Among adult Medicaid enrollees, buprenorphine use for opioid use disorder increased more after 2010, reaching 12 users per 1,000 Medicaid enrollees by 2020 — nearly double the prevalence of methadone use for opioid use disorder, according to a study published Nov. 25 in JAMA Health Forum.
Researchers from Philadelphia-based Penn Medicine conducted a repeated cross-sectional study using a national dataset from CMS, covering adult Medicaid enrollees receiving methadone or buprenorphine from 1999 to 2020 across all 50 states, Washington, D.C., Puerto Rico and the Virgin Islands. Individuals enrolled in both Medicaid and Medicare were excluded.
Methadone treatment for opioid use disorder was identified using Healthcare Common Procedure Coding System codes associated with opioid treatment programs, while methadone prescribed for pain was identified using National Drug Codes. Buprenorphine use was limited to FDA-approved formulations for opioid use disorder.
The study was limited by possible incompleteness of Medicaid data.
Here are four things to know:
- Methadone prescriptions among Medicaid enrollees increased from 1.9 per 1,000 enrollees in 2010 to 6.2 per 1,000 enrollees in 2020, roughly tripling over the decade.
- Buprenorphine prescriptions increased at a higher rate than methadone. By 2020, about 12 of every 1,000 Medicaid enrollees had a buprenorphine prescription, representing roughly five times more use than in 2010 (2.3).
- Buprenorphine’s faster growth may reflect easier access, as it can be prescribed in outpatient settings, including primary care, according to a Feb. 6 news release from the university. Methadone, by contrast, can be dispensed only through federally certified opioid treatment programs.
- Recent federal actions have allowed more take-home methadone doses, and legislation introduced in Congress in 2023 would permit addiction specialists to prescribe methadone from outpatient clinics, potentially broadening access, the release said.
