By Alison Takkunen and Karmen Hanson
The country is amid an opioid epidemic, and states are actively addressing the issue by working to expand access to evidence-based treatment.
Medication assisted treatment (MAT) is the most effective therapy, which combines FDA-approved medications with behavioral therapies such as counseling.
States have recently increased access to MAT through different legislative actions including expanding opioid use disorder (OUD) treatment programs and enhancing health insurance coverage for these diseases.
Wisconsin expanded its effort to combat the heroin and opioid epidemic through the Heroin and Opioid Prevention and Education agenda. The state enacted Act 262 in the 2017-18 session, which created a behavioral health review committee proposing substance abuse counseling and modified administrative rules related to substance abuse counseling.
It qualified physician assistants and advanced practice nurses to provide maintenance and detoxification treatment. The act also requires school boards to provide instruction about drug abuse awareness and prevention, extends graduate training of psychiatric nurses and created education materials for social workers handling substance abuse cases.
Indiana’s comprehensive state effort aims to expand Opioid Treatment Programs (OTPs).
This session, Indiana enacted House Bill 1007 (2018), which allows the Division of Mental Health and Addiction to grant approval for an additional nine OTPs operated by a licensed hospital or community mental health center. Opioid treatment programs created under this expansion must report the impact on access, number of individuals served, treatment outcomes and recommendations for future programs. Indiana’s Senate Act 221 (2018) mandates prescriber use of the INSPECT Program—the state’s prescription drug monitoring program—and requires prescribers to check the database and obtain patient information prior to prescribing an opioid.
In April of 2017, Virginia’s Medicaid program launched an enhanced substance use disorder (SUD) treatment benefit through an 1115 demonstration waiver.
The program—Addiction and Recovery Treatment Services (ARTS)—provides treatment benefits for SUD and expands access to comprehensive addiction services for enrollees of Medicaid, FAMIS, FAMIS MOMS and the Governor’s Access Plan. Benefits include expanded community-based addiction and recovery treatment services, inpatient detoxification, residential treatment and medication assisted treatment under Medicaid and other providers.
According to the Virginia Department of Medical Assistance Services, the ARTS programs increased treatment rates by more than 50 percent since implementation for individuals with opioid and other use disorders, by increasing the number of treatment facilities and practitioners who prescribe buprenorphine, a medication-assisted treatment.
In addition, Vermont’s Hub and Spoke model focuses on coordinated care by integrating treatment facilities and programs into its health care system. Rhode Island increased substance use disorder screening and access to medication assisted treatment services for people incarcerated in correctional facilities.
These are just some of the many examples of how state legislatures are acting to increase access to treatment for opioid use disorder. More legislative examples to combat substance use disorder may be found here.
Alison Takkunen is an intern in NCSL's Health program. Karmen Hanson is a program director in NCSL's Health program.