NEW RESEARCH: OPIOID CRISIS “MIRACLE MOLECULE” METHADONE PREDICTABLY TIED TO MORE OVERDOSE DEATHS
As consistently evidenced over decades, increased provision of the doctor-dispensed drug commonly abused with additional opioids again increases opioid overdose deaths
by Clark Miller
Published October 10, 2025
From the published research appearing August 20 of this year –
Abstract
Methadone is a vital medication for opioid use disorder, yet it remains underused because of restrictive federal and state regulations. Before 2018, not all state Medicaid programs covered methadone treatment. This prompted passage of the 2018 Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, mandating Medicaid coverage of methadone by 2020. This study evaluated the impact of expanded coverage on methadone distribution and opioid overdoses. Using controlled substance distribution data from the period 2016–24, as well as national mortality data, we compared states newly covering methadone in Medicaid to states with existing coverage. New coverage of methadone was associated with an increase of 86.6 grams per 100,000 population (a 13.2 percent relative change) in treatment versus control states. Still, there was an increase of 14.4 percent in opioid overdose deaths in treatment versus control states in the post period. These results suggest that the SUPPORT Act boosted population-level methadone distribution, although rising overdose rates indicate a need for broader addiction treatment policy solutions to effectively address the crisis.
[emphasis added]
That of course was the predicted outcome
based on what we understand, what is established, for methadone’s role in fueling overdose in the worsening crisis covered including here and here. More recent research and evidence establishing the predictable contribution of methadone to opioid deaths are covered here and here.
The research article is worth reading through to gain some appreciation for the degree of remarkable contortions required to attempt to maintain the pretense that methadone does or has ever provided benefit against high-risk opioid use and the decades-old worsening crisis.
Let’s review, just to stay grounded:
A 13.2 percent increase in provision of the medical opioid use cure methadone led to an increase by 14.4 percent in opioid overdose deaths.
Predictably.
As for other reports consistently (see here and here and here and here) – following the measured increase in methadone use in the treatment states versus control and along with the increase in opioid overdose deaths – overdose deaths in treatment states attributed to methadone trended upward while they trended downward in control states, that apparent decrease in control states almost certainly tied to widespread, intensive naloxone campaigns over that period.
[Highlighting and emphasis added]
Those changes correspond closely to timeline of the increase in methadone dispensing in control versus treatment states.
[Highlighting and emphasis added]
And the results are congruent with analyses of effects of Medicaid expansion on high-risk opioid use, nonfatal overdose, and overdose deaths, described for example in this post.
And a graphic illustrating trends for expansion along with opioid overdose incidence for one state pre- and over pandemic years –
It’s important to affirm, as reported widely, that a primary and successful desired outcome of Medicaid expansion has been to increase enrollment of individuals trapped in compulsive opioid use and the crisis on the rationale that state insurance paying for increased access to America’s gold standard, proven treatments for opioid use disorder (OUD) including medications for OUD (MOUD) would benefit them and predict gains against the lethal crisis.
What we know is that those changes instead predicted increased high-risk opioid use, overdose, and deaths, study outcomes and evidence continuing to consistently affirm those outcomes.
