Improving Access To Substance Use Disorder Care In Nursing Facilities

The population of aging patients with substance use disorder (SUD) requiring care in nursing facilities is growing, yet these facilities are not sufficiently prepared to provide evidence-based treatment for such conditions, including opioid use disorder. Policy and practice innovations are needed to address barriers to access and care within these settings. This article provides an overview of the regulatory landscape and reviews existing efforts to improve the uptake of care for SUD in US nursing facilities, including educational and technical assistance programs; policy toolkits; state-based financial incentives; and collaborations among nursing facilities, community-based addiction services, and hospital systems. We also discuss broader reforms, such as improving reimbursement for SUD treatment, reducing regulatory barriers for methadone treatment, standardizing facility policies related to SUD care, and aligning quality measures with financial incentives.