Medication-Assisted Treatment for Opioid Use Disorder

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Summary

The opioid overdose epidemic continues to claim lives across the country with a record 47,600 overdose deaths in 2017. (This number represents 67.8% of the 70,237 overdose deaths from all drugs) [CDC 2018a]. More Americans now die every year from drug overdoses than in motor vehicle crashes [CDC 2016]. The crisis is taking an especially devastating toll on certain parts of the U.S. workforce. High rates of opioid overdose deaths have occurred in industries with high injury rates and physically demanding working conditions such as construction, mining, or fishing [Massachusetts Department of Public Health 2018; CDC 2018b]. Certain job factors such as high job demands, job insecurity, and lack of control over tasks have also been linked to opioid use [Kowalski-McGraw et al. 2017]. Medication-assisted treatment (MAT) (also known as medication- based treatment*) has been shown to be effective for many people with opioid use disorder [SAMHSA 2015b; National Academies of Sciences, Engineering, and Medicine 2019]. In addition to providing general information about MAT, this document provides information for employers wishing to assist or support workers with opioid use disorder.

Background

Challenges related to prescription drug misuse, illicit drug use, and addiction affect individual workers, their families, and both large and small businesses. In a 2017 National Safety Council survey, 70% of employers reported suffering the negative effects of prescription drug misuse; noting positive drug tests, absenteeism, injuries, accidents, and overdoses [Hersman 2017]. In 2013, the total U.S. societal costs of prescription opioid use disorder (OUD) and overdoses were $78 billion. Of that, about $2.8 billion was for treatment [Florence et al. 2016].^†

In 2016, individuals with insurance coverage received $2.6 billion in services for treatment of opioid addiction and overdose, a dramatic increase from $0.3 billion in 2004 (based on claims data from large employers). Of that $2.6 billion, $1.3 billion was for outpatient treatment, $911 million was for inpatient care, and $435 million was for prescription drugs [Cox et al. 2018].

Employers may save up to $2,607 per worker annually (based on 2012‒2014 data) by getting workers into treatment [NSC et al. 2016; NORC].

Despite these findings, 80% of individuals in need of treatment for a substance use disorder in 2016 did not receive treatment [CBHSQ 2017]. Making medication- assisted treatment (MAT) more readily available to people with OUD can help diminish the opioid crisis in the United States.

^{*Note that some experts recommend the term “medication-based treatment” or MBT instead of MAT. This change in nomenclature aligns with the premise that OUD is a chronic disorder for which medications are first-line treatments (often an integral part of a person’s long-term treatment plan) rather than complementary or temporary aids on the path to recovery [National Academies of Sciences, Engineering, and Medicine 2019].}

^{†The White House Council of Economic Advisers [CEA 2017] estimated the economic cost of these deaths related to opioids “using conventional economic estimates for valuing life routinely used by U.S. Federal agencies.” The CEA report “also adjusts for underreporting of opioids in overdose deaths, includes heroin-related fatalities, and incorporates nonfatal costs of opioid misuse.” CEA estimates that in 2015, the economic cost of the opioid crisis was $504.0 billion, or 2.8 percent of GDP that year.”}

Treatment

What is medication-assisted treatment (MAT)?

MAT uses medications approved by the U.S. Food and Drug Administration (FDA) in combination with counseling and behavioral therapies to treat OUD involving misuse of either prescription or illicit opioids.

Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health logos
Centers for Disease Control and Prevention
National Institute for Occupational Safety and Health