Admissions to Drug Treatment Programs Fell Sharply During First Year of COVID-19 Pandemic

For Release

September 22, 2022

Admissions to drug treatment programs declined by nearly one-quarter during the first year of the COVID-19 pandemic, with the cuts steepest among people of color, according to a new RAND Corporation study.

The study is the first national analysis to establish declines in the number of treatment admissions during the COVID-19 pandemic and provides one possible reason for the recent surge in drug overdose deaths.

Researchers found that the decline in drug treatment admissions was steepest in New Mexico (61 percent), Hawaii (55 percent), Washington D.C. (45 percent), Nevada (42 percent), and West Virginia (33 percent). Just three states (Rhode Island, Louisiana, Mississippi) saw increases in treatment admissions, all small.

The study is published in the latest edition of the journal JAMA Network Open.

“These declines in the number of Americans receiving treatment are especially noteworthy given evidence of increases in substance use disorder and overdose death rates during the same time period,” said Jonathan H. Cantor, the study's lead author and a policy researcher at RAND, a nonprofit research organization.

To comprehensively examine one possible reason for the surge in drug overdose deaths, RAND researchers quantified changes in national substance use disorder treatment admissions both before (2017–2019) and during the COVID-19 pandemic (2020).

Researchers analyzed information from the federal Treatment Episode Data Set, which has admission-level data for substance use disorder treatment from state agencies as reported by facilities that receive state funds or block grants.

Admissions were calculated per 10,000 people in participating states, with researchers examining demographic differences as well as overall changes in admission rates. The study does not include Idaho, Oregon, Maryland, Vermont, and Washington because there was insufficient data.

Prior to 2020, the number of treatment admissions was relatively stable. However, in 2020 the number of treatment admissions declined from 66 per 10,000 in 2019 to 50 per 10,000 in 2020, a relative reduction of 24 percent. The decline was larger for men (88 per 10,000 to 67 per 10,000) as compared to women (45 per 10,000 to 35 per 10,000).

All racial and ethnic groups experienced a decline in treatment admissions, with the largest decline observed for Native Americans (145 per 10,000 to 83 per 10,000), followed by Black people (86 per 10,000 to 63 per 10,000), Hispanic people (55 per 10,000 to 41 per 10,000), white people (54 per 10,000 to 43 per 10,000), and Asian individuals (10 per 10,000 to 7 per 10,000).

Researchers say that future work is needed to examine possible reasons for the differences, including the impact of policies such as elective procedure bans and shelter-in-place policies in the drug treatment admission changes.

Support for the study was provided by the federal Centers for Disease Control and Prevention, National Institute on Aging, and the National Institute on Drug Abuse.

Other authors of the study are Christopher M. Whaley, Bradley D. Stein, and David Powell.

RAND Health Care promotes healthier societies by improving health care systems in the United States and other countries.

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