Association between availability of medications for opioid use disorder in specialty treatment and use of medications among patients: A state-level trends analysis

Keisha T. Solomon, Sachini Bandara, Ian S. Reynolds, Noa Krawczyk, Brendan Saloner, Elizabeth Stuart, Elizabeth Connolly

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Access to medication for opioid use disorder (MOUD) is a recognized public health challenge to improving the health of people with opioid use disorder (OUD) in many communities. Prior studies have shown that although MOUD availability has increased over time, particularly in some states, many substance use treatment facilities still do not offer medications. The relationship between greater availability of MOUD and use of MOUD among patients in treatment programs is not well understood. Methods: We used the National Survey of Substance Abuse Treatment Services to calculate the percent of specialty facilities per state providing MOUD from 2007 to 2018 and the Treatment Episode Data Set-Admissions (TEDS-A) to estimate the likelihood that a patient would have MOUD as part of their treatment plan during the same time period. We estimated models with patient-level TEDS-A data as the outcome and state-aggregated one-year lagged availability of MOUD in facilities as the main predictor, stratifying by treatment facility type (intensive outpatient, non-intensive outpatient, and residential). Results: We found that increasing MOUD availability at the facility level was associated with increased MOUD use in non-intensive and residential facilities at the patient level. Specifically, a 10 percentage point increase in MOUD availability was associated with a 4.5 percentage point increase in MOUD use among patients of non-intensive outpatient facilities (p-value = 0.03), and a 2.5 percentage points increase in residential facilities (p-value = 0.02). Non-Whites and patients in the Northeast had greater likelihoods of increased MOUD use in response to increased availability by facilities. Conclusion: Increasing MOUD availability among specialty treatment facilities is likely to promote better access to MOUD for patients seeking treatment for OUD.

Original languageEnglish (US)
Article number108424
JournalJournal of Substance Abuse Treatment
Volume132
DOIs
StatePublished - Jan 2022

Keywords

  • Medication availability
  • Medication treatment
  • Medication use
  • Opioid use disorder
  • Outpatient treatment facilities
  • Residential treatment facilities

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health

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