{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T16:50:27Z","timestamp":1784652627405,"version":"3.55.0"},"reference-count":37,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Medications for opioid use disorder (MOUD) are an effective but underutilized treatment. Opioid use disorder prevalence is high among people receiving treatment in community outpatient mental health treatment facilities (MHTFs), but MHTFs are understudied as an MOUD access point.<\/jats:p><\/jats:sec>Objective<\/jats:title>To quantify availability of MOUD at community outpatient MHTFs in high-burden states as well as characteristics associated with offering MOUD.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cross-sectional study performed a phone survey between April and July 2023 among a representative sample of community outpatient MHTFs within 20 states most affected by the opioid crisis, including all Certified Community Behavioral Health Centers (CCBHCs). Participants were staff at 450 surveyed community outpatient MHTFs in 20 states in the US.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>MOUD availability. A multivariable logistic regression was fit to assess associations of facility, county, and state-level characteristics with offering MOUD.<\/jats:p><\/jats:sec>Results<\/jats:title>Surveys with staff from 450 community outpatient MHTFs (152 CCBHCs and 298 non-CCBHCs) in 20 states were analyzed. Weighted estimates found that 34% (95% CI, 29%-39%) of MHTFs offered MOUD in these states. Facility-level factors associated with increased odds of offering MOUD were: self-reporting being a CCBHC (odds ratio [OR], 2.11 [95% CI, 1.08-4.11]), providing integrated mental and substance use disorder treatment (OR, 5.21 [95% CI, 2.44-11.14), having a specialized treatment program for clients with co-occurring mental and substance use disorders (OR, 2.25 [95% CI, 1.14-4.43), offering housing services (OR, 2.54 [95% CI, 1.43-4.51]), and laboratory testing (OR, 2.15 [95% CI, 1.12-4.12]). Facilities that accepted state-financed health insurance plans other than Medicaid as a form of payment had increased odds of offering MOUD (OR, 1.95 [95% CI, 1.01-3.76]) and facilities that accepted state mental health agency funds had reduced odds (OR, 0.43 [95% CI, 0.19-0.99]).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this study of 450 community outpatient MHTFs in 20 high-burden states, approximately one-third offered MOUD. These results suggest that further study is needed to report MOUD uptake, either through increased prescribing at all clinics or through effective referral models.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.17545","type":"journal-article","created":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T15:30:31Z","timestamp":1718724631000},"page":"e2417545","source":"Crossref","is-referenced-by-count":15,"title":["Availability of Medications for Opioid Use Disorder in Community Mental Health Facilities"],"prefix":"10.1001","volume":"7","author":[{"given":"Jonathan","family":"Cantor","sequence":"first","affiliation":[{"name":"RAND, Santa Monica, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth Ann","family":"Griffin","sequence":"additional","affiliation":[{"name":"RAND, Arlington, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Levitan","sequence":"additional","affiliation":[{"name":"RAND, Santa Monica, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sapna J.","family":"Mendon-Plasek","sequence":"additional","affiliation":[{"name":"RAND, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley D.","family":"Stein","sequence":"additional","affiliation":[{"name":"RAND, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah B.","family":"Hunter","sequence":"additional","affiliation":[{"name":"RAND, Santa Monica, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison J.","family":"Ober","sequence":"additional","affiliation":[{"name":"RAND, Santa Monica, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2024,6,18]]},"reference":[{"issue":"22","key":"zoi240575r2","doi-asserted-by":"publisher","first-page":"2063","DOI":"10.1056\/NEJMp1402780","article-title":"Medication-assisted therapies\u2013tackling the opioid-overdose epidemic.","volume":"370","author":"Volkow","year":"2014","journal-title":"N Engl J Med"},{"issue":"3","key":"zoi240575r3","doi-asserted-by":"publisher","first-page":"137","DOI":"10.7326\/M17-3107","article-title":"Medication for opioid use disorder after nonfatal opioid overdose and association with mortality: a cohort study.","volume":"169","author":"Larochelle","year":"2018","journal-title":"Ann Intern Med"},{"key":"zoi240575r4","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.jsat.2016.05.002","article-title":"Impact of medication-assisted treatment for opioid addiction on medicaid expenditures and health services utilization rates in Vermont.","volume":"67","author":"Mohlman","year":"2016","journal-title":"J Subst Abuse