Study: OUD rate in Massachusetts four times higher than previously estimated

A recent study finds that 4.6% of people over the age of 11 in Massachusetts have an opioid use disorder, a figure nearly four times higher than previous estimates based on national data.

The study, led by researchers at Boston Medical Center and published in the American Journal of Public Health, involved an analysis of various public health data sets. Traditional estimates, by comparison, count only those who have interacted with the healthcare system. Those who don’t encounter the system and perhaps overdose, for example, would not be included in typical estimates.

Researchers also noted in the release that individuals with substance use disorders are less likely to seek care or be insured, and when asked by a provider about sensitive topics such as drug use, tend not to self-report.

“The majority of people with opioid use disorder are in the community but have not had contact with the healthcare system,” Joshua Barocas, MD, the researcher at Boston Medical Center who led the study, told Addiction Professional in an email. “These individuals are at particular risk for overdose since they have not encountered any resources or medications that can help with their disease. It is incredibly important for clinicians to be aware of the barriers that exist for patients with opioid use disorder, to ensure that they are using non-stigmatizing language, and that their practices have the capacity to treat this disease.”

Among the study’s findings:

• The portion of Massachusetts residents over the age 11 with opioid use disorder climbed from 2.72% in 2011 to 4.6% in 2015, with increases in each year along the way.
• Those between the ages of 11 and 25 had the greatest increase of any age group, climbing from 63,989 in 2011 to 119,160 in 2015.
• Rural counties had some of the highest prevalence estimates, including: Barnstable (5.03%), Berkshire (6.06%), Bristol (5.81%), Hampden (5.34%) and Worcester (4.38%). Suffolk County, which includes Boston, had a prevalence of 3.36%.

Clinicians should focus on two action items based on the findings of this study, Barocas said.

“As clinicians, we need to recognize that the onus is on us to engage with the community, rather than waiting for people who are suffering from opioid use disorder to come to us,” Barocas said. “Second, we need to ensure that treatment is accessible. This means that more clinicians need to obtain a waiver to prescribe buprenorphine. We need to ensure low barrier access to medications.”