{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T02:49:55Z","timestamp":1778554195894,"version":"3.51.4"},"reference-count":33,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,12,27]],"date-time":"2021-12-27T00:00:00Z","timestamp":1640563200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["K01DA049900"],"award-info":[{"award-number":["K01DA049900"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA037866"],"award-info":[{"award-number":["R01DA037866"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA048572"],"award-info":[{"award-number":["R01DA048572"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>To prevent COVID\u201019 transmission, some United States (US) federal regulations on substance use disorder (SUD) treatment were suspended in March 2020. This study aimed to quantify the extent of state\u2010level policy uptake and the potential number of people with SUD affected by these policy changes across the US, as well as to assess if policy uptake correlated with rates of people with SUD already in treatment or needing treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross\u2010sectional analysis of policies implemented as of April 13, 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting and Participants<\/jats:title><jats:p>A total of 50\u2009US states and the District of Columbia<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>State\u2010level implementation of: oral schedule II controlled substances emergency prescription, extended take\u2010home doses for medication for opioid use disorders (MOUD), home\u2010delivery of take\u2010home medications, telemedicine for schedule II\u2010IV prescriptions, telemedicine for buprenorphine prescribing initiation, and waiver of out\u2010of\u2010state Drug Enforcement Administration (DEA) registration. Rates per 100\u2009000 population of: adults in treatment for SUD, MOUD treatment at facilities with opioid treatment programs, SUD based on Diagnostic and Statistical Manual of Mental Disorders (DSM)\u2010IV criteria, and needing, but not receiving treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Half of the states (<jats:italic>n<\/jats:italic>\u2009=\u200924) enacted no policies, leaving ~460\u2009955 people in treatment and 114\u2009370 people on MOUD pre\u2010pandemic uncovered by any policy expansion. Only telemedicine for buprenorphine initiation was marginally associated with pre\u2010pandemic rate of SUD treatment (OR\u2009=\u20091.003, 95% CI\u2009=\u2009[1.001, 1.006]) and rate of MOUD therapy (OR\u2009=\u20091.006, 95% CI\u2009=\u2009[1.002, 1.011]) in univariable analysis, but these associations were no longer significant when controlling for state\u2010level demographics. No policies were associated with state\u2010wide SUD prevalence or rate of unmet treatment need (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Twenty\u2010four United States states did not implement at least one federal policy for substance use disorder treatment expansion as of April 2020, leaving approximately half a million people in treatment pre\u2010pandemic potentially without access to treatment or risking exposure to COVID\u201019 to continue in\u2010person therapies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.15778","type":"journal-article","created":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T08:23:53Z","timestamp":1638865433000},"page":"1781-1786","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["The estimated impact of state\u2010level support for expanded delivery of substance use disorder treatment during the COVID\u201019 pandemic"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8562-8646","authenticated-orcid":false,"given":"Elizabeth D.","family":"Nesoff","sequence":"first","affiliation":[{"name":"Department of Biostatistics, Epidemiology, and Informatics University of Pennsylvania Perelman School of Medicine  Philadelphia PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8845-663X","authenticated-orcid":false,"given":"Megan E.","family":"Marziali","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Columbia University Mailman School of Public Health  New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3059-9993","authenticated-orcid":false,"given":"Silvia S.","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Columbia University Mailman School of Public Health  New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,12,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/M20-1212"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.6373"},{"key":"e_1_2_8_4_1","unstructured":"8.12 Federal Opioid Treatment Standards [Internet]. 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