Substance use disorder (SUD), a major public health issue in the United States, is a condition characterized by behavioral, cognitive and physiological symptoms that indicate continued use of a substance despite harmful effects. SUD can refer to the use of or dependence on opioids, alcohol, stimulants or other substances. In 2017 alone, 19.7 million Americans age 12 and over had a SUD related to the use of alcohol and/or illicit drugs. In the same year, approximately 4 million Americans received some form of substance use treatment.
A variety of treatment options are available to individuals experiencing SUD, including inpatient treatment, residential programs, partial hospitalization/day treatment, outpatient programs, and medication-assisted treatment (MAT), an evidence-based approach which combines behavioral therapy and medications to treat SUD. Within this range of treatment options, most programs involve components such as clinical assessment, counseling, relapse prevention training, and treatment for mental disorders, among others.
States have adopted distinct strategies relating to the accessibility, coverage and regulation of substance use treatment programs and facilities. In 2019, at least 18 states enacted a total of 39 bills addressing SUD treatment to date. Of these 18 states, 10 enacted legislation relating specifically to MAT for opioid use disorder. While some states sought to increase MAT accessibility through scope of practice expansions (i.e., the procedures a health care practitioner is permitted to undertake in keeping with the terms of his or her professional license), others established MAT pilot programs and grants.
In addition to MAT legislation, five states passed bills regarding parity and coverage, most of which require private insurers to expand coverage of SUD treatment. Other topics covered in states’ SUD treatment legislation include residential/hospital-based treatment, recovery support services, telehealth and Medicaid. NCSL tracks these policies, including counseling and behavioral health, in a new database on its website. For more information and to view enacted legislation, please visit Substance Use Disorder (SUD) Treatment Database.
Resources: DSM-V; Substance Abuse and Mental Health Services Administration.