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28% Fewer People Began Addiction Treatment During the COVID-19 Pandemic, New Study Finds

Researchers urge continued monitoring of access to addiction treatment and efforts to address access barriers

RESEARCH TRIANGLE PARK, N.C. — A new study by the nonprofit research institute RTI International found that addiction treatment providers in California saw a 28% drop in patients initiating treatment in the eight months after the start of the COVID-19 pandemic relative to the year before. By October, 2020 treatment initiations had still not returned to pre-pandemic levels. The study was published in the Journal of the American Medical Association.

“COVID-19 had a devastating effect on access to addiction treatment, which may have contributed to the acceleration in overdose deaths over the same time period,” said Tami Mark, Ph.D., senior director, Behavioral Health Financing at RTI. “Federal, state and local governments need to ensure that access barriers have been removed. In the future, addiction treatment should be classified as an essential service to avoid similar disruptions following disasters and public health emergencies.”

Researchers found larger declines in addiction treatment program initiations among individuals with criminal justice involvement, who had recently been released from prison, who were referred from driving under the influence programs or drug courts, and who were referred from child protective services and other community sources. The findings highlight the disruption that COVID-19 caused in the criminal justice and social service systems as prisons, courts, and child protective services curtailed efforts to connect individuals to addiction treatment.

Larger declines also occurred among individuals without Medicaid coverage underscoring the importance of Medicaid in facilitating access. 

The authors highlight other factors that may have contributed to the decline including:

  • Individuals’ reluctance to seek addiction treatment for fear of becoming infected with the virus
  • Providers’ inability to maintain the same volume of services because of staff shortages stemming from fear of the being infected with the virus, lack of personal protective equipment, lack of funding to implement telemedicine and hire temporary staff, and lack of residential treatment capacity to allow for social distancing.

The authors outline lessons learned for future public health emergencies, including federal and state government prioritization of addiction treatment as an essential service, better disaster planning by the criminal justice and social welfare systems, greater public outreach and assurance about the importance of addiction treatment, expansion of financing for telemedicine and remote treatment.  

View the full study

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