Access to opioid addiction drugs in Philadelphia remains uneven

From Philly and the Pa. suburbs to South Jersey and Delaware, what would you like WHYY News to cover? Let us know! Maggie Lowenstein, an addiction medicine specialist, has seen her patients struggling to get access to medications to treat opioid addiction. She’s an internal medicine doctor at Penn Medicine in Philadelphia. And 2021 research confirms her observation — only one in five people who struggled with addiction received medication to treat it, even though these medications have shown to be effective. So Lowenstein wanted to figure out what it’s like to try to get access to buprenorphine, one of three approved drugs in Philadelphia. To survey the treatment programs in Philadelphia, a researcher called them, posing as a case manager trying to get a patient into treatment. They asked how long a patient would have to wait for an appointment, whether a patient would be able to get a prescription for buprenorphine and whether the program would require patients to be in counseling to get buprenorphine. They conducted their study from September 2022 to January 2023, and published their findings in a recent journal article. Overall, they found that despite some advances, access to treatment remains uneven. They found that programs could offer appointments within a few days. Lowenstein said she was pleasantly surprised by this, as it was an improvement compared to years past. However, only around 42% of the programs said they could offer buprenorphine to a patient immediately, and around 48% could not say whether they require counseling for access to the medication. “We really shouldn’t be delaying medication starts. This is a lifesaving treatment that cuts the risk of death in half,” Lowenstein said. “And there’s no clear justification for why we wouldn’t do it.” She added that research shows requiring counseling as a condition for access to treatment does not help, because the medication works with or without counseling. In 2023, the U.S. Department of Health and Human Services said so as well in an open letter to clinicians. “The mortality of a person who’s had a nonfatal overdose is comparable to … somebody who’s had a heart attack,” Lowenstein said. “The person really needs care as soon as they can get it.”