Treat"},{"issue":"5","key":"zoi240575r5","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1377\/hlthaff.2019.01085","article-title":"Impact of long-term buprenorphine treatment on adverse health care outcomes in Medicaid.","volume":"39","author":"Samples","year":"2020","journal-title":"Health Aff (Millwood)"},{"issue":"2","key":"zoi240575r6","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.20622","article-title":"Comparative effectiveness of different treatment pathways for opioid use disorder.","volume":"3","author":"Wakeman","year":"2020","journal-title":"JAMA Netw Open"},{"key":"zoi240575r8","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2022.103786","article-title":"Has the treatment gap for opioid use disorder narrowed in the U.S.?: A yearly assessment from 2010 to 2019\u201d.","volume":"110","author":"Krawczyk","year":"2022","journal-title":"Int J Drug Policy"},{"issue":"6","key":"zoi240575r9","doi-asserted-by":"publisher","first-page":"693","DOI":"10.15288\/jsad.2019.80.693","article-title":"Increasing Access to Opioid Use Disorder Treatment: Assessing State Policies and the Evidence Behind Them.","volume":"80","author":"Hinde","year":"2019","journal-title":"J Stud Alcohol Drugs"},{"issue":"1","key":"zoi240575r10","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1370\/afm.2757","article-title":"Increasing Capacity for Treatment of Opioid Use Disorder in Rural Primary Care Practices.","volume":"20","author":"Zittleman","year":"2022","journal-title":"Ann Fam Med"},{"issue":"3","key":"zoi240575r11","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1177\/08897077231179824","article-title":"Exploring the Association of State Policies and the Trajectories of Buprenorphine Prescriber Patient Caseloads.","volume":"44","author":"Griffin","year":"2023","journal-title":"Subst Abus"},{"key":"zoi240575r12","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1016\/j.drugalcdep.2018.12.030","article-title":"Co-occurring substance use and mental disorders among adults with opioid use disorder.","volume":"197","author":"Jones","year":"2019","journal-title":"Drug Alcohol Depend"},{"issue":"2","key":"zoi240575r13","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.apnu.2009.04.006","article-title":"Challenges and struggles: lived experiences of individuals with co-occurring disorders.","volume":"24","author":"Villena","year":"2010","journal-title":"Arch Psychiatr Nurs"},{"issue":"3","key":"zoi240575r14","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1176\/appi.ps.202000818","article-title":"Opioid Use Disorder Among Clients of Community Mental Health Clinics: Prevalence, Characteristics, and Treatment Willingness.","volume":"73","author":"Ober","year":"2022","journal-title":"Psychiatr Serv"},{"key":"zoi240575r16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsat.2022.108788","article-title":"Consumer access to buprenorphine and methadone in certified community behavioral health centers: A secret shopper study.","volume":"139","author":"Presnall","year":"2022","journal-title":"J Subst Abuse Treat"},{"issue":"6","key":"zoi240575r19","doi-asserted-by":"publisher","first-page":"968","DOI":"10.1377\/hlthaff.2019.01557","article-title":"Fewer Than Half Of US Mental Health Treatment Facilities Provide Services For Children With Autism Spectrum Disorder.","volume":"39","author":"Cantor","year":"2020","journal-title":"Health Aff (Millwood)"},{"issue":"2","key":"zoi240575r20","doi-asserted-by":"publisher","DOI":"10.1001\/jamahealthforum.2023.5142","article-title":"Availability of Mental Telehealth Services in the US.","volume":"5","author":"Cantor","year":"2024","journal-title":"JAMA Health Forum"},{"issue":"25","key":"zoi240575r23","doi-asserted-by":"publisher","first-page":"3083","DOI":"10.1002\/sim.v28:25","article-title":"Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity-score matched samples.","volume":"28","author":"Austin","year":"2009","journal-title":"Stat Med"},{"issue":"28","key":"zoi240575r25","doi-asserted-by":"publisher","first-page":"3661","DOI":"10.1002\/sim.v34.28","article-title":"Moving towards best practice when using inverse probability of treatment weighting (IPTW) using the propensity score to estimate causal treatment effects in observational studies.","volume":"34","author":"Austin","year":"2015","journal-title":"Stat Med"},{"issue":"11","key":"zoi240575r28","doi-asserted-by":"publisher","first-page":"1105","DOI":"10.1001\/jamapsychiatry.2020.1511","article-title":"Methadone for Opioid Use Disorder-Decades of Effectiveness but Still Miles Away in the US.","volume":"77","author":"Joudrey","year":"2020","journal-title":"JAMA Psychiatry"},{"issue":"1","key":"zoi240575r30","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1186\/s13722-022-00299-1","article-title":"Factors associated with retention on medications for opioid use disorder among a cohort of adults seeking treatment in the community.","volume":"17","author":"Biondi","year":"2022","journal-title":"Addict Sci Clin