SUD Treatment in Medicaid: Variation by Service Type, Demographics, State, and Spending

REGION 8 SUBSTANCE USE DISORDER CONSULTATION TEAM DATA SNACK: MEASURES OF SUCCESS IN TREATMENT FOR OPIOID USE DISORDER? JANUARY 15, 2025 Dana Abbey, MLS Engagement Specialist Network of the National Library of Medicine, Region 4 Data Snack Article Key Themes •7.2% of Medicaid enrollees aged 12-64 have a diagnosed SUD, but this may underestimate the true prevalence. •Nearly three-quarters of diagnosed enrollees received some form of treatment in 2020. •Only 4 in 10 Black enrollees with OUD received medication treatment compared to nearly 7 in 10 White enrollees. •States vary significantly in their treatment rates for SUD among Medicaid enrollees. Diagnosed substance use disorders in Medicaid claims data, by state, 2020 State Any SUD Opioid Use Disorder Alcohol Use Disorder Colorado 7.8% 2.5% 3.5% Montana 11.4% 3.2% 5.9% North Dakota 11.1% 3.0% 5.5% South Dakota 6/8% 0.7% 3.8% Utah 11.4% 5.5% 3.5% Wyoming 6.4% 1.2% 3.1% Key Implications •A need for better screening and diagnostic practices. •A need for increased outpatient services. •Address racial, ethnic, and age disparities in treatment access. •Address state spending and policy disparities. •Prioritize funding to develop cost effective management strategies. •Address behavioral health workforce and facilities shortages. Emerging Themes of Success 1. Staying sober (patient/physician) 2. Taking steps to improve physical and mental health (patient/physician) 3. Improved psychological well-being (patient/physician) 4. Improved relationships (patient/physician) 5. Improved role functioning (patient/physician) 6. Tapering off buprenorphine (patient) 7. Decreased stigma and shame (patient) Addressing Tapering •Tailor messages about tapering to suit each patient's circumstances. •Make a plan to manage other withdrawal symptoms, including anxiety and sleeping problems. •Discuss non-medicine approaches to help when tapering and ensure patient feels supported. VA Opioid Taper Decision Tool Affects of Stigma •People who need care may not seek it. •People fear disclosing their substance use. •People receive a poorer quality of care. •People have reduced access to health programs. •People may increase their substance use. Addressing Stigma •Replace stigmatizing language •Address systemic discrimination •Understand substance use disorders as chronic, treatable medical conditions.