The Effect of Opioid Abatement Funds on Medication-Assisted Treatment Utilizations for Opioid Use Disorder

• In Event: From Funding to Outcomes: Evaluating Opioid Policy, Spending, and Treatment Access

Abstract

Introduction: The opioid crisis has affected more than 5.7 million individuals in the United States. Although medication-assisted treatment (MAT) is an effective and recommended first-line treatment for opioid use disorder (OUD), its uptake remains low. Limited access and insufficient government support are among the key factors contributing to the underutilization of MAT. Beginning in 2022, state governments and localities started receiving opioid abatement funds from pharmaceutical manufacturers and distributors as part of legal settlements to address the opioid crisis. Several states have allocated portions of these funds to programs aimed at expanding access to MAT. Purpose/Research Question: This study evaluates the impact of state spending of opioid abatement funds on MAT utilization in substance use treatment centers using a difference-in-differences design.Data: State-reported admissions to substance use treatment centers were obtained from the Treatment Episode Data Set–Admissions maintained by the Substance Abuse and Mental Health Services Administration. Thirty-three states spent opioid abatement funds to MAT-related programs in 2022 and 2023, with the share of funds devoted to MAT ranging from 3% to 56%. Treatment variables were constructed as binary indicators reflecting whether a state allocated any funds to the general treatment category or to specific MAT strategies. The primary outcome was MAT-related admissions, measured both as the absolute change in admissions per 100,000 state population and as the relative change in MAT admissions as a share of all substance use treatment admissions.Results: Spending in the general treatment category was associated with a marginal 13.4% increase in admissions to substance use treatment centers (p < 0.10), but showed no significant effect on MAT utilization. However, analyses of heterogeneity across states revealed important differences. In states that restricted the supplantation of abatement funds with existing program funds, spending either in the general treatment category or in targeted MAT programs was associated with significant increases in MAT utilization. These states also experienced a significant rise in MAT use among individuals admitted with OUD.Conclusion/Implications: This study provides the first multi-state evidence on the effects of opioid abatement funding on MAT utilization in treatment settings. Overall, the findings suggest that investments in the general treatment category increase overall utilization of substance use treatment services in state-funded facilities. Importantly, states that prohibit supplantation experience substantial gains in both MAT utilization and overall treatment access. In contrast, allowing supplantation appears to offset nearly all positive effects of the funding. This suggests that, without such restrictions, abatement funds may substitute for existing healthcare expenditures rather than generating a net increase in resources for opioid-related programs.

Author

• Jiajing Scarlette Shi, Georgia State University
  Presenting Author