Latest news with #OUD
Health Line
30-06-2025
- Health
- Health Line
Does Medicare Cover Opioid Treatment Programs?
Original Medicare covers opioid treatment programs (OTPs) for opioid use disorder (OUD) from Part B. The program must be government-certified and accredited by an independent, government-approved accrediting body. Opioid use disorder (OUD) is a severe medical condition that can affect people psychologically and physically. Help is available from many healthcare professionals, clinics, and facilities, with some offering OTPs. Medicare covers eligible treatments for OUDs. However, if you choose an OTP, you may have fewer out-of-pocket costs. Medicare coverage and opioid treatment programs (OTPs) For an OTP to be eligible for coverage through Medicare, it must be Substance Abuse and Mental Health Services Administration (SAMHSA) certified and have accreditation from a SAMHSA-approved body. If you receive Medicare-approved OTP services from a facility or healthcare professional enrolled in Medicare, you will not typically have to pay any copayments. However, you must pay the Part B deductible for OTP supplies and some medications. If you receive the same services through a doctor or another healthcare professional, you must pay the 20% Part B coinsurance after you've paid the $257 deductible. If you're eligible for both Medicare and Medicaid, you will pay $0 for the services you receive through your state Medicaid program. If you have a Medicare Advantage plan, you will have the same coverage rules as Original Medicare. However, you may have network restrictions based on your plan type. Medicare's OTP services Medicare covers different services under its OTP benefit, including: Food and Drug Administration (FDA)-approved medications, including opioid agonists like methadone and opioid antagonists like naltrexone substance misuse counseling, including individual and group sessions periodic assessments intensive outpatient programs peer recovery help services toxicology tests referral services coordinated care Original Medicare Part B will cover some of the prescription medications you may be given. However, you may need a Part D prescription drug plan for others. If you have a Medicare Advantage plan, your plan must include drug coverage for some medications to be covered. Medicare and OTP eligibility Anyone with OUD is eligible for an OTP, and doctors look for specific symptoms when diagnosing the condition. The Centers for Disease Control and Prevention (CDC) states that healthcare professionals should confirm a diagnosis of OUD using a checklist. This list derives from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR). You may also require blood or urine screenings that check for opioids and assess whether you are at risk of addiction. »Learn more: Risk Factors for OUD Support for opioid use disorder Seeking help for addiction can feel daunting or even scary, but several organizations are there to help. If you believe that you or someone close to you is displaying signs of addiction, you can contact the following organizations for immediate help and advice: SAMHSA: 800-662-4357 (TTY: 800-487-4889) 988 Suicide & Crisis Lifeline: 988 Frequently asked questions Below are some common questions about OUD and OTP treatment services. Does Medicare pay for opioid treatment? Yes, both Original Medicare and Medicare Advantage plans pay for eligible costs relating to the diagnosis and treatment of OUD. Medicare Part D prescription drug plans also cover the costs of some OUD medications. Out-of-pocket costs may apply, and depending on their plan, you may have to visit in-network doctors and facilities. Yes, both Original Medicare and Medicare Advantage plans pay for eligible costs relating to the diagnosis and treatment of OUD. Medicare Part D prescription drug plans also cover the costs of some OUD medications. Out-of-pocket costs may apply, and depending on their plan, you may have to visit in-network doctors and facilities. What is the new treatment for opioids? In May 2023, the Food and Drug Administration (FDA) approved Brixadi (buprenorphine) extended-release injections to treat moderate to severe OUD. Brixadi (buprenorphine) is available in either a weekly or monthly injection. Which one a doctor gives you will depend on whether you are new to the medication. In May 2023, the Food and Drug Administration (FDA) approved Brixadi (buprenorphine) extended-release injections to treat moderate to severe OUD. Brixadi (buprenorphine) is available in either a weekly or monthly injection. Which one a doctor gives you will depend on whether you are new to the medication. What is the gold standard treatment for opioid use disorder? Research from 2023 confirms that the 'gold standard' evidence-based medication treatment for OUD is methadone, buprenorphine, or naltrexone. Research from 2023 confirms that the 'gold standard' evidence-based medication treatment for OUD is methadone, buprenorphine, or naltrexone. What are opioid treatment programs? Opioid treatment programs are purpose-driven treatment plans for OUD. OTPs typically involve a combination of different therapies, including talking therapies, prescription medications, periodic assessments, and peer support. Opioid treatment programs are purpose-driven treatment plans for OUD. OTPs typically involve a combination of different therapies, including talking therapies, prescription medications, periodic assessments, and peer support. Summary If you have Original Medicare, Part B covers opioid treatment programs (OTPs) in full if you have opioid use disorder (OUD) and meet eligibility requirements. People with Medicare Advantage plans have the same coverage but may need to visit in-network doctors or healthcare facilities. If you have OUD, you can recover, and help is available through your healthcare team, Substance Abuse and Mental Health Services Administration (SAMHSA) at 800-662-4357, or through the 988 Suicide & Crisis Lifeline at 988. The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.
