Few Patients Offered Evidence-Based Treatment for OUD

TOPLINE:

More than a third of substance-use treatment facilities do not offer medications for opioid use disorder (MOUD), and less than half were offered evidence-based psychosocial treatments.

METHODOLOGY:

• To investigate the number of facilities offering medications and psychotherapy for MOUD, researchers conducted a cross-sectional study of specialty outpatient substance use disorder (SUD) treatment facilities for individuals with OUD using the 2022 National Substance Use and Mental Health Services Survey (N-SUMHSS).
• The N-SUMHSS is an annual, multimodal survey conducted via internet, mail, and telephone, targeting representatives of all SUD and mental health treatment facilities in the United States.
• Investigators surveyed 17,353 representatives from outpatient SUD facilities across the United States, with a response rate of 91%.

TAKEAWAY:

• OUD treatment was available at 12,060 outpatient facilities, yet only 7498 offered MOUD (62%). Of these, 45.6% offered at least two types of MOUD, and only 2% offered all four types of MOUD.
• A lower proportion of opioid treatment programs (OTPs) offered any MOUD, any psychosocial treatment, other SUD treatment, and mental health services compared with non-OTPs (16.7% vs 33.5%; P < .001).
• Overall, 35.2% of facilities offered psychosocial treatments only, without any MOUD.
• Contingency management, the psychosocial treatment with the most evidence of effectiveness for OUD, was offered at less than half of facilities (44.6%).

IN PRACTICE:

“Federal and state policymakers should consider implementing payment and regulatory reforms to induce facilities to offer all evidence-based treatments for OUD, including exploring ways to allow non-OTPs to offer methadone, expanding coverage of contingency management, and providing care for co-occurring mental disorders and other SUDs,” the authors noted.

SOURCE:

Tae Woo Park, MD, MSc, of the Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, led the study, which was published online on July 11, 2024, in JAMA. 

LIMITATIONS:

Study limitations include reliance on facility self-report, which may introduce bias. Additionally, the results may not generalize to the 9% of facilities that did not complete the N-SUMHSS or to clinicians who treat OUD outside of a program captured by the survey.

DISCLOSURES:

The study was funded by the National Institute on Aging. Disclosures are noted in the original article. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.