Opioid use disorder (OUD) is rising among older adults. Better access to the treatment drug methadone in skilled nursing facilities would help to improve recovery rates in this population, according to a call for regulatory change published Tuesday in Health Affairs.
Older adults with OUD have an outsized risk of complications from falls and fractures. This can lead to frequent transitions among ambulatory clinics, hospitals and post-acute care settings, wrote Molly McGrath, a policy specialist at the American Society for Addiction Medicine. McGrath advocates for increased access to “effective, evidence-based treatment models for older adults” at these clinical transit points and in multiple settings of care.
In particular, OUD treatment could be “improved dramatically” for older adults undergoing post-acute rehabilitation in SNFs, she wrote.
SNFs are required to offer access to the three standard treatments for OUD, including methadone. But strict methadone regulations require that patients who are prescribed these drugs visit opioid treatment programs on a nearly daily basis, limiting use in these settings.
McGrath recommends three policy changes that would help remove current barriers to methadone access in SNFs:
- Align Medicare reimbursement for opioid treatment programs under skilled nursing facilities’ “consolidated billing”;
- Allow addiction medicine physicians to prescribe and dose methadone for OUD; and
- Cover methadone treatment for OUD with Medicare Part D
“These policy changes are essential during a time when hospitalizations related to opioid use have been rising and older adults have a growing need for treatment for OUD,” she concluded.
The full story can be found on Health Affairs’ website.
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