Medication Treatment For Opioid Use Disorders In Substance Use Treatment Facilities

Abstract

Medication treatment (MT) is one of the few evidence-based strategies proposed to combat the current opioid epidemic. We examined national trends and correlates of offering MT in substance use treatment facilities in the United States. According to data from national surveys, the proportion of these facilities that offered any MT increased from 20.0 percent in 2007 to 36.1 percent in 2016-mainly the result of increases in offering buprenorphine and extended-release naltrexone. Only 6.1 percent of facilities offered all three MT medications in 2016. Facilities in states with higher opioid overdose death rates, facilities that accepted health insurance overall (and, more specifically, those that accepted Medicaid in states that opted to expand eligibility for Medicaid), and facilities in states with more comprehensive coverage of MT under their Medicaid plans had higher odds of offering MT. The findings highlight the persistent unmet need for MT nationally and the role of expansion of health insurance in the dissemination of these treatments.

Exhibit 1. Trends in the proportion of outpatient substance use treatment facilities that offered medication treatment (MT), 2007–16

source Authors’ analysis of data for 2007–16 from the National Survey of Substance Abuse Treatment Services. note All changes from the first year to the last year were statistically significant (p < 0:001). ^aExtended release.

Exhibit 2. Association between the proportion of outpatient substance use treatment facilities in each state that offered medication treatment (MT) in 2016 andstates’ opioid overdose death rates per 100,000 population in 2015–16

source Authors’ analysis of data for 2016 from the National Survey of Substance Abuse Treatment Services and for 2015–16 based on data from the Centers for Disease Control and Prevention drawn by the authors from the CDC Wonder database. notes The exhibit shows death rates for the District of Columbia as well as the fifty states. The correlation between the share of facilities offering MT and death rates was significant (p < 0:001), with a correlation coefficient of 0.61.