Survey Finds Low Availability of Opioid Use Disorder Medications in Psych Hospitals
Less than half of US psychiatric hospitals surveyed reported providing medications for opioid use disorder (MOUD), according to a research letter published online in JAMA Network Open.
“[O]ur findings suggest that low MOUD availability is a systematic issue in psychiatric care,” wrote first author Shawn M. Cohen, MD, of the Yale School of Medicine, New Haven, Connecticut, and study coauthors. “Stigma against MOUD likely plays a role in these findings. Lack of knowledge about MOUD, its effectiveness, and regulations surrounding its provision also likely contributes.”
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The cross-sectional analysis included 1107 psychiatric hospitals that responded to the 2022 National Substance Use and Mental Health Services Survey. Among them, 1021 facilities answered a question about the availability of MOUD (ie, buprenorphine, methadone, and/or naltrexone) as a service provided to patients. Among them, 54.65% were inpatient psychiatric units within a general hospital, 41.92% were freestanding psychiatric hospitals, and 3.43% were state hospitals.
Just 47.99% of facilities said they provided MOUD, according to the research letter. The likelihood of providing MOUD was higher in facilities that provided medications for alcohol use disorder (91.87% provided MOUD) and facilities that provided medically managed withdrawal services (69.84% provided MOUD).
“It is additionally concerning that 30% of psychiatric facilities offering medically managed withdrawal did not provide MOUD,” researchers pointed out, “given the possible harm of this approach including increased risk of overdose.”
Facilities providing MOUD had a median bed capacity of 36 compared with 30 for the overall sample, the analysis showed. Providing MOUD was positively associated with being located in the Northeastern US. Conversely, psychiatric hospitals that were publicly owned were less likely to offer MOUD.
“This study exposes the deficiency in MOUD access at inpatient psychiatric hospitals and possible avenues to improve MOUD provision,” researchers wrote, “particularly to people with comorbid OUD and mental illness.”
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