Medication Availability for Alcohol Use Disorder in Substance Use Disorder Treatment Facilities

Area of Science:

• Public Health
• Addiction Medicine
• Health Services Research

Background:

• Alcohol Use Disorder (AUD) is a significant public health issue.
• Medications for AUD (MAUD) are effective but underutilized treatments.
• Understanding MAUD access is crucial for improving treatment capacity.

Purpose of the Study:

• To analyze trends in MAUD availability at US substance use disorder treatment facilities (SUDTFs) from 2017 to 2023.
• To identify county-level characteristics associated with the presence of SUDTFs offering MAUD.

Main Methods:

• Nationwide cross-sectional study utilizing longitudinal data from the Mental Health and Addiction Treatment Tracking Repository (2017-2023).
• Quantified MAUD availability at SUDTFs, defined as offering acamprosate, disulfiram, or naltrexone.
• Used logistic regression with state and year fixed effects to assess associations between county characteristics (rurality, poverty, demographics) and MAUD availability.

Main Results:

• The percentage of US counties with at least one SUDTF offering MAUD rose from 34.12% in 2017 to 43.88% in 2021, with growth plateauing thereafter.
• Limited MAUD availability was associated with rural-adjacent and rural-remote counties, higher poverty rates, older populations, and higher proportions of non-Hispanic White individuals.
• Conversely, higher rates of binge drinking and greater percentages of college-educated individuals were linked to increased MAUD presence.

Conclusions:

• MAUD availability in SUDTFs expanded significantly from 2017 to 2021 but has since stagnated.
• Persistent disparities in access exist, particularly in underserved rural and high-poverty areas.
• Policy interventions are necessary to enhance MAUD access and address treatment gaps in vulnerable populations.