New data demonstrates that fentanyl has complicated addiction treatment in the U.S. by increasing the prevalence of polysubstance use in patients seeking treatment.
The data — from the Kennewick, Washington-based medication-assisted treatment (MAT) provider Ideal Option — show that as many as 61% may need treatment for at least two different substances.
“Polysubstance use disorder is now the most common diagnosis at Ideal Option,” Tim Kilgallon, CEO at Ideal Option, said in a news release. “In 2022, over half of all patients tested positive for two or more substances at enrollment, and 27% tested positive for three or more substances.”
In 2020, Ideal Option reported that 51% of patients came to treatment with polysubstance use.
The outcome data come from toxicology results and patient-reported outcomes.
“In the outpatient treatment setting, objective and accurate test accountability is essential to the patient-provider therapeutic alliance and, together with medication and psycho-social support and guidance, is a key element of the treatment process,” the report states.
Ideal Option was founded in 2012 and is a Varsity Healthcare Partners portfolio company. It invested in Ideal Option in 2018. Ideal Option lists 92 locations in 11 states and continues adding several locations yearly.
The company’s average annual census growth was 17% from 2019 to 2022. Ideal Option cared for about 15,000 patients at the end of 2022. About two-thirds were unemployed; 16% were homeless and 69% were covered by Medicaid.
About 56% of patients required care for opioid-use disorder (OUD), the single most common condition. Including some of those patients, 24% of all patients required treatment for OUD and stimulant-use disorder. Only 40% of patients came to Ideal Option needing treatment for using only one substance.
The data also tracks how fast fentanyl, a synthetic opioid, has replaced other opioids on the illicit market. In 2017, the positivity rates for patients positive for opioids who were using heroin or prescription pills were about 60% and 77%, respectively. In 2022, fentanyl positivity was just under 50%, while prescription pills and heroin positivity dropped to about 30% and 20%, respectively.
The report also spells out how patients make their way to Ideal Option.
“To build relationships with community stakeholders and encourage patient referrals, Ideal Option conducts outreach in every community in which our clinics are located,” the report states.
Social services deliver about 38% of Ideal Option’s community referrals, the single largest source of referrals. Social services, inpatient treatment providers and jails account for 73% of all referrals.
The report also details aggregate treatment outcomes.
About 67% of patients who made it two a second treatment remained in treatment for six months, while 59% made it to nine months and 53% made it to 12 months. About 85% of Ideal Option patients return for that second visit.
By the end of 2022, Ideal Option saw the percentage of those that made it to one of two defined maintenance phases of treatment was 52%, compared to 16% in 2019. Population drug positivity rates for all substances drop to single-digit percentages in these maintenance states.
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