Health Insurance and MOUD: Predicting OUD Treatment Success

Health Insurance and MOUD: Predicting OUD Treatment Success | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Health Insurance and MOUD: Predicting OUD Treatment Success Amy S. White, Jennifer I. Manuel This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9051451/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 6 You are reading this latest preprint version Abstract Background Opioid use disorder (OUD) is a chronic condition with low rates of treatment completion; access to medication for OUD (MOUD) is inconsistent across treatment settings, particularly within residential programs. The purpose of the study was to examine the independent and interactive associations of MOUD and health insurance coverage with treatment completion across residential and outpatient treatment settings. Methods We conducted multilevel random-effects logistic regression analyses of the 2022 Treatment Episode Dataset–Discharge (TEDS-D) to estimate associations among MOUD receipt, insurance status (Medicaid, Medicare, private insurance, uninsured), and treatment completion. Models adjusted for demographic and clinical characteristics and stratified by treatment setting. The sample included 175,942 treatment episodes among adults aged 18 years and older whose primary substance at admission was heroin, non-prescription methadone, or other opiates and synthetics. Results Associations between MOUD, insurance status, and treatment completion varied by treatment setting. In short-term residential treatment, private insurance—particularly in combination with MOUD—was associated with significantly higher odds of completion relative to uninsured individuals not receiving MOUD (aOR: 2.45; 95% CI: 1.62–3.85). In long-term residential treatment, private insurance was associated with higher odds of completion, although interaction effects were not significant. In intensive outpatient treatment, Medicaid recipients receiving MOUD had significantly lower odds of completion compared to the reference group (aOR: 0.69; 95% CI: 0.51–0.92), whereas Medicare and privately insured patients had higher odds of completion. In non-intensive outpatient treatment, private insurance was associated with higher odds of completion in main effects models (aOR: 1.18; 95% CI: 1.05–1.34); however, interaction analyses indicated that Medicaid (aOR: 1.29; 95% CI: 1.12–1.48) and Medicare (aOR: 1.35; 95% CI: 1.09–1.69) beneficiaries receiving MOUD had greater odds of completion than uninsured patients not receiving MOUD. Conclusions Insurance coverage and MOUD receipt are differentially associated with treatment completion across care settings. Private insurance is consistently linked to higher completion in residential treatment, while Medicaid coverage is associated with lower completion in intensive outpatient care. Insurance expansion alone may be insufficient to improve treatment retention, underscoring the need for Medicaid-focused policies and supports that address barriers to accessing OUD treatment. MOUD TEDS-D Opioid use disorder Medicaid insurance Figures Figure 1 Background Since 2017, the United States determined that the country was in a public health crisis because of the high rates of addiction, overdose, and death from opioids(1). Opioid use disorder (OUD) is a chronic, relapsing disease of addiction that alters brain chemistry, resulting in cyclical use, treatment readmission, and relapse cycles (2). Opioids are the deadliest category of drugs, accounting for approximately 76% of drug overdose deaths (3). Estimates of OUD prevalence in the United States range from six to over eight million reportedly misusing opioid pills (4). Treatment Options No single treatment is effective for all individuals with OUD, and successful treatment completion is shaped by complex, multifactorial processes. OUD treatment may include diagnosis and assessment, overdose or withdrawal management, pharmacotherapy, counseling or behavioral therapy, and community-based supports (5–7). Services are delivered across outpatient and inpatient (residential) settings and are commonly categorized by treatment intensity: non-intensive outpatient care (fewer than nine hours per week), intensive outpatient care (nine to 20 hours per week), short-term residential treatment (21–45 days), and long-term residential treatment (up to 90 days) (8). The course of treatment is usually sequential, with individuals often beginning in high-intensity residential or inpatient care and stepping down to outpatient services as clinical stability improves. Individuals may start out in a more intensive residential or inpatient treatment and over time, step down the level of intensity receiving treatment in an outpatient setting (9). Clinical guidelines generally recommend residential treatment for individuals with moderate to severe OUD (8, 9). In addition, evidence-based care for OUD includes one of three medications for opioid use disorder (MOUD) – methadone, buprenorphine, or naltrexone – which are considered the standard of care (12). MOUD is most effective when combined with counseling and behavioral therapies and has been shown to reduce overdose risk and support sustained recovery (10, 11, 13). However, evidence regarding treatment completion is mixed. For example, Stahler and Mennis (2020) found that MOUD use was associated with higher completion rates in short-term residential treatment but lower completion in long-term residential treatment (14). Despite evidence supporting the integration of residential treatment and MOUD, most individuals receive MOUD in outpatient rather than residential treatment (15). Approximately 60 percent of residential treatment programs do not offer MOUD (15), limiting access within these settings. This disconnect between clinical recommendations and service