Researchers posing as Medicaid patients in need of buprenorphine were often denied appointments by providers.
Researchers called hundreds of addiction treatment providers across the U.S. while posing as individuals in need of help—in a study of the barriers that people with addiction disorders face when seeking treatment. What they found was a minefield of discouragement, especially when they were posing as people on Medicaid.
According to ABC News, two researchers reading from scripts called 546 prescribers of the opioid addiction treatment drug, buprenorphine, to attempt to schedule an initial screening appointment.
After three tries, 77 of the prescribers were unreachable, often due to outdated contact information on government websites. When they were able to make contact at all, 46% of prescribers denied the researchers appointments when they said they were on Medicaid, compared to 38% when they said they could pay with cash.
This is a serious problem in light of the fact that finding the motivation to go through such a frustrating process is even more difficult when you’re coping with an addiction disorder, says study co-author Dr. Michael Barnett.
“Think about the last time you had to make four or five phone calls in a row and how annoying that was,” he explained. “Addiction makes doing tasks like that even harder.”
According to the Kaiser Family Foundation, 38% of “nonelderly” people with opioid use disorders are covered by Medicaid. Analysis by the foundation found that those on Medicaid were twice as likely to receive treatment for addiction than those with either private insurance or no insurance.
However, the results of this latest study suggest that prescribers are still reluctant to take patients on Medicaid, likely because it doesn’t pay as much as private insurance.
This is particularly true for doctors, who only agreed to schedule appointments 40% of the time. Nurse practitioners and physician assistants, on the other hand, agreed to appointments 70% of the time.
Other barriers included the cost of buprenorphine treatment, which averaged $250 to start but could go as high as $500, plus lab fees. Additionally, some states require Medicaid patients to try other avenues of treatment before they’re allowed to go on buprenorphine in spite of multiple studies finding it more effective than many other forms of opioid addiction treatment.
“Abundant evidence shows that methadone, buprenorphine, and naltrexone all reduce opioid use and opioid use disorder-related symptoms, and they reduce the risk of infectious disease transmission as well as criminal behavior associated with drug use,” reads the National Institute on Drug Abuse website. NIDA Director Dr. Nora Volkow said of the study that the barriers discovered “should be eliminated.”