Researchers posed as heroin users seeking help to examine if real users have easy access to treatment in areas where opioid mortality is high.
The team phoned clinics in Massachusetts, Maryland, New Hampshire, West Virginia, Ohio, and the District of Columbia from July 2018 to November 2018. They contacted a total of 546 publicly listed buprenorphine, which is used to treat opioid dependence/addiction, twice during the period while pretending to be uninsured or Medicaid-covered patients.
They published the study in the Annals of Internal Medicine on June 4, Tuesday.
Access To Treatment In States Where Opioid Mortality Is High
They found that patients seeking treatment for opioid dependence face a number of roadblocks.
"I found it surprising how many calls I had to make before being offered an appointment," shared Tamara Beetham, a graduate student who was involved in the study, to AP News. "Whether you have cash in your pocket can determine whether you have access to life-saving treatment."
Beetham also said that receiving a scolding from some clinic staff that they encountered during the study.
The study reported that, overall, researchers received 78 percent response rate from contacted schedulers. New appointments were offered to 54 percent of Medicaid users and 62 percent of uninsured patients (who offered to pay cash up-front). About 27 percent of Medicaid users and 41 percent of uninsured contacts were offered prescription of buprenorphine during their first visit.
Room For Improvement
When new appointments were offered to the callers, the average wait time is six (Medicaid) and five (uninsured) days. This suggested that some might be shunning Medicaid users even when they have room in their schedules because the insurance pays less than others.
The researchers said that in some states, Medicaid rules require opioid users to go through counseling and other therapies before they are allowed to start taking buprenorphine.
"Those barriers should be eliminated," said Nor Volkow, director of the National Institute on Drug Abuse.
The study also found that government website offered hundreds of outdated contacts, preventing researchers and opioid users from reaching clinics.
Michael Barnett from the Harvard T.H. Chan School of Public Health and a co-author of the study explained that not getting treatment as soon as possible endangers the lives of opioid users. Moreover, motivation can be fleeting among people who are fighting addiction.
After every successful call, the researchers immediately canceled their appointments.