Pract"},{"key":"zoi240575r31","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.jhealeco.2018.06.004","article-title":"The role of health insurance on treatment for opioid use disorders: Evidence from the Affordable Care Act Medicaid expansion.","volume":"60","author":"Meinhofer","year":"2018","journal-title":"J Health Econ"},{"issue":"3","key":"zoi240575r32","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1377\/hlthaff.2019.01428","article-title":"Specialty Substance Use Disorder Treatment Admissions Steadily Increased In The Four Years After Medicaid Expansion.","volume":"39","author":"Saloner","year":"2020","journal-title":"Health Aff (Millwood)"},{"issue":"1","key":"zoi240575r33","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1186\/s13722-021-00263-5","article-title":"Clinical leaders and providers\u2019 perspectives on delivering medications for the treatment of opioid use disorder in Veteran Affairs\u2019 facilities.","volume":"16","author":"Hawkins","year":"2021","journal-title":"Addict Sci Clin Pract"},{"key":"zoi240575r34","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.108783","article-title":"Characteristics and correlates of U.S. clinicians prescribing buprenorphine for opioid use disorder treatment using expanded authorities during the COVID-19 pandemic.","volume":"225","author":"Jones","year":"2021","journal-title":"Drug Alcohol Depend"},{"issue":"2","key":"zoi240575r35","first-page":"32","article-title":"Perceived Ability to Treat Opioid Use Disorder in West Virginia.","volume":"3","author":"Sheppard","year":"2021","journal-title":"J Appalach Health"},{"issue":"8","key":"zoi240575r37","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.13456","article-title":"Association of Pregnancy and Insurance Status With Treatment Access for Opioid Use Disorder.","volume":"3","author":"Patrick","year":"2020","journal-title":"JAMA Netw Open"},{"key":"zoi240575r7","volume-title":"National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Sciences Policy; Committee on Medication-Assisted Treatment for Opioid Use Disorder. Medications for Opioid Use Disorder Save Lives","author":"Mancher","year":"2019"},{"key":"zoi240575r15","author":"Protecting Access to Medicare Act of","year":"2014"},{"key":"zoi240575r17","author":"Substance Abuse Center for Behavioral Health Statistics and Quality","year":"2021"},{"key":"zoi240575r21","volume-title":"Stata Statistical Software: Release 18","author":"StataCorp","year":"2023"},{"key":"zoi240575r29","author":"Substance Abuse and Mental Health Services Administration","year":"2023"},{"key":"zoi240575r1","unstructured":"National Institute on Drug Abuse. Drug overdose death rates. Published February 9, 2023. Accessed February 24, 2023. https:\/\/nida.nih.gov\/research-topics\/trends-statistics\/overdose-death-rates"},{"key":"zoi240575r18","unstructured":"Substance Abuse and Mental Health Services Administration. Certified Community Behavioral Health Clinics (CCBHCs). Published March 28, 2023. Accessed May 31, 2023. https:\/\/www.samhsa.gov\/certified-community-behavioral-health-clinics"},{"key":"zoi240575r22","unstructured":"Substance Abuse and Mental Health Services Administration. About the Locator - SAMHSA Behavioral Health Treatment Services Locator. Published 2022. Accessed May 17, 2022. https:\/\/findtreatment.gov\/about"},{"key":"zoi240575r24","doi-asserted-by":"crossref","unstructured":"Markoulidakis? A, Holmans? P, Pallmann? P, Busse? M, Griffin? BA. How balance and sample size impact bias in the estimation of causal treatment effects: A simulation study.arXiv. Preprint posted online July 19, 2021. doi:10.48550\/arXiv.2107.09009","DOI":"10.21203\/rs.3.rs-1742290\/v1"},{"key":"zoi240575r26","unstructured":"Kaiser Family Foundation. 2023. Status of State Medicaid Expansion Decisions: Interactive Map. KFF. Published March 27, 2023. Accessed April 21, 2023. https:\/\/www.kff.org\/medicaid\/issue-brief\/status-of-state-medicaid-expansion-decisions-interactive-map\/"},{"key":"zoi240575r27","unstructured":"Centers for Disease Control and Prevention. NCHS Urban-Rural Classification Scheme for Counties. Published 2017. Accessed January 23, 2022. https:\/\/www.cdc.gov\/nchs\/data_access\/urban_rural.htm"},{"key":"zoi240575r36","unstructured":"Pattani? A. National Addiction Treatment Locator Has Outdated Data and Other Critical Flaws. KFF Health News. Published May 9, 2022. Accessed June 4, 2023. https:\/\/kffhealthnews.org\/news\/article\/national-addiction-treatment-locator-has-outdated-data-and-other-critical-flaws\/"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2820096\/cantor_2024_oi_240575_1718024551.03166.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T15:30:37Z","timestamp":1718724637000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2820096"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,18]]},"references-count":37,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6,3]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.17545","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,18]]}}}