For the second time in recent years, life expectancy in the United States declined in 2017. The Centers for Disease Control and Prevention (CDC) reported this news in November, citing a record-breaking 70,237 drug overdose deaths—including more than 47,000 fatal opioid overdoses—as a main culprit. CDC found a steep 45 percent rise in fatal overdoses from fentanyl—a powerful, synthetic opioid. Overall, opioid deaths increased 12 percent between 2016 and 2017.
More than 2 million Americans suffer from opioid use disorder (OUD) but too few have access to effective treatment. According to the 2017 National Survey on Drug Use and Health, only 1 in 9 receive any kind of treatment for a substance use disorder.
Fortunately, proven treatment exists for managing OUD. Medication-assisted treatment (MAT), which combines behavioral counseling with U.S. Food and Drug Administration (FDA)-approved medicines, is the most effective, evidence-based therapy for this chronic condition. Research shows that patients who use MAT medications stay in therapy longer than those who do not and are less likely to use illicit opioids such as fentanyl. MAT helps decrease overdose deaths and allows people with OUD to lead productive lives while managing their illness.
What can be done?
It is essential that more Americans—no matter where they live—get access to quality care. Almost 20 million people in this country live in areas without a single physician authorized by federal authorities to prescribe buprenorphine, one of three FDA-approved medications for OUD. In addition, fewer than half of substance use treatment facilities in the U.S. (5,995 of 13,749) offered MAT services in 2018; only 3 percent made all three MAT drugs available.
The federal government has taken some steps to improve these numbers. Earlier this fall, President Donald Trump signed the SUPPORT for Patients and Communities Act, bipartisan legislation aimed at addressing the opioid crisis and reducing overdose deaths. The law will make it easier for seniors and low-income Americans to get coverage for MAT, allow more types of health care providers to prescribe MAT drugs, and promote better care transitions for people with OUD who re-enter society from prison.
This law was an important step forward, but policymakers, providers, and communities must do more to close the treatment gap. Improving outcomes for Americans with OUD and reversing the trends found by CDC depend on those efforts.
Beth Connolly directs The Pew Charitable Trusts’ substance use prevention and treatment initiative.