Methadone Treatment for Opioid Use Disorder has Increased, but Access Gaps Persist

Despite growth in the use of medications used to treat opioid use disorder (OUD) – including methadone, buprenorphine, and naltrexone – most people with OUD in the United States still do not receive medication. National estimates show only 25% of individuals with OUD receive medications for OUD (MOUD), underscoring a persistent gap between need and access.

Research published in JAMA Health Forum found methadone treatment among Medicaid enrollees increased substantially over the past decade. After modest growth between 1999 and 2010, methadone use more than tripled in the years that followed, reaching 6.2 people with OUD per 1,000 Medicaid enrollees by 2020. Buprenorphine use rose even more sharply, reaching 12.0 people with OUD per 1,000 enrollees that same year.

Although these increases reflect progress in the use of medications supported by a robust evidence base, the findings underscore MOUD access remains far below the level of need. Medicaid is the largest insurer of people with OUD in the United States, making trends within the program central to national treatment capacity. Even with the rising use of methadone and buprenorphine, the majority of individuals with OUD are still not receiving medication treatment.  Stigma against people who use drugs and the use of medication to treat drug use disorders are known barriers to uptake. 

The authors highlight recent policy efforts to expand methadone access, including increased take-home flexibility and proposals to broaden prescribing authority, and stress the importance of examining whether these changes lead to greater treatment

access.

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Reference:

Hsu, Y., Thakrar, A. P., Leonard, C. E., et al. (2025). Trends in methadone use for pain and opioid use disorder among Medicaid enrollees. JAMA Health Forum, 6(11), e255023. https://doi.org/10.1001/jamahealthforum.2025.5023