Medication-Assisted Treatment Provider Shortage Hitting Rural Areas Hardest

Providers might have an easier time than in years past when it comes to getting approval to offer medication-assisted treatment (MAT) to individuals dealing with opioid addiction. Nonetheless, geographical barriers remain a significant impediment to those services being dispensed on a wider scale, especially in rural communities.

These are the findings of a new report released by the U.S. Department of Health and Human Services’ (HHS) Office of Inspector General (OIG). It reveals that the nation’s rural areas have been particularly affected by a lack of adequate access to MAT.

An estimated 2.1 million Americans have been diagnosed with opioid use disorder (OUD), according to the Substance Abuse and Mental Health Services Administration (SAMHSA), a branch of HHS, which supplied data for the report.


Additionally, opioid overdose deaths have increased sixfold in America since 1999, according to OIG, with opioids making up a majority of the nation’s drug overdose fatalities in 2017, according to the Centers for Disease Control and Prevention.

In 2000, Congress passed the Drug Addiction Treatment Act, enabling physicians to obtain waivers to provide MAT to patients suffering from drug addiction, including OUD.

Although more legislative measures in the years since have expanded the availability of MAT services, only a relatively small percentage of the individuals who need MAT have gotten it.


“The growth of opioid misuse and abuse among Americans combined with inadequate access to quality, specialized substance abuse treatment continues to fuel the opioid crisis,” HHS said in the report.

Buprenorphine — sold under the brand name Subutex — is one of the more commonly used MAT drugs, as it helps diminish opioid withdrawal symptoms.

For people in rural communities, however, buprenorphine can be hard to come by, according to the report.

The report indicates that 40% of all U.S. counties lacked a single provider authorized to dispense buprenorphine, and the vast majority of those counties — 72% — are located in rural areas. Meanwhile, only about 63% of all counties nationwide can be categorized as rural.

The report also noted that 56% of 1,110 counties where need for the drug was needed most had little to no transportation access to clinics or other health facilities where buprenorphine could be administered.

OIG advocated for more providers to deliver buprenorphine services in areas where need is the greatest. They specifically suggested that in rural areas, SAMHSA could work closely with states and grantees to help providers obtain buprenorphine waivers, as well as to help them develop effective telehealth services for patients lacking adequate transportation access in their communities.

SAMHSA concurred with HHS’ recommendations.

“OIG appreciates SAMHSA’s efforts to address this important issue, and urges SAMHSA to continue their work in this area to ensure access to MAT,” OIG stated in the report.