Availability of Medications for Opioid Use Disorder Remains Strikingly Low in Specialty Addiction Treatment Programs

Medications for opioid use disorder (MOUD) are proven to treat opioid use disorder and reduce the risk of opioid overdose, but they are underutilized in the U.S. Specialty substance use disorder (SUD) treatment programs—including outpatient, intensive outpatient, and residential programs—have access to health care professionals with SUD treatment expertise and should offer a prime opportunity to initiate MOUD. This study merged a national database of admissions to SUD treatment with state-level data on MOUD accessibility to estimate rates of MOUD availability among SUD treatment programs, and the likelihood that individuals with OUD admitted to these programs will receive MOUD.

• MOUD availability increased in all treatment facilities over time, although a minority of all programs offered MOUD.
• MOUD receipt among individuals with OUD increased from 2007 to 2018 in all treatment facilities.
• In 2018, MOUD receipt by individuals with OUD was lowest in residential treatment settings (11%) versus non-intensive outpatient treatment (40%).
• MOUD utilization gains were highest for individuals in the Northeast, non-White individuals, and those who live in Medicaid expansion states.

Comments: This study demonstrates that access to MOUD remains very low for patients with OUD, even among facilities and programs that receive state and federal funding to provide OUD treatment. Although MOUD availability has increased over the last 10 years, large barriers to access exist in the very programs that have the most resources to provide this care. Efforts to expand MOUD access need to target specialty addiction treatment programs.

Melissa Weimer, DO, MCR

Reference: Solomon KT, Bandara S, Reynolds IS, et al. Association between availability of medications for opioid use disorder in specialty treatment and use of medications among patients: a state-level trends analysis. J Subst Abuse Treat. 2021;132:108424.