availability—compounded by regulatory constraints that restrict certain medications, such as methadone, to opioid treatment programs (16) — may undermine treatment continuity and patient outcomes. Geographic considerations, including the proximity of home, work, and treatment facilities, may further constrain treatment access and influence decisions about whether and where to seek care. Health Insurance Coverage and MOUD Treatment OUD treatment is costly. Treatment capacity remains insufficient to meet demand, and program costs frequently exceed insurance coverage limits (17). Among the nonelderly adult receiving OUD treatment, more than half receive Medicaid while 26% have private insurance (18). In total, Medicaid provides benefits for 20% of all OUD patients (19). In the past five years, Medicaid enrollment has decreased from post-COVID Medicaid unwinding and other spending reductions, resulting in 7.6% Medicaid enrollment decline in 2025 (20). We hypothesized that individuals prescribed MOUD, with reliable insurance, would have better discharge outcomes (lowering relapse risk) than those without MOUD and insurance. Because ongoing access to MOUD and behavioral treatment often depends on health insurance coverage, access to insurance plays a critical role in treatment completion and continuity. Considering the impending Medicaid eligibility changes, we conducted a secondary analysis of Treatment Episode Dataset-Discharge (TEDS-D) data to examine the relationship between MOUD and treatment completion among individuals with OUD receiving four different types of rehabilitation, and whether insurance status moderates the relationship between MOUD and treatment completion. This study contributes to the literature by comparing individuals across insurance type and MOUD status. We offer a nuanced perspective on how structural and individual factors interact to influence treatment completion. This is especially important considering the impending changes to Medicaid eligibility criteria, with expected challenges in accessing OUD treatment. Methods Data source and sample The primary data source for this analysis was the 2022 Treatment Episode Dataset-Discharge (TEDS-D), a publicly available administrative dataset containing treatment admissions collected annually by Substance Abuse and Mental Health Services Administration (SAMHSA) from state health agencies (21). The TEDS-D reports publicly-funded substance use treatment admissions, which are de-identified data collected by state data systems. It is important to note that the unit of analysis for TEDS-D is discharges rather than individuals. TEDS-D represents discharge data from publicly funded treatment facilities across the United States. We analyzed 175,942 treatment episodes by adult individuals aged 18 years and older whose primary substance at admission was heroin, non-prescription methadone, or other opiates and synthetics (i.e., opioid use) and receiving treatment from residential and outpatient programs in 2022, the most recent year of data available at the time of the analysis. We examined treatment completion by treatment type given the treatment philosophy and services differ between these settings. We excluded hospital inpatient and detoxification settings given the acute nature of hospital-based substance use treatment and the fact that detoxification is not recognized as a formal treatment modality on its own (22). Because health insurance status was a primary independent variable, analyses were restricted to the 35 states and jurisdictions that reported insurance information for at least 75% of discharges [1] (23). The study did not qualify as human subjects research given the data are de-identified and accessible to the public and thus was approved as exempt by the institutional review board. Study variables Our primary dependent variable was treatment completion (yes/no). We operationalized non-completion as discharge episodes classified as (1) dropped out, (2) transferred to another facility, (3) terminated by the facility, (4) incarcerated, (5) death, or (6) other. Our primary independent variables of interest included access to medications for opioid use disorder (MOUD) and health insurance status. MOUD was defined whether the treatment plan at admission included methadone, buprenorphine, and/or naltrexone (yes/no). The original health insurance variable included mutually exclusive categories for private, Medicaid, Medicare, and uninsured. The TEDS-D does not distinguish among Medicare, Tricare, Civilian Health and Medical Program of the Uniformed Services, and other related programs. Uninsured was the reference category in the analysis. Potentially confounding variables that have been shown in the literature to be correlated with treatment completion included demographic and clinical characteristics. Demographic variables included age, sex, race and ethnicity, relationship status, education status, employment status, and living situation. Clinical variables included whether the patient was mandated to treatment, any polysubstance use, any co-occurring mental health need, prior treatment episodes, and treatment type, including residential short-term, residential long-term, intensive outpatient, and non-intensive outpatient treatment. We also included state opioid overdose death rates, specifically the 2022 opioid overdose date rates of states where patients were discharged from treatment. We obtained these rates from Kaiser Family Foundation (2022) (24). Analyses Stata/SE version 18.0 was used for all statistical analyses. Descriptive statistics were computed for all variables in the analysis. To address the primary study objective, we used multilevel random effects logistic regression to assess the associations among MOUD, health insurance, and treatment completion, controlling for demographic and clinical characteristics. States