Services Available at United States Addiction Treatment Facilities That Offer Medications versus Behavioral Treatment Only: A Cross-Sectional, Observational Analysis

Abstract

Purpose

Substance use disorders (SUDs) are widespread and cause significant morbidity and mortality, yet most people in the United States with a SUD do not receive treatment. Recommendations call for widespread use of pharmacotherapy, including medications for opioid use disorder (MOUD). However, many facilities do not offer a full array of medication treatments. This study aims to characterize programs that do and do not offer pharmacotherapy as part of addiction treatment services. We hypothesized that the availability of pharmacotherapy would predict the existence of other recommended components of treatment.

Patients and Methods

We analyzed characteristics regarding treatment facilities (n = 15,782) recorded by the 2019 National Survey of Substance Abuse Treatment Services (N-SSATS) to determine how many SUD treatment facilities offer any pharmacotherapy. We compared facilities that offer any pharmacotherapy to facilities that offer none.

Results

We found that 65% of SUD treatment facilities that responded to the N-SSATS survey provided at least one pharmacotherapy, while 35% of SUD treatment facilities did not. The facilities that provided at least one pharmacotherapy offered, on average, 6 additional treatment options (Cohen’s d = 0.87; 95% CI: 0.84–0.91). Psychiatric medications were the most commonly available pharmacotherapy, followed by buprenorphine/naloxone and naltrexone.

Conclusion

These results support that pharmacotherapy availability, such as MOUD, at SUD treatment facilities is associated with an increased number of recommended treatment components. Since MOUD has been shown elsewhere to reduce mortality for people with OUD, it should be universally available at SUD treatment facilities. Further efforts are needed to make pharmacotherapy more widely available.

Keywords:

• substance use treatment
• buprenorphine
• naltrexone
• pharmacotherapy

Disclosure

Dr. Benjamin Miskle reports stock options from Johnson & Johnson, received speaker fees at the annual meeting from Iowa Pharmacists Association, outside the submitted work. The authors report no other conflicts of interest in this work.