Medscape
12-06-2025
- Health
- Medscape
Fast Five Quiz: Opioid Use Disorder
Opioid use disorder (OUD) currently impacts approximately 16 million people worldwide. It is considered a significant public health issue, with experts noting a 'burden that is increasing' globally. As research into optimal management of OUD evolves, updates to clinical guidelines emphasize a more individualized approach to pharmacologic treatment, psychosocial support, and special considerations for specific patient populations, such as pregnant individuals. However, OUD remains a complex disease that comes with many serious health and legal concerns for both patients and clinicians. What do you know about OUD? Check your knowledge with this quick quiz. Despite pharmacologic treatment being known to be highly effective for treating OUD, a CDC report states that 30% of patients with OUD who require OUD treatment received only nonpharmacologic treatment. Further, 43% of patients did not perceive a need for OUD treatment at all. In this significant report, males aged 35-49 years were most likely to receive OUD treatment with medications, while females and younger and older adults had lower rates of access to pharmacologic interventions. The CDC concluded that engaging patients needing OUD treatment with pharmacologic interventions is 'essential.' Learn more about essential statistics for OUD. Data from a predictive-model study indicate that service setting was the strongest predictor for premature discontinuation of OUD treatment. The strength of this predictor declined with length of stay, becoming negligent after 365 days. Other system-level factors such as geographic region, primary source of payment for treatment, and referral source were also strong predictors of early discontinuation; individual factors such as age of first use, sex, and race were less predictive. Previous research cited by the study has also stressed the importance of reducing system-level barriers to care, and the updated federal guidance for opioid treatment programs have expanded access in several ways. Learn more about OUD guidance. Precipitated withdrawal can occur when transferring a patient from methadone to buprenorphine due to buprenorphine being only a partial opioid agonist; as such, the traditional method of transfer involves putting the patient in a controlled, moderate withdrawal state before initiating buprenorphine therapy. However, a novel dosing strategy called microinduction, which involves starting buprenorphine at submilligram doses (or 'low-dose induction'), and cross-tapering with methadone can prevent precipitated withdrawal. Additionally, this method is ideal for patients who want to switch from methadone to buprenorphine and those with chronic use of intravenous or intranasal fentanyl. A recent systematic review found that microinduction and traditional transfer methods had similar rates of successful induction of buprenorphine at 95.6%. Learn more about safe withdrawal practices for OUD. Both the CDC and the latest American Society of Addiction Medicine (ASAM) guidelines specifically state that pharmacotherapy for OUD should be offered as early as possible in pregnancy to prevent harms to both the patient and the fetus, noting that pharmacotherapy for OUD has been associated with improved maternal outcomes. ASAM specifically states, 'increasing the dose or split dosing is often required, especially in the third trimester.' Federal guidelines emphasize that pregnant individuals seeking treatment for OUD are considered a priority for enrollment in opioid treatment programs. Once receiving treatment, they do not generally recommended medically supervised withdrawal from pharmacotherapy for pregnant patients as it might harm the fetus and patient; further, ASAM guidelines state that patients who undergo medically supervised withdrawal are at an increased risk for 'return to opioid use.' However, if a patient decides to proceed with medically supervised withdrawal, ASAM guidelines suggest physicians provide education and resources regarding associated risks. The CDC also specifically recommends against abruptly discontinuing opioids during pregnancy, citing data and resources from the American College of Obstetricians and Gynecologists and the Substance Abuse and Mental Health Services Administration. Learn more about OUD. Federal guidelines specify that opioid treatment programs must conduct at least eight random drug tests per year on their patients. These tests must use FDA approved products that test for commonly abused substances that might affect patient safety, recovery, or adherence to OUD treatment. ASAM affirms this requirement, noting that many patients might need more frequent testing and that eight tests per year 'should be viewed as a minimum.' Learn more about drug testing in OUD. Editor's Note: This article was created using several editorial tools, including generative AI models, as part of the process. Human review and editing of this content were performed prior to publication.
