Do States and Counties Have Capacity to Treat Opioid Use Disorder?

Analyses for DC, Maine, Michigan, New Jersey, New Mexico, Pennsylvania, and West Virginia

Drug overdose deaths have soared during the COVID-19 pandemic; an estimated 99,106 occurred in the 12 months ending March 2021. Strong evidence shows that medication treatment for opioid use disorder (OUD) is effective in reducing overdose deaths, with estimates showing 40 percent reductions in opioid overdose death within community programs.

Yet medication treatment is in critically short supply in counties across the United States. Even if the treatment capacity was doubled, it would fill just between 7 and 28 percent of the need for treatment in the District of Columbia, Maine, Michigan, New Jersey, New Mexico, Pennsylvania, and West Virginia.

In this project, we analyzed opioid use disorder rates and OUD treatment needs and treatment capacity in DC and six states in the Bloomberg Opioid Initiative. Fact sheets about each state, county, and ward can be downloaded below.

 

Data Download

Additional data about medication treatment for OUD in Maine, including estimates for Medicaid, can be found here.

About the Data

The OUD rates are averages of two estimates derived from the National Survey on Drug Use and Health (NSDUH): The first estimate uses substate and national estimates from the NSDUH. The second estimate multiplies these NSDUH-based numbers by a ratio representing the relationship between an NSDUH-based OUD rate, known to be biased downward, and an OUD rate for Massachusetts based on a capture-recapture analysis of seven administrative databases linked at the person level.

We estimate each county’s buprenorphine opioid-agonist treatment capacity using Drug Enforcement Administration data and IQVIA Real-World Longitudinal Prescription data analyzed and published by the RAND Corporation.

We also estimate each county’s methadone treatment capacity using opioid treatment program data from the Opioid Treatment Program Directory and the National Survey of Substance Abuse Treatment Services.

Lastly, we estimate the number of additional buprenorphine prescribers needed per county to fill the estimated treatment gap and discuss strategies to meet the demand for treatment.

Fact sheets display point-in-time estimates of the number of people receiving treatment on any given day, not the total number of people receiving treatment throughout the year.

separate methodological appendix (220.9 KB pdf)  describes the data, assumptions, and methodology.

These fact sheets build on previous work conducted for California in 2019. However, our 2021 methodology differs substantially from our previous methodology, and these estimates cannot be compared with our previously published estimates.