Laws for expanding access to medications for opioid use disorder: a legal analysis of 16 states & Washington D.C

• Type of Material: Article
• Authors: Barbara Andraka-Christou, University of Central Florida; Brendan Saloner, Johns Hopkins University; Adam J Gordon, University of Utah; Rachel Totaram, University of Central Florida; Olivia Randall-Kosich, Georgia State University; Matthew Golan, Emory University; Bradley D Stein, RAND Corporation, Pittsburgh
• Language: English
• Date: 2022-01-01
• Publisher: Taylor & Francis Online
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2024Informa UK Limited
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1080/00952990.2022.2082301
• Title of Journal or Parent Work: American Journal of Drug and Alcohol Abuse
• Volume: 48
• Issue: 4
• Start Page: 492
• End Page: 503
• Grant/Funding Information: NIH National Institute on Drug Abuse, Awards # R01DA045800 and P50DA046351, with principal investigator Dr. Bradley Stein from the RAND Corporation. Brendan Saloner acknowledges funding support from Arnold Ventures. Adam Gordon acknowledges support from NIH
• Keywords: medications for opioid use disorder; policy; Opioid-Related Disorders; insurance; buprenorphine; Opiate Substitution Treatment; methadone; state; criminal justice; Buprenorphine; law; Washington; Health Services Accessibility; Analgesics, Opioid; Humans; qualitative; opioid use disorder; Methadone
• Research Categories: Law; Health Sciences, Epidemiology; Health Sciences, Public Health

Abstract

Background: Medications for opioid use disorder (MOUDs) are the gold standard for OUD treatment but are underused. To our knowledge, no published study has systematically identified and categorized state policy innovations for expanding MOUD utilization. Objective: We sought to identify and categorize state MOUD policy innovations. Methods: Within a stratified random sample of 16 U.S. states and Washington D.C. we searched for 2019 state statutes and regulations related to MOUD in Westlaw legal database. We then identified laws that appeared designed to increase MOUD utilization and categorized them using a template analysis approach. Results: We found 82 laws with one or more MOUD expansion policies. We identified six high-level MOUD expansion policy categories: 1) policies expanding the availability of waivered buprenorphine providers; 2) needs assessments and policies increasing public MOUD awareness; 3) criminal justice system policies; 4) Substance use disorder (SUD) treatment and sober living facility policies; 5) insurance policies; and 6) hospital policies. SUD treatment and housing facility policies, as well as insurance policies, were most common. Conclusions: Multipronged approaches are being pursued by several states to increase MOUD access. Our results can inform policymakers of MOUD expansion approaches in other jurisdictions. Policy categories can serve as the basis for policy variables for future analyses of policy effects.