In order to be a Recovery and Prevention focused community we need sufficient capacity to treat substance use disorders. When specifically treating opioid use disorder (OUD), a question is how much Medication-Assisted -Treatment (MAT) capacity should be available in a region. Not all physicians can prescribe OUD medicines. In order for a physician to treat a patient for OUD, they need to complete 8 hours of on-line training and receive a certification. The Federal Substance Abuse and Mental Health Services Administration (SAMSHA) tracks certified physician capacity by state.
This regression analysis compares opioid overdose death rates to SAMHSA reported certified physician capacity within sixteen states over a 14-year period (2002 – 2016) with purpose of understanding if increasing MAT capacity will reduce opioid overdose deaths.
Using a straight-line regression (see Figure 1), the data shows higher deaths at higher physician capacity. However, applying a more nuanced regression approach, semi-parametric tools in R, that look at state data over the years within sections, shows a different curve (see Figure 2).
Figure 1 States are CA, CO, WA, OR, NY, VT, NH, ME, IL, WI, MI, IN, KY, OH, WV, PA
Figure 2 States include CA, CO, WA, OR, NY, VT, NH, ME, IL, WI, MI, IN, KY, OH, WV, PA
The second graph gives some hope that once a community is in the grips of the opioid crisis that deaths can be decreased by increasing the capacity of physicians certified to treat opioid use disorder.
Centerstone has had MAT along with counseling services for several years. Local physician Dr. Saddoris recently became board certified in addiction medicine, increasing her capacity to treat OUD. Columbus Regional Health is planning to open a new specialty Addiction Medicine Clinic with intensive outpatient counseling programs that will include MAT capacity. Groups Recovering Together, Inc. has opened over twenty MAT and counseling clinics across the state in the last year and one in Columbus last month. The state of Indiana is actively promoting awareness that MAT with counseling works in recovering from opioid addiction. Additionally, Indiana is opening up new state certified opioid treatment programs.
 Using mgcv package in R, gamm(Opioid_OD_Deaths ~ Year +s(Certified_Physician_capacity), random = list(State_code=~1), data=Opioid_all )