There’s another epidemic that’s accompanied the country’s opioid crisis, according to a new report.
The opioid epidemic is driving a simultaneous epidemic of infectious diseases, according to a report from the National Academies of Sciences, Engineering, and Medicine.
The U.S. has seen an increase in numerous infectious diseases—including HIV, hepatitis C virus and bacterial infections and sexually transmitted infections, the report said. That increase is attributed to people sharing needles, having unprotected sex and lacking access to medical care.
Four states hardest hit by the opioid epidemic—Tennessee, Kentucky, Ohio, and West Virginia—have seen a 364% increase in acute hepatitis C virus infections in the past few years, the report said. Patients in rural areas, in particular, lack access to care since there is a shortage of providers including physicians, social workers, therapists, and counselors.
Numerous barriers stand in the way of addressing the co-occurring epidemics including policy, financing, stigma and workforce shortages, according to the report, which called for the integration of opioid use disorder (OUD) and infectious disease services.
The report recommended state and federal policy actions, including removing insurance requirements on prescribing medications for OUD, such as buprenorphine, expanding access to medications in criminal justice settings and lifting state bans on controversial syringe service programs.
Methadone clinics, primary care clinics, and jails and prisons see thousands of patients that need treatment for both OUD and infectious diseases each year and should be able to integrate care for both, the National Academies said.
Restrictions on the types of services they can provide prevent some organizations from integrating services for patients. For example, some state Medicaid laws do not allow billing for medical care and behavioral health services on the same day, the report noted.
“Substance and opioid use disorder treatment is already segregated from traditional medical care. Treating OUD and infectious diseases as separate epidemics only reinforces stigma,” said Carlos del Rio, M.D., professor of medicine at Emory University School of Medicine and professor of global health at the Rollins School of Public Health of Emory University, and chair of the committee that wrote the report.
“The better we integrate services, the sooner we can connect people to diagnosis, treatment, and prevention and achieve successful health outcomes,” he said.
Among the changes called for in the report:
- Removal of prior authorization requirements for prescribers to obtain approval from insurers to prescribe buprenorphine to treat patients with OUD
- Congress should take action to make more providers eligible to prescribe buprenorphine without undergoing time-consuming mandatory training
- Congress lifting the ban on using federal funds to purchase equipment at syringe service programs
- States revising billing policies to allow for more than one service in a given day, which would allow multiple providers to bill on the same day for the same patient or allow the same provider to bill for different diagnoses
A study released earlier this year found that despite changes to expand access to medication treatment for patients with opioid addiction, only 10% of primary care providers in the U.S. are certified to prescribe buprenorphine—not enough to address the country’s ongoing opioid epidemic