Report Sheds Light on Barriers States are Confronting When Addressing Opioid Crisis

The Centers for Disease Control and Prevention estimate that over 72,000 people died from drug overdose in 2017. Approximately 49,000—or nearly 70 percent—of these deaths involved opioids. To combat this national health crisis, the Opioid Response Network (ORN) was created to address prevention, treatment and recovery by providing training and technical assistance to meet locally identified needs.

A year into the initiative, ORN partner organization, the National Council for Behavioral Health (NCBH) conducted a series of focus groups in sample states to gain an understanding of their grant-funded activities and uncover barriers. The information they collected is vital to help the ORN provide even more effective assistance.

The focus groups were conducted in Maryland, Michigan, Missouri, North Carolina and New Hampshire. “These states were selected because recent research suggests they have low averages of buprenorphine prescribers relative to opioid overdose deaths,” said Aaron Williams, MA, Senior Director, Training and Technical Assistant for Substance Use, NCBH. “We wanted to learn, in an objective way, what is happening in these communities.” Results from reviewing how the states were using both State Targeted Response (STR) and State Opioid Response (SOR) funding, Williams said, were illuminating and shed light on the challenges they face.

What were the challenges?

Several themes emerged from the focus group discussions:

• Workforce shortages;
• Prescribers with the waiver to prescribe are not prescribing;
• Regulatory challenges;
• Stigma associated with opioid use disorder treatment; and
• Evaluation and sustainability of relevant programs and services.

NCBH’s report notes that a robust and competent workforce of mental health and substance use disorder providers is critical to providing individuals with opioid use disorder essential treatment, recovery, and prevention services. However, it’s estimated that by 2025 workforce shortages will reach more than 10,000 for many behavioral health provider types. In addition to a robust workforce, addressing the opioid use disorder crisis requires Drug Enforcement Administration waivered prescribers of buprenorphine, one of three approved medications for treatment. While efforts have been made at the state and federal levels to increase the number of clinicians prescribing, states still suggested the lack of waivered providers was a concern.

Progress being made

“But what was awesome to see is the creative thinking at play to address problem areas facing states,” Williams said. He calls out how both Medicaid expansion and Non-Medicaid expansion states are being creative to improve the sustainability of their opioid use disorder programs and services. In addition to the STR/SOR funding, all states included in the focus groups are using a variety of funding streams, such as Substance Abuse Prevention and Treatment block grant dollars, Medicaid funding, state general funds, foundation funding, and funding from other federal sources to pay for services and programs.

The full report will soon be available and is intended to be used as a learning tool for all ORN members, TTSs, states, consultants and beyond. For more information contact Aaron Williams at AaronW@TheNationalCouncil.org.