Single State Authorities and Medication Assisted Treatment: Assessing Availability, Data Capacity and Provider Performance

Several pharmacological interventions have been approved by the Food and Drug Administration for the treatment of substance use disorders (SUDs) (McGovern and Carroll 2003; Miller, Zweben et al. 2005; NIDA 2009). This study served as a preliminary exploration to understand States' infrastructure capabilities and policies related to medication assisted treatment (MAT). This study, which began in December 2010, had two components: 1) a telephone survey with each State's substance abuse treatment data manager and 2) a survey of all 50 SSA's on the use of medication assisted treatment and performance measures. All 50 States and the District of Columbia responded to the data manager survey and 40 States (79%) responded to the inquiry of Single State Authorities. Three quarters (72.5%) of States collected patient diagnosis. However, just 14 States (28 %) captured whether patients received MAT and only 8 (16%) were able to identify the type of MAT. In addition, only 12 (23.5%) states claimed to use an electronic health record system. Although many States reported that MAT was available, a majority reported that they do not mandate that a prescribing professional be on the treatment site at least once a week. With few exceptions, States' technological capacity to support and the availability of MAT appears uneven. Even as the Patient Protection and Affordability Care Act (2010) may dramatically change the payment and delivery systems for SUDs, without targeted infrastructure investment in States' and specialty care system, health reform is unlikely to sufficiently expand the existing treatment systems' MAT capacity.