Opioid and alcohol use disorder medication availability in outpatient care: national estimates & potential policy levers.

Abstract

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.