Medications for Opioid Use Disorder Offered at Less Than Half of US Psychiatric Hospitals

A substantial proportion of US psychiatric hospitals do not offer medications for opioid use disorder (MOUD), according to a research letter published in JAMA Network Open.

MOUD is considered the gold standard for treating OUD, yet its utilization remains limited in healthcare settings, including facilities treating patients with co-occurring psychiatric conditions. Therefore, researchers conducted a cross-sectional analysis of facility-level data from the 2022 National Substance Use and Mental Health Services Survey to evaluate the availability of MOUD—namely methadone, buprenorphine, or naltrexone—across psychiatric hospitals nationwide. MOUD availability was assessed as a dichotomous variable, based on self-reported provision of at least a single MOUD option.

Researchers reviewed responses from 1107 psychiatric hospitals, of which 1021 (92.23%) provided complete data on MOUD availability. The hospitals included inpatient psychiatric units within general hospitals (54.65%), freestanding psychiatric hospitals (41.92%), and state hospitals (3.43%). Only 48% of facilities reported offering MOUD.

Facilities that integrated medications for alcohol use disorder (92%) or offered medically managed withdrawal services (70%) were significantly more likely to provide MOUD (both P<.001). However, 30% of facilities offering medically managed withdrawal did not provide MOUD. This gap raises concerns about the increased risk of overdose among patients undergoing detoxification.

Several factors were associated with MOUD provision. Facilities with greater bed capacity were more likely to offer these services (P =.03). Geographic disparities also emerged, with psychiatric hospitals in the Northeast more likely to offer MOUD than those in other regions (57.29%; P=.004). Publicly owned facilities were the least likely to provide MOUD, with only 35.86% offering access, compared to 50.2% of private nonprofit facilities (P=.002).

Overall, the availability of MOUD was positively associated with facilities accepting Medicare or private insurance, offering co-occurring mental health and substance use programs, and having a larger median bed capacity (P<.05).

This study’s limitations include its cross-sectional design, which restricts the ability to explore longitudinal trends or establish causation, and its reliance on self-reported data, which may inflate estimates of true MOUD availability.

“Consistent with prior research in community outpatient mental health facilities, our findings suggest that low MOUD availability is a systematic issue in psychiatric care,” the researchers concluded.

This research was supported by the National Institute on Drug Abuse and the Connecticut Department of Mental Health and Addiction Services. One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

This article originally appeared on Psychiatry Advisor