To Help Tackle the Opioid Epidemic, Indiana Should Expand Access to Evidence-Based Approaches Like Medication-Assisted Treatment

Alex Cohen is the Director of Learning and Evaluation for the Richard M. Fairbanks Foundation.


The opioid epidemic continues to take a devastating toll in Indianapolis and across the state. While there are no silver bullets, there are interventions that have strong evidence for impact. Chief among them is medication-assisted treatment, or MAT.

MAT is often controversial because of the common misconception that it simply substitutes one drug for another (i.e., methadone for heroin). On the contrary, medications like buprenorphine and methadone provide a limited dosage to reduce cravings and withdrawal and help individuals with opioid use disorder on their path to recovery.

Most importantly, it works. There is ample scientific evidence that MAT “successfully reduces substance use, risk of relapse and overdose, associated criminal behavior, and transmission of infectious disease, as well as helps patients return to a healthy, functional life.”

As a result, expanding access to MAT is a key strategy for addressing the opioid epidemic. A look at the data from Marion County, however, reveals that the total need for treatment for opioid use disorder outstrips MAT treatment capacity.

MAT Capacity & Need in Marion Co

An estimated 8,000 people in Marion County suffer from opioid use disorder and may therefore benefit from MAT. MAT can be administered through physicians who have applied for a special waiver to administer buprenorphine to a limited number of patients or through Opioid Treatment Programs, which provide medications, including methadone, and counseling. However, the total number of patients able to be treated in Marion County, either through certified physicians or Opioid Treatment Programs, is just 4,500.

This means that even if certified physicians were prescribing to as many patients as their waiver allowed and Opioid Treatment Programs were operating at full capacity, just 56% of people with opioid use disorder would receive treatment, leaving 3,500 without access.

These numbers underscore the need for ongoing support to expand access to MAT and overcoming barriers like stigma and misinformation about this evidence-based treatment. All who are working to tackle the opioid epidemic in Indiana should focus on what the evidence tells us—and not on anecdotes or misinformation.

Notes on table: Capacity for MAT is the sum of treatment capacity for buprenorphine from physicians and treatment capacity at Opioid Treatment Programs. Treatment capacity for buprenorphine is calculated using the current number of DATA-certified physicians in Marion County and estimated share who are certified to prescribe to 30 and 100 patients, respectively, which is based on the state share for 2016. Treatment capacity at Opioid Treatment Programs is calculated using the current number of Opioid Treatment Programs in Marion County and estimated capacity per facility, which is based on the median Indiana Opioid Treatment Program facility size for 2015. Need for MAT is based on the rate of opioid use disorder in national data for 2015 and the Marion County population for 2015. All data come from SAMHSA, except for population estimates from Census. This approach for calculating gaps in access to MAT follows Jones et al. (2015) “National and State Treatment Need and Capacity for Opioid Agonist Medication-Assisted Treatment” American Journal of Public Health.

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