Executive Summary:

The opioid overdose epidemic is one of the most urgent public health issues in the United States today, killing nearly 50,000 people every year and contributing to a variety of other health complications. Opioid agonist treatment (OAT) is the provision of medications that activate the opioid receptors to prevent withdrawal and reduce cravings for opioids and is the safest and most effective treatment for people with opioid use disorders. Currently, the two medications approved for OAT are methadone and buprenorphine. Opioid agonist treatment is credited with dramatically reducing risk of opioid overdose deaths and improving other health outcomes.

Despite its demonstrated effectiveness, barriers to OAT access arise in various areas of law and policy, restricting access for many in need. The Network for Public Health Law convened the Cross-Sector Attorneys for Health, a group of more than a dozen public health attorneys seeking to bring cross-cutting areas of legal and policy expertise to address critical public health issues. The group identified the overdose crisis and OAT access as a high priority requiring immediate attention and met monthly over the past 18 months to develop the findings and recommendations in this paper. We hope advocates across different legal and policy areas will utilize it to address OAT access barriers in their areas of work.

This paper identifies barriers to OAT access and potential solutions to improve OAT uptake in eight sectors. We do not represent this document as comprehensive of all that must be
done, but we do believe the barriers described are the most significant and the solutions proposed would be the most impactful.

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