Opioid and alcohol use disorder medication availability in outpatient care: national estimates & potential policy levers.
Study Goal
The researchers aimed to identify program characteristics associated with providing medications for alcohol use disorder (MAUD) and explore policy levers to increase access to these evidence-based treatments.
Results Summary
The study found that only 45% of outpatient programs provided MAUD, with state licensure/certification negatively associated and national accreditation positively associated with offering these medications. SUD programs were less likely to offer MAUD compared to MH/SUD programs, highlighting missed policy opportunities.
Population
Outpatient programs providing primarily SUD services or primarily mental health but also SUD services (N = 9,921 programs).
Effective Dosage
Not applicable
Duration
Not applicable
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Medications for opioid and alcohol use disorder (MOUD/MAUD) | increase | relapse prevention care | - | - | are efficacious, important components of relapse prevention care | #1 |
Medications for opioid and alcohol use disorder (MOUD/MAUD) | decrease | use | - | markedly | markedly underused | #2 |
Medications for opioid use disorder (MOUD) | no change | provision by outpatient programs | outpatient programs (excluding opioid treatment programs) that provided 'primarily SUD services' (SUD) or 'primarily mental health but also SUD services' (MH/SUD) | 51% | only approximately half (51%) provide | #3 |
Medications for alcohol use disorder (MAUD) | decrease | provision by outpatient programs | outpatient programs (excluding opioid treatment programs) that provided 'primarily SUD services' (SUD) or 'primarily mental health but also SUD services' (MH/SUD) | 45% | fewer (45%) provide | #4 |
State licensure/certification | decrease | provision of MOUD or MAUD | outpatient programs (excluding opioid treatment programs) that provided 'primarily SUD services' (SUD) or 'primarily mental health but also SUD services' (MH/SUD) | - | was negatively associated with providing these medications | #5 |
National organization accreditation | increase | provision of MOUD or MAUD | outpatient programs (excluding opioid treatment programs) that provided 'primarily SUD services' (SUD) or 'primarily mental health but also SUD services' (MH/SUD) | - | was positively associated | #6 |
SUD programs | decrease | offering MOUD/MAUD | outpatient programs (excluding opioid treatment programs) that provided 'primarily SUD services' (SUD) or 'primarily mental health but also SUD services' (MH/SUD) | - | were less likely to offer MOUD/MAUD compared with MH/SUD programs | #7 |
Medications for opioid and alcohol use disorder (MOUD/MAUD) are efficacious, important components of relapse prevention care, and markedly underused. Yet, not all programs treating substance use disorders (SUD) offer them. Using the Substance Abuse and Mental Health Services Administration's 2022 National Substance Use and Mental Health Services Survey (N-SUMHSS), for outpatient programs (excluding opioid treatment programs) that provided "primarily SUD services" (SUD) or "primarily mental health but also SUD services" (MH/SUD; N = 9921 programs), we identified program characteristics associated with providing MOUD or MAUD, focusing on potential policy levers (state licensure/certification, national organization accreditation) that could increase MOUD/MAUD access. We found that only approximately half (51%) provide MOUD and fewer (45%) provide MAUD. State licensure/certification was negatively associated with providing these medications, while national organization accreditation was positively associated. However, states varied widely in these associations. Additionally, SUD programs were less likely to offer MOUD/MAUD compared with MH/SUD programs. These findings demonstrate missed policy opportunities for states and national accreditation organizations to move SUD care into evidence-based practice.