Receipt of Pharmacotherapy and Association with Healthcare Utilization Among US Adults with Alcohol or Opioid Use Disorder, 2022-2023.

Abstract

Every year, millions of US adults with substance use disorders (SUDs) interface with the healthcare system, with high rates of emergency department (ED) visits and hospitalizations. FDA-approved medications for alcohol (AUD) and opioid use disorder (OUD) have been shown to decrease acute care utilization for addiction-related issues. However, the characteristics of adults who receive these medications and how receipt is associated with healthcare utilization are not well understood. The objective of this study was to characterize US adults with AUD or OUD who received addiction pharmacotherapy and to examine the association between pharmacotherapy receipt and healthcare utilization in a nationally representative cross-sectional sample. Using data from the National Survey of Drug Use and Health 2022-2023, we included US adults with AUD or OUD and tested the association between self-reported receipt of pharmacotherapy for SUD and healthcare utilization (ED visits, nights hospitalized, and outpatient visits) using negative binomial regression models adjusted for sociodemographic covariates and medical comorbidities. Among US adults with AUD and/or OUD, only 4.8% reported use of medication for addiction treatment in the past 12 months. In adjusted models, receiving pharmacotherapy for substance use was associated with increased number of times treated in the ED (IRR 1.57; 95% CI 1.16, 2.14) increased number of nights hospitalized (IRR 2.79; 95% CI 1.10, 4.87) and increased number of outpatient visits (IRR 1.28; 95% CI 1.02, 1.60). In this nationally representative sample of adults with substance use disorder, few reported receipt of pharmacotherapy for SUD in the past year. Individuals receiving MAUD or MOUD reported higher rates of healthcare utilization. The findings underscore the need to identify best practices in outpatient settings to screen and initiate treatment for individuals with substance use disorders, ideally prior to decompensation requiring a higher level of care.