Yahoo
02-06-2025
- Business
- Yahoo
Foundation for Opioid Response Efforts Announces New Funding Opportunity for Community-Based Organizations Addressing Opioid Use Disorder
New York, June 02, 2025 (GLOBE NEWSWIRE) -- The Foundation for Opioid Response Efforts (FORE) is announcing a new Request for Proposals (RFP) to support community-based organizations (CBOs) working to reduce opioid use disorder (OUD) and overdose mortality in local communities. FORE will hold an informational webinar on June 5, 2025, at 2:00 p.m. ET to discuss the RFP and answer questions. Interested organizations can . This RFP expands FORE's Community-Driven Responses to OUD and Overdose Mortality Program, providing new funding to help CBOs: Enhance operational effectiveness, including administration, finance, human resources, and technology, to strengthen long-term sustainability and diversify funding. Improve communications to raise awareness and attract attention and resources. Strengthen and evaluate programming to expand access to evidence-based OUD services for individuals and families. Foster cross-sector collaborations with partners in education, business, courts, and healthcare to deepen community engagement and expand services. FORE invites eligible organizations to apply for up to $75,000 per year for two years (up to $150,000 total). Applicants must be a U.S.-based 501(c)(3) or have a 501(c)(3) fiscal sponsor, have been in operation for at least two years, and have an annual operating budget between $150,000 and $7 million. Complete details and application instructions are available on FORE's Grants & Funding page. Applications must be submitted through FORE's grants management system by 11:59 p.m. PT on July 2, 2025. 'Community-based organizations are uniquely positioned to identify and respond to local needs, yet they often face barriers to securing the flexible funding they need to strengthen operations and sustain programming,' said Dr. Karen Scott, President of FORE. 'By supporting their capacity, we help ensure communities have access to effective prevention, treatment, harm reduction, and recovery services tailored to their needs.' Since 2023, FORE has supported 22 community-based organizations through capacity-building grants and remains committed to advancing community-driven, evidence-based solutions to the opioid crisis. About FOREFounded in 2018, FORE is a national 501(c)(3) grant-making foundation dedicated to addressing the nation's opioid crisis. Through strategic grantmaking, convening stakeholders, and developing informational resources, FORE supports patient-centered, innovative solutions that drive long-term change. To date, FORE has awarded 118 grants totaling $47.5 million to 101 organizations. Follow us on X (Twitter) and LinkedIn for updates. CONTACT: Myrna Manners Foundation for Opioid Response Efforts 718-986-7255 mmanners@ in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Yahoo
02-06-2025
- Business
- Yahoo
Berkshire Biomedical Awarded NIH Research Grant to Support Clinical Study Program to Evaluate Patient Retention and Other Benefits of the COPA™ System for Take-Home Methadone Medication Management
Funds from the Two-Phase Fast-Track SBIR Grant, Combined, Would Total Approximately $2.9 Million DALLAS, June 2, 2025 /PRNewswire/ -- Berkshire Biomedical Corporation ("Berkshire" or "the Company"), focused on developing its proprietary drug dispensing technology to enhance patient wellness, today announced that it has been awarded the first phase of a two-phase Fast-Track Small Business Innovation Research (SBIR) grant (1 R44DA061908-01A1) from the National Institutes of Health's (NIH) National Institute of Drug Abuse (NIDA). Valued at approximately $2.9 million over 30 months, the two-phase grant will support execution of a clinical study to evaluate patient retention and other benefits of the Company's COPA™ System for Take-Home Methadone Medication Management as part of Medication for Opioid User Disorder (MOUD) treatment. Phase I funds of approximately $326,400 will support the execution of a single-site study. Receipt of the approximate $2.55 million Phase II award will support the execution of an open-label, randomized, parallel multi-site study, which will be contingent on an assessment of the Phase I report, as well as the review and approval of any other documentation necessary for continuation and availability of NIH funds. COPA is a novel, oral liquid dispensing system specifically designed to deliver accurate and precise doses of controlled and non-controlled prescription medications to only an Authenticated Intended User (AIU™), upon confirmation of dual biometric identifications (fingerprint and dentition) prior to each dose, with the goal of enhancing patient wellness and providing remote monitoring. "The Fast-Track SBIR grant process is highly competitive, with only 18% of applicants having been chosen under this program in 2023, alone," stated John Timberlake, Chief Executive Officer of Berkshire. This is Berkshire's second Fast-Track SBIR Grant from NIH. The Company received an initial two-phased award totaling $2.2 million (1R44DA057185) in 2022 which extended through 2024, to complete the development of the COPA system. Berkshire's receipt of this newest award reflects the NIH's continued belief in the strength of the technology behind COPA and its potential to significantly increase access to Opioid Treatment Programs for persons suffering from Opioid Use Disorder (OUD) by dramatically increasing the number of persons being allowed to utilize take home therapy." Mr. Timberlake continued, "The requirement to travel to an Opioid Treatment Program (OTP) clinic, daily, has been shown to reduce treatment retention and deter some patients from even starting treatment. A mixed methods study found that take-home dose flexibility among stable patients was associated with receiving more take homes, higher rates of