Merely 1 in 4 individuals with opioid dependence receives life-saving medications. Why?

From 1999 to 2023, around 806,000 U.S. citizens succumbed to opioid overdoses, as reported by the Centers for Disease Control and Prevention. However, among the estimated 2.4 million adults in the United States with opioid use disorder, only one in four receives medications that can mitigate overdose risks.

Telehealth has demonstrated potential as a promising approach to avert opioid overdose fatalities, yet funding for a study initiated last year by health economist Haiden Huskamp analyzing its application and effects was cut during the mass termination of federal research grants by the Trump administration in May.

“Much of our investigation, including this grant, is focused on understanding why such a limited number of individuals are receiving evidence-supported treatments for substance use disorder,” remarked Huskamp, Henry J. Kaiser Professor of Health Care Policy at Harvard Medical School. “Medications for opioid use disorder are exceptionally effective. They decrease opioid use; they diminish overdose risks and other adverse effects. These drugs save lives.”

A deficit of professionals specialized in caring for opioid use disorders — especially in rural settings — constitutes a significant obstacle to obtaining treatment, she noted.

“Our research has been aimed at discerning, particularly since the pandemic, who has been utilizing telemedicine for opioid use disorder,” said Huskamp, “and whether the availability of treatment through telemedicine has allowed clinicians handling substance use disorders to see an increased number of patients in regions where there is a shortage of doctors specializing in this field.”

For the last five years, Huskamp, Ph.D. ’97, has been researching telemedicine as a strategy to broaden access to opioid use disorder treatment and essential medications like methadone, buprenorphine, and the rapid overdose-reversal drug naloxone.

“Given the ongoing opioid crisis we are experiencing, telemedicine could be a solution since it might address various barriers to treatment accessibility,” stated Huskamp.

Despite the CDC reporting that opioid overdose fatalities decreased from 83,140 in 2023 to 54,743 in 2024, the mortality rate remains alarmingly high. According to the CDC, in 2023, an average of 217 individuals lost their lives each day due to an opioid overdose.

The objective of Huskamp’s halted four-year study, launched last year with a cohort of 15 researchers, was to furnish evidence-based information regarding the effectiveness of telemedicine to guide policymakers in addressing the opioid crisis. This study was a renewal of a previous grant, which resulted in 24 different publications whose findings have influenced new regulations issued by the Drug Enforcement Agency to enhance telemedicine access for treating opioid dependence. Supported by the National Institute on Drug Abuse, the latest research aimed to evaluate quality of care and clinical outcomes through data analysis from Medicare, Medicaid, commercial insurance, and national pharmacy claims.

Telemedicine for opioid use disorder saw increased adoption nationwide during the COVID-19 pandemic, and researchers have been keen to analyze the data to determine if it enhanced access to care for patients in remote locations and how the quality of care stacked up against traditional face-to-face treatment.

“Every step we can take to enhance the healthcare system to enable individuals to access care more effectively and efficiently is crucial,” stated Huskamp. “We require research like this to inform policymaking so that we can optimize the system as much as possible for patients to receive the treatment they require.”