RELAXED PRESCRIBING AND SAFETY STANDARDS FOR MEDICAL (MAT) OPIOIDS TIED TO INCREASED OVERDOSE DEATHS
In Vermont as elsewhere, OD deaths involving MAT opioids buprenorphine and methadone have increased after experts pushed through changes to make them easier to get.
by Clark Miller
Published June 3, 2024
Vermont is among a majority of states that adopted federal loosening of take-home doses and other standards for methadone dispensing, and was granted less restrictive safety standards as were all states for buprenorphine prescribing and training requirements for prescribers.
How have opioid trends played out over the period of relaxed safety standards beginning in 2020? Here are the data for select years, from this report –
For methadone-involved opioid overdose deaths:
2015 2016 2017 2018 2019 2020 2021 2022 2023
7 14 12 11 9 18 17 29 19
One could construct a line graph, but I don’t think that’s necessary.
And for buprenorphine-involved OD deaths:
2015 2016 2017 2018 2019 2020 2021 2022 2023
2 1 0 6 3 2 2 5 14
Those apparent trends and changes associated with more reckless prescribing and dispensing of America’s gold standard opioid treatment medications are not anomalous, are instead predicted and consistent with outcomes in other locales.
From JAMA, an illustration that Vermont is one of a minority or few states that increased methadone provision over past years by relaxing longstanding safety standards.
As fully explored in this recent post, additional states or regions illustrating the same lethal, predictable outcomes include:
Ohio
Arizona
Colorado
Washington DC, and
Ontario, Canada
In Vermont as in other locations, those increases in MAT opioid-involved deaths occurred despite concurrent increases over the time period in use of naloxone to reverse potentially lethal overdoses.
And while the Narcan moderating effect appeared to slow overdose deaths for other, non-MAT opioids –
a pattern seen in Ohio as well –
That should tell us something.