MAT Access for OUD Lower for Patients Involved with Criminal Justice System

A new study from researchers at the University of Pennsylvania has found that Medicaid expansion has been associated with “substantial improvements” in access to medications for the treatment of opioid use disorder for individuals referred to treatment by criminal justice agencies. Still, however, criminal justice-involved individuals are less likely to receive MAT for OUD compared to those referred to treatment by other sources.

Findings from the study were published this month by Health Affairs.

Reviewing 2008-17 data from SAMHSA’s Treatment Episode Data Set-Admissions (TEDS-A), researchers noted flags indicating medications for OUD were part of a patient’s treatment plan at admission. The data included more than 3.2 million adults with OUD, 21% of which were referred by a criminal justice agency.

While the overall percentage of individuals receiving MAT increased across all referral sources during the 10-year period, criminal justice-involved individuals were less likely to receive medications. The disparity did narrow, however, with the expansion of Medicaid, as 16.5% of criminal justice-involved OUD patients received medications in 2017 compared to 6.5% of those in 2008.

“Our study shows that Medicaid expansion is an important tool for expanding access to evidence-based care for people involved in the criminal justice system,” senior author Tyler Winkelman, MD, MSc, Co-Director of the Health, Homelessness, and Criminal Justice lab at the Hennepin Healthcare Research Institute and a clinician-investigator in the Division of General Internal Medicine at Hennepin Healthcare, said in a Penn Medicine News release.

“However, Medicaid alone will not entirely close gaps in care between people with and without criminal justice involvement. Additional work is needed to understand key drivers of the persistent disparities we identified.”