Viewpoint: Strengthening opioid treatment resources for Maine seniors



By Sen. Susan M. Collins 

The opioid epidemic continues to claim the lives of far too many people, with record numbers of both Mainers and Americans lost in 2021. While many perceive the face of opioid addiction as young, the epidemic harms older adults as well. In Maine, more than 10 percent of drug overdose deaths last year were among residents 60 and older.  

We must ensure the unique needs of seniors struggling with addiction are not forgotten. That’s why I joined my colleague from Maryland, Sen. Ben Cardin, to introduce legislation to improve seniors’ awareness of, and access to, opioid use disorder treatment covered by the Medicare program. Our bill, the Supporting Seniors with Opioid Use Disorder Act of 2022, is in response to recent findings from the inspector general that confirm the urgent need to increase the number of Medicare beneficiaries receiving treatment for opioid use disorder. 

The challenges of the COVID-19 pandemic, combined with the increased prevalence of fentanyl, have aggravated this national crisis. Well before COVID, however, the number of people age 55 or older treated in emergency rooms for non-fatal opioid overdoses was increasing, with an alarming 32 percent jump in ER visits from 2016 to 2017. In 2018, as chair of the Senate Special Committee on Aging, I chaired a hearing on this very topic in attempt to shed light on this often-overlooked population. One expert witness told the Aging Committee, “Medicare beneficiaries are the fastest growing population of diagnosed opioid use disorders.” 

Compounding these disturbing statistics is a December 2021 Department of Health and Human Services Office of Inspector General report exploring whether Medicare beneficiaries with opioid use disorder receive medication and behavioral therapy. It found more than one million Medicare beneficiaries were diagnosed with opioid use disorder in 2020, yet fewer than 16 percent of those patients received medication to treat their addiction. The report also concluded older beneficiaries were three times less likely to receive medication to treat their disorder than younger beneficiaries. Even fewer beneficiaries received both medication and behavioral therapy. The conclusion is clear: Medicare beneficiaries are not receiving the treatment they need.  

Our bill would codify the recommendations made by the HHS OIG regarding how to improve beneficiaries’ awareness of Medicare coverage for opioid use disorder treatment, and how to identify current gaps and opportunities to better meet the needs of this unique population. Specifically, our legislation would require Centers for Medicare & Medicaid Services to conduct additional outreach to beneficiaries to increase awareness about Medicare coverage for the treatment of the disorder, such as by revising outreach and enrollment materials, making state and national contact information for health care providers publicly available in an easily accessible manner, and developing or improving continuing education programs on opioid medications and substance use disorder treatment programs. Our bill would also improve data sharing within agencies at Health and Human Services with the goal of obtaining a better understanding of current treatment gaps. 

Lastly, the bill would require Health and Human Services to convene a stakeholder meeting to share best practices on the use of behavioral therapy among beneficiaries receiving medication to treat opioid use disorder. Emerging research points to evidence that patients receiving medication to treat opioid use disorder may also benefit from behavioral therapy, so this opportunity for collaboration on strategies to support better treatment engagement and continuity could be beneficial to both patients and health care professionals. 

The overdose crisis continues to ravage our country, and it is critical that people who are suffering from opioid use disorder have access to the treatment they need to survive and thrive – including our seniors. Challenges in treatment and recovery undoubtedly persist, but the actions taken in this legislation can help guide our continued response.  

Susan Collins is Maine’s senior U.S. senator.  

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