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How do services offered within opioid treatment programs vary based on state methadone policies?
Zoe Lindenfeld1, Noa Krawczyk2, Erin A Taylor3
1Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, NJ, 08901, USA.
Journal of Substance Use and Addiction Treatment
|July 1, 2026
Summary
State regulations for opioid treatment programs (OTPs) impact service availability. Highly restrictive state policies are linked to fewer medication for opioid use disorder (MOUD) options and behavioral health services in OTPs.
Area of Science:
- Addiction Medicine
- Health Services Research
- Public Health Policy
Background:
- State regulations for opioid treatment programs (OTPs) exhibit wide variation in restrictiveness.
- The relationship between state policies and the availability of services within OTPs is understudied.
- This study investigates how state policy restrictiveness affects MOUD options, psychosocial services, and housing supports in OTPs.
Purpose of the Study:
- To compare the availability of medication for opioid use disorder (MOUD) options, psychosocial services, and housing supports across OTPs in states with varying policy restrictiveness.
- To analyze the impact of state-level OTP policies on service offerings within treatment facilities.
Main Methods:
- Cross-sectional study of 1501 OTPs in the United States.
- Examined 11 state-level policies creating barriers for OTPs or patient care.
- Utilized data from the 2023 Mental Health and Addiction Treatment Tracking Repository, linked to a state policy typology (low vs. high restrictiveness) derived from latent class analysis.
Main Results:
- OTPs in highly restrictive states were significantly less likely to offer all three MOUD options and behavioral health services (mental health, trauma-informed counseling, contingency management) compared to those in low-restrictiveness states.
- Adjusted regression models showed facilities in highly restrictive states were less likely to offer naltrexone (ARR: 0.73) and all three MOUD options (ARR: 0.70).
Conclusions:
- Opioid treatment programs (OTPs) are crucial for delivering evidence-based opioid use disorder (OUD) treatment, especially for methadone dispensing.
- Findings indicate that increased state-level restrictions on OTPs correlate with a reduced range of services offered within these facilities.
- Policy implications suggest that reducing regulatory barriers may enhance access to comprehensive OUD treatment services.
Keywords:
BuprenorphineHealth policyHealth services researchMethadoneOpioid treatment programsOpioid use disorderMore Related Videos
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