.00%，p<0.001），从 2015 年到 2020 年增加了（+26.22%，p<0.001）。然而，从 2019 年到 2021 年，向 OTP 的分布并没有显著变化（-5.15%，p=0.491）。在向医疗补助患者开美沙酮处方方面，各州之间存在相当大的差异，有四个州没有处方。
OUD 患者的美沙酮使用分布发生了动态变化。此外，观察到各州之间的美沙酮分布存在明显差异，有些州没有 OTP 或医疗补助覆盖。急需制定新政策，增加美沙酮治疗的可及性，解决美国的阿片类药物泛滥问题，减少用药过量死亡人数。
