Bureaucratic red tape at the state and federal levels is hindering access to treatments for opioid use disorder, a new analysis from the Pew Charitable Trusts shows.

Why it matters: Pew found that nearly all states have rules governing opioid treatments that are not based in evidence and, in turn, limit access to care or worsen the patient experience.

What they found: 19 states and the District of Columbia require a certificate of need to open a new facility that can dispense methadone, and experts say is critical to reducing overdose deaths.

• 16 states require opioid treatment programs to have a pharmacy license or registration.
• Every state except South Dakota and Massachusetts allows programs to terminate a person if they use drugs while receiving treatment, despite federal guidelines and research recommending against this.
• Federal guidelines require eight drug tests per year as a part of methadone treatment, but 26 states require more than the federally-required amount.

Despite opioid dispensing rates decreasing in the last decade, the painkillers still play a role in many overdose deaths; in 2020, opioids were involved in 68,630 such fatalities, per the CDC.

• The majority of people needing treatment for opioid-use disorder don't get it, and if pandemic-era reforms expire, it's possible even more people will lose access.