California Substance Use Disorder Treatment Facility Characteristics Associated with Offering Medications for Opioid Use Disorder

Background The use of medication for opioid use disorders (MOUD) are not keeping up with the rise of the opioid epidemic. There is mixed research on how MOUD is utilized in different treatment settings for substance use disorders. This study explored factors influencing the implementation of medication for opioid use disorders (MOUD) in substance use disorder treatment (SUDT) facilities in California. Methods Secondary analyses of the 2019 National Survey of Substance Abuse Treatment Services (N-SSATS) data were conducted, focusing on facility type, funding, and accreditation. Chi-square analyses and multiple logistic regressions were used to examine associations with offering MOUD. Results A total of 1,778 California facilities were surveyed, with 47.7% offering MOUD. Significant differences in facility type and funding sources were observed. Private for-profit facilities were more likely to accept cash/self-payment, federal military insurance, and IHS/tribal/urban funds (all p < .001), while government-owned facilities were more likely to accept government funding, Medicaid, Medicare, and state-financed insurance (all p < .001). Accreditation was associated with accepting cash/self-payment, federal military insurance, and IHS/tribal/urban funds (all p < .001) and was more common in private for-profit facilities (X ² (2, 1776) = 427.02, p < .001). Logistic regression revealed that government-owned facilities had lower odds of offering MOUD (AOR: 0.33; 95% CI: 0.23, 0.47), while accredited facilities (AOR: 5.23; 95% CI: 3.97, 6.90), those accepting private insurance (AOR: 2.96; 95% CI: 2.10, 4.16), and IHS/Tribal/Urban funds (AOR: 1.49; 95% CI: 1.05, 2.12) had higher odds. Government funding was associated with lower odds (AOR: 0.69; 95% CI: 0.48, 0.98). Conclusions MOUD are underutilized in Californian substance use facilities. Accreditation, funding, and facility type significantly affect MOUD availability. Future policies should focus on increasing accreditation and aligning government funding and insurance with MOUD delivery.