A new study by Dr. Yong-Fang Kuo, PhD, Professor and Chair of the Department of Biostatistics and Data Science at the UTMB School of Public and Population Health (SPPH), and Dr. Jordan Westra, PhD, MPH, Assistant Professor, Department of Epidemiology, examines the rise in medication treatment for opioid use disorder (OUD) among older adults—and the disparities that continue to exist. The study, published in the American Journal of Preventive Medicine, shows that while more Medicare beneficiaries over 65 are receiving treatment, the rate was still low. In addition, many populations face barriers to care.
Progress Made, But Gaps Remain
Analyzing national Medicare data from 2017 to 2022, researchers found that medication use for OUD—including methadone, buprenorphine, and naltrexone—rose from 4.8% in 2017 to 15.0% in 2022. This increase came after Medicare began covering methadone treatment, showing how policy changes can improve access. However, the research revealed that Black and Hispanic patients, men, rural residents, and older individuals were less likely to receive these medications.
The study also found that 79% of patients suffered from chronic pain or arthritis, and half had anxiety, depression, or anemia, highlighting the complex health needs of older adults with OUD.
Insights from UTMB Researchers
Dr. Kuo, the Don W. and Frances Powell Professor in Aging Research, brings decades of expertise in biostatistics, health services research, and pharmacoepidemiology to the study. Her work has been widely published in medical and health services research journals and has been supported by the National Institutes of Health (NIH), the Agency for Healthcare Research and Quality, and Cancer Prevention and Research Institute of Texas. Dr. Kuo’s research evaluates patterns of care, treatment effectiveness, and health outcomes in aging populations, including the safety and effectiveness of opioid and benzodiazepine substitutes.
“The disparity in MOUD use suggests a need for policy and clinical guideline changes aimed at narrowing race, sex, and rural-urban disparities in MOUD use,” said Dr. Kuo. “Analyzing real-word data can provide empirical evidence on the impact of health policies which is important for public health practice.”
Dr. Westra, an Assistant Professor and biostatistician, focuses on health disparities and treatment access. Before joining UTMB SPPH, he worked in data management and research analysis, specializing in biostatistics for health outcomes and healthcare utilization studies. His background in clinical science and public health research informs his approach to analyzing complex healthcare data and identifying barriers to effective treatment.
“The percent of people who use MOUD to treat opioid use disorder is too low overall, which exacerbates the disparities that are present by age, race, or comorbidity status,” said Dr. Westra. “Highlighting these areas of disparity can help guide future research and set priorities in policy changes to improve treatment of opioid use disorder.”
A Focus for Public Health
Dr. Neil Mehta, PhD, MSc, MA, Associate Dean for Research at SPPH, emphasized the importance of continued investigation. "This important research by Drs. Kuo and Westra provides critical evidence about opioid treatment access among older adults, an often-understudied population in addiction research. Their findings showcase our school's strengths in aging research and commitment to engaging in rigorous research on health disparities."
Closing the Gap in Treatment Access
This research demonstrates how academic public health can shape healthcare policy and address urgent public health issues. As opioid use disorder continues to affect older adults, UTMB SPPH remains focused on leading the charge in research, education, and practice.
For more information about this study, please visit the American Journal of Preventive Medicine.