Community health centers play an important role in efforts to address the opioid epidemic. In many communities, they are on the front lines of the epidemic and have become an important source of treatment for those with opioid use disorder (OUD). This issue brief presents findings from a 2018 survey of community health centers on health center activities related to the prevention and treatment of OUD. Survey responses indicated that health centers have expanded treatment services in response to the escalating crisis, yet treatment capacity challenges remain. Additionally, health centers in Medicaid expansion states seem to be more equipped to respond to the epidemic in their states than are those in non-expansion states. Key findings include: (1) Most health centers reported an increase in the number of patients with OUD in the past three years. Nearly seven in ten said they saw more patients with prescription OUD while 63% said the number of patients with nonprescription OUD had increased. (2) Nearly half (48%) of health centers provide medications as part of medication-assisted treatment (MAT), considered to be the most effective OUD treatment. Among health centers that provide MAT, nearly two-thirds (65%) offer at least two of the three MAT medications. Buprenorphine is the most commonly prescribed MAT medication, available at 87% of health centers that provide MAT, and 71% of health centers have increased the number of providers who have waivers to prescribe it. (3) Health centers in Medicaid expansion states are more likely to provide MAT than those in non-expansion states (54% vs. 38%).They are also more likely to provide injectable naltrexone, a longer-acting MAT medication. (4) Health centers face many treatment capacity challenges in responding to the opioid epidemic. Among those that provide MAT, 69% do not provide MAT services at all of their sites, and 63% report not having the capacity to treat all patients with OUD. Among health centers that attempt to refer patients for MAT services, 68% said they face provider shortages when doing so. (5) Many health centers (40%) distribute naloxone, an opioid overdose reversal drug. Those in expansion states are nearly twice as likely as those in non-expansion states to provide the drug (47% vs. 26%). Health centers play a critical role in addressing the opioid epidemic and many rely on Medicaid, especially in expansion states, to increase their ability to respond to the crisis.
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