Just 10% of mental health treatment facilities offer medications for alcohol use disorder (AUD), according to a research letter published today in JAMA Network Open.
Perhaps more concerning, only about 40% of facilities that provide both mental health and substance use disorder (SUD) services offer medications for AUD—a disorder estimated to affect more than 11 million adults in the United States.
Susan H. Busch, Ph.D., of the Yale School of Public Health, and colleagues compiled data on 6,572 mental health and SUD facilities that provided outpatient care and responded to the 2023 National Substance Use and Mental Health Services Survey (hospitals, federal facilities, and residential treatment centers were excluded). Of these, 2,640 facilities primarily provided mental health services (but could potentially treat co-occurring SUD), while the remaining 3,932 facilities provided both primary mental health and primary SUD services.
Among the facilities specializing in mental health, just 262 (9.9%) reported offering medications for AUD, even though many such facilities offered other SUD services such as individual/group counseling or case management. Among the mental-health-plus-SUD facilities, 1,633 (41.5%) offered medications for AUD.
There were several differences in medication for AUD availability based on facility setting, region, and other characteristics. For example, among primary mental health facilities, medications for AUD were most likely offered at certified community behavioral health clinics (21.2%), whereas among mental-health-plus-SUD facilities, medications for AUD were most common at partial hospitalization/day treatment facilities (51.9%).
Busch and colleagues also found that medications for AUD were more likely to be offered at facilities that accepted insurance, those that had integrated primary care, and those that prescribed antipsychotics (the latter indicating the presence of a prescribing physician onsite).
“When people do not access substance use treatment due to misconceptions, ambivalence, stigma, or uncertainty about how to seek care, mental health facilities are uniquely positioned to help overcome these barriers,” Jennifer D. Ellis, Ph.D., wrote in an invited commentary. However, increasing uptake of evidence-based medications for AUD “requires buy-in of physicians, administrators, and clinic directors.”
Ellis cited multiple approaches to increase engagement with AUD medications, such as incentivizing screening and referral to treatment, increasing insurance coverage of these medications, and possibly leveraging accreditation organizations such as the Joint Commission to improve training and monitoring of staff.
For related information, see the Psychiatric News Alert “Stigma, Unfamiliarity Identified as Patient Barriers to Medications for AUD.”
(Image: Getty Images/iStock/Stella_E)
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