The medical system is missing a critical step in protecting the health of people with opioid use disorder.
A new study from the University of Pittsburgh and the University of Southern Maine looked at 361,000 Medicaid recipients across 11 states, including Pennsylvania. Researchers found that just one out of four Medicaid enrollees who enter treatment for opioid use disorder get screened for HIV, hepatitis B, or hepatitis C – less than one in five are checked for all three.
Men and rural patients had the lowest screening rates.
These viruses are associated with injection drug use and can result in significant health issues or even death. Pitt's Julie Donohue, the study's senior author, says if people aren't getting tested, they're not getting treatment: "There are highly effective, and in some cases, curative treatments for these conditions. So, we really should see much higher rates."
The study has implications for population health: The more people who don't know they've got one of these viruses, the more likely they are to spread infectious diseases to others.
Donohue, a professor of health policy and management, thinks that policymakers should consider creating financial incentives to increase testing for Medicaid enrollees.
"[The findings are] partly a function of the way substance use disorder treatment is delivered in the U.S.," she said. "It tends to be quite segregated from the rest of medical care and treated separately, even from mental health treatment, which is also necessary and needed for many people with addictions."
Though researchers only looked at Medicaid enrollees, Donohue suspects that similarly low testing rates would be found among patients with private insurance.
The findings will appear in an upcoming issue of Clinical Infectious Diseases.
