Twelfth International Conference on Health, Wellness & Society

Abstract

COVID-19 continues to worsen the overdose crisis; of the over 93,000 fatal overdoses in 2020, 70% were opioid-involved. In response, FDA regulatory policies related to the medications used to treat opioid use disorder [OUD] have been loosened to expand access to medication-assisted treatment [MAT]. However, MAT remains stigmatized, and its uneven implementation has an ongoing, harmful impact on access to pharmacotherapy amongst marginalized groups. In this paper, I conduct an interpretive content analysis wherein I examine eleven federal policy and clinical guideline documents to answer the following research questions: What is MAT, and who are the key actors, institutions, and stakeholders in its development? Why is MAT considered best practices while remaining controversial and under-implemented? To what extent and in what ways does MAT represent a novel approach for treating OUD? My findings suggest that contradictions at the interface of policy and practice, stigma in the medical and public sphere, an absence of institutional pathways that guarantee or streamline the cooperation of clinical jurisdictions, insufficient attention to factors mitigating access to treatment, and the persistence of ideologies which frame addiction medicine as a specialty, hinder the implementation of MAT, especially amongst marginalized groups. These contradictions, along with federal policy shifts and the rising prominence of synthetics in the drug supply, signal a new wave of the opioid epidemic. I contend that the development of more robust policies which codify, promote, and guarantee cross-jurisdictional cooperation is necessary to expand access to medication-assisted treatment.