Association for Public Policy Analysis & Management

The current opioid epidemic is a national public health crisis. There were more than 52,000 deaths from opioid overdose in 2015, and at least 64,000 deaths in 2016. Medication-assisted treatment provided by certified Opioid Treatment Programs (OTPs) are effective evidence-based resources that are critical for fighting the epidemic. However, only 20% of individuals with opioid use dependence receive treatment. While there is a growing literature on need for and capacity of the opioid treatment resources, little is known about the association between Medicaid expansion and access to the OTPs, controlling for state effects. This study draws on 2017 data from a national sample of OTPs, including data on waitlists; program location by region, and Medicaid expansion; state-level rates of past-year opioid abuse or dependence; and maximum potential buprenorphine treatment capacity. We analyzed the data with Generalized Estimating Equations (GEE) models that allow for state level variation. Results showed that OTPs located in Medicaid expansion states are less likely to have waitlists for patients, suggesting that Medicaid expansion plays a role in promoting access to OTPs. In addition, we found OTPs located in the West and South are less likely to have waitlists than OTPs in the Northeast.