Lifting eviction moratoria shifted treatment for substance use disorders

About 2.7 million U.S. households face an eviction filing each year. The effect of eviction policy on substance use disorder (SUD) treatment is uncertain.

We used IQVIA all-payer claims, Jan 2020-Dec 2021, in a difference-in-differences design. Phase 1 compared states where moratoria expired March-August 2020 with states that kept protections. Phase 2 examined the August 2021 end of the federal moratorium, contrasting states with ongoing state moratoria vs none. The population was people with a mental health or SUD diagnosis. Outcomes were state-week counts of unique patients with outpatient SUD visits, inpatient SUD stays, medications for opioid or alcohol use disorder, and opioid use disorder (OUD)-specific outpatient and inpatient care.

Ending moratoria was associated with more patients receiving outpatient SUD care: +3.3% (95% CI -0.5% to 7.2%; P = 0.09) in Phase 1 and +4.9% (95% CI 1.8% to 8.0%; P = 0.002) in Phase 2. We observed no change in inpatient SUD care. In Phase 2, medication treatment increased by 2.5% (95% CI 0.3% to 4.7%; P = 0.03). OUD-specific results were similar.

The return of eviction risk coincided with greater use of clinic-based SUD services but not hospital care. Housing policy may shift where and how people seek SUD treatment.