The Supply of DATA-waivered Providers and Opioid Treatment Programs for Medication-Assisted Treatments in Ohio

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Date

2021-05

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The Ohio State University

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Abstract

Introduction: The United States' opioid crisis has hit Ohio especially hard with being among the top 5 states for the highest drug overdoses. The expansion of Medication Assisted Treatment (MAT) under the DATA of 2000 has enabled more providers outside of opioid treatment programs (OTPs) to prescribe treatment for opioid use disorder. This study aims to characterize the co-locations of waivered providers and OTPs authorized to perform MAT and the concentrations of drug overdose deaths in Ohio to understand whether capacity is available to meet the needs of reducing opioid mortality. Methods: Provider waiver data and a directory of OTPs for Ohio counties were obtained from the Substance Abuse and Mental Health Administration during 2019. Opioid overdose metrics were extracted from the County Health Rankings and Roadmaps program, and poverty and population levels were taken from the U.S Census. Waivered provider density was calculated as the number of DATA-waivered providers per 100,000 population for each county. Pearson correlational tests tested the correlations between waivered provider density, poverty rate, and opioid mortality rate, along with OTPs and overdose deaths. Results: Results indicated that most of the waivered practitioners across Ohio with waivers to prescribe buprenorphine for substance abuse were Physicians (57%), followed by Nurse Practitioners (NPs) (27%) and Physician Assistants (PAs) (4%). The average waivered provider density was 13.90 per 100,000 population. A significant positive relationship was observed between the density of providers and opioid overdose death rates across Ohio counties (P<0.001). Poverty rates weakly correlated with overdose rates overall. Also, a strong positive relationship was observed between the number of OTPs and drug overdoses in a county (P <.001). Conclusion: Although the Comprehensive Addiction and Recovery Act expanded prescribing capacity to include NPs and PAs, physicians still represent the majority of waivered providers in Ohio. A medium positive relationship between waivered provider density and opioid overdose mortality rates suggest that providers in high need regions are more likely to obtain waivers. But, a moderate correlation may still suggest an inadequate workforce supply to reduce opioid burdens. A strong relationship between OTPs and drug overdose deaths may indicate that these programs do locate to where high opioid burdens occur.

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Second Place award in the Health Promotion Category at the 26th Annual Richard J. and Martha D. Denman Undergraduate Research Forum

Keywords

Substance Abuse Disorder, Ohio, DATA-Waivered Providers, Opioid Treatment Programs, Medication-Assisted Treatment, Opioid Mortality

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