treatment retention, and lower rates of opioid-positive drug tests. Higher retention rates in opioid use disorder medication among patients with OUD were, therefore, associated with better outcomes. There have been a considerable number of retrospective studies evaluating opioid use disorder treatment retention; however, there are very few prospective comparison studies." About the National Institute on Drug Abuse (NIDA)NIDA is a component of the National Institutes of Health, U.S. Department of Health and Human Services. NIDA supports most of the world's research on the health aspects of drug use and addiction. The Institute carries out a large variety of programs to inform policy, improve practice, and advance addiction science. For more information about NIDA and its programs, visit About the National Institutes of Health (NIH)NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit About Berkshire Biomedical Corporation Berkshire Biomedical Corporation is a privately held medical device company. Berkshire is pioneering the use of biometric technologies, combined with encrypted HIPAA compliant cloud-based and healthcare provider-enabled remote management systems, to provide precise and accurate personalized medication delivery to only the Authenticated Intended User (AIU). The Company's lead product under development, the Computerized Oral Prescription Administration System (COPA), is a hand-held, automated, personalized oral liquid dispensing system designed and intended to deliver controlled and non-controlled liquid oral medications to only the AIU upon confirmation of dual biometric identification (fingerprint and dentition). Upon receiving regulatory authorization, the Company intends to initially seek opportunities to leverage COPA in the delivery and remote management of oral liquid medication methadone, for Medication Use for Opioid Use Disorder treatment and subsequently for the delivery of controlled medications for the treatment of pain, as those patients have the greatest need for the benefits of COPA's features. In addition, the Company will look to expand COPA use in broader drug therapeutic categories, clinical applications, and businesses that manage the commercialization and data analytics provided by electronic devices to improve outcomes and reduce risk. Additional information about Berkshire Biomedical and the COPA System can be found at The COPA™ System is currently under development, has NOT been reviewed by the U.S. Food and Drug Administration and is not available for commercial sale. Disclaimer: Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Numbers R44DA057185 and R44DA061908-01A1. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. CONTACT: Berkshire Biomedical Corporationinfo@ Melody CareyFounder, President, and CEORx Communications Group, LLCmcarey@ View original content: SOURCE Berkshire Biomedical Corporation Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Axios
28-05-2025
- Health
- Axios
What opioid addiction costs Arkansas
Opioid abuse is as much an economic problem as a public health one, according to a comprehensive analysis from Avalere provided to Axios. Why it matters: The total average annual cost to Arkansas for each case is $551,000. The big picture: The cost burden falls unevenly, with states in a belt stretching through Appalachia to New England typically having bigger caseloads and a higher cost per case. Opioid use disorder cost the U.S. an estimated $4 trillion last year, per the analysis, which used 2017 figures to project 2024 net costs. "While this is a cost to government, it's also a cost to private businesses, and the huge cost, of course, is to the individuals who have OUD," said Margaret Scott, a principal at Avalere and author of the report. By the numbers: The projected cost of opioid use disorder in 2024 ranged from $419,527 per case in Idaho to more than $2.4 million in D.C. That covers lost productivity, health insurance costs, property lost to crime and other variables. The cost per case totaled more than $1 million in West Virginia, Rhode Island, Ohio and Maryland. Some of the regional variation in costs is from lost tax revenue, which varies by state. The local availability of treatment for opioid use disorder may also drive the cost, Scott said. Zoom in: Overdose deaths from all drugs in Arkansas dropped 26% in 2024, according to CDC data. In 2023, Arkansas Children's Hospital announced a $70 million National Center for Opioid Research and Clinical Effectiveness to be established in Little Rock with $50 million coming from opioid settlement money. State of play: Opioid use disorder — defined as frequent opioid use and unsuccessful efforts to quit — is estimated to affect more than 6 million people in the United States. The cumulative economic burden on patients, including years of life lost and reduced quality of life, exceeded $3 trillion in 2024, Avalere estimated. Private businesses absorbed more than $467 billion in costs from lost productivity and health insurance costs while the federal government bore about $118 billion in Medicare and other federal insurance costs, lost taxes and criminal justice expenses. It cost state and local governments more than $94 billion, with about $42 billion of that going toward criminal justice costs. The Trump administration in March released its own analysis that estimated illicit opioids cost the U.S. about $2.7 trillion in 2023. Treatment can defray the costs by more than 40% in some instances, the analysis found. Behavioral therapy alongside long-acting injectable buprenorphine — a treatment that reduces the risk of future overdoses — generated an estimated $295,000 savings per case, the biggest cost-saver of the options Avalere analyzed. Therapy plus methadone and therapy plus buprenorphine administered through mucous membranes like the mouth each save about $271,000. Behavioral therapy alone saves a project $144,000 per case.
