Has the treatment gap for opioid use disorder narrowed in the U.S.?: A yearly assessment from 2010 to 2019"

Int J Drug Policy. 2022 Dec:110:103786. doi: 10.1016/j.drugpo.2022.103786. Epub 2022 Aug 4.


Background: The United States overdose crisis continues unabated. Despite efforts to increase capacity for treating opioid use disorder (OUD) in the U.S., how actual treatment receipt compares to need remains unclear. In this cross-sectional study, we estimate progress in addressing the gap between OUD prevalence and OUD treatment receipt at the national and state levels from 2010 to 2019.

Methods: We estimated past-year OUD prevalence rates based on the U.S. National Survey on Drug Use and Health (NSDUH), using adjustment methods that attempt to account for OUD underestimation in national household surveys. We used data from specialty substance use treatment records and outpatient pharmacy claims to estimate the gap between OUD prevalence and number of persons receiving medications for opioid use disorder (MOUD) during the past decade.

Results: Adjusted estimates suggest past-year OUD affected 7,631,804 individuals in the U.S. in (2,773 per 100,000 adults 12+), relative to only 1,023,959 individuals who received MOUD (365 per 100,000 adults 12+). This implies approximately 86.6% of individuals with OUD nationwide who may benefit from MOUD treatment do not receive it. MOUD receipt increased across states over the past decade, but most regions still experience wide gaps between OUD prevalence and MOUD receipt.

Conclusions: Despite some progress in expanding access to MOUD, a substantial gap between OUD prevalence and treatment receipt highlights the critical need to increase access to evidence-based services.

Keywords: Buprenorphine; Medications for opioid use disorder; Methadone; Opioid use disorder; Treatment gap; overdose.

MeSH terms

  • Adult
  • Analgesics, Opioid / therapeutic use
  • Buprenorphine* / therapeutic use
  • Cross-Sectional Studies
  • Drug Overdose* / drug therapy
  • Humans
  • Opiate Substitution Treatment / methods
  • Opioid-Related Disorders* / drug therapy
  • United States / epidemiology


  • Buprenorphine
  • Analgesics, Opioid