were treated as random effects to account for variability among states even after controlling for measurable state-level opioid overdose rates. We included two-way interaction terms for MOUD by health insurance status to examine whether the relationship between MOUD and treatment completion varied as a function of health insurance status. Because discharges due to incarceration, death, or other may reflect circumstances beyond the treatment episode itself and are often excluded in prior research (23), we conducted a sensitivity analysis removing these cases to assess the robustness of our findings. The results were substantively unchanged. Accordingly, we present results from the primary analysis to preserve statistical power and retain a larger, more representative sample. We report coefficients as significant if p <0.05. Results Sample Characteristics Our study sample included individuals with an OUD diagnosis who participated in residential or outpatient substance use treatment (n = 175,942). Figure 1 presents the PRISMA diagram showing how the final sample was determined. Table 1 provides descriptive statistics for the discharges we analyzed. The majority are male (63%) and white (72%); almost a third (32%) were between 35-44 years old. Less than a quarter (21%) of the sample had a college degree or higher, and 22% percent were employed (50% are unemployed) at the time of admission. Almost half of the sample resided in the northeastern region of the U.S. Like previously cited sources, the majority of the sample population had Medicaid (62%). About 42 percent of the study population were prescribed MOUD in their treatment plan. The majority of the sample (60%) received treatment as non-intensive outpatients. Considering the goal of treatment, 31% of the total sample completed treatment while a third dropped out and another third were transferred to another facility. Predicting Treatment Completion Table 2 presents the multilevel random effects logistic regression models examining the associations of MOUD, insurance status, and treatment completion stratified by treatment type. Short-Term Residential Treatment In the main effects model, patients with Medicare had higher odds of treatment completion compared to uninsured patients (aOR: 1.30; 95% CI: 1.06–1.61), although no significant interaction between MOUD and Medicare was observed. In both unadjusted and adjusted main effects models, private insurance was associated with higher odds of completion. In the interaction model, patients receiving MOUD with private insurance had significantly greater odds of completing short-term residential treatment relative to uninsured patients not receiving MOUD (aOR: 2.45; 95% CI: 1.62–3.85). No significant association was observed for Medicaid, and no significant MOUD-by-Medicare interaction was found. Long-Term Residential Treatment In the adjusted analyses, private insurance was associated with higher odds of treatment completion (aOR: 1.43; 95% CI: 1.04–1.97). However, no significant interaction between MOUD and private insurance was found. No statistically significant associations were observed between other forms of insurance and treatment completion in long-term residential settings. Although interaction estimates suggested a trend toward higher completion rates among patients with insurance and MOUD relative to the reference group, these findings did not reach statistical significance. Intensive Outpatient Treatment In the interaction model, Medicaid recipients receiving MOUD had 31% lower odds of treatment completion compared to uninsured patients not receiving MOUD (aOR: 0.69; 95% CI: 0.51–0.92). Conversely, patients with Medicare (aOR: 1.42; 95% CI: 1.13–1.79) or private insurance (aOR: 1.37; 95% CI: 1.12–1.68) had significantly higher odds of completion in adjusted analyses; however, interactions between MOUD and these insurance types were not statistically significant. Non-Intensive Outpatient Treatment In the main effects model, receipt of MOUD and coverage by Medicaid or Medicare were each associated with lower odds of treatment completion (p < 0.001), whereas private insurance was associated with higher odds of completion (aOR: 1.18; 95% CI: 1.05–1.34). In the interaction model, however, Medicaid and Medicare beneficiaries receiving MOUD had significantly greater odds of completing treatment compared to uninsured patients not receiving MOUD (Medicaid: aOR: 1.29; 95% CI: 1.12–1.48; Medicare: aOR: 1.35; 95% CI: 1.09–1.69). Discussion Our study findings suggest that MOUD and health insurance influence the likelihood of treatment completion in varying ways, depending on the treatment type. Contrary to expectation, MOUD alone in the models did not increase individual’s treatment completion. Across the models, insurance coverage was a stronger predictor of OUD patient treatment completion. Private insurance was consistently associated with treatment completion. Results from public insurance showed mixed effects. Insurance influences the relationship between MOUD and treatment completion which in turn vary by treatment type. Modeling the interaction of MOUD and insurance in short-term residential and non-intensive outpatient treatment settings predicted OUD patients had significantly increased odds of completing treatment. Conversely, our study found that Medicaid was associated with significantly decreased odds of intensive outpatient treatment completion. The finding that individuals with insurance were less successful at completing treatment than those with no health insurance is counterintuitive and contradicts other studies of the impact of health insurance on successful treatment ( 25 , 26 ). Within non-intensive outpatient treatment, the finding reverses and patients on MOUD plus Medicaid or Medicare insurance were significantly more likely to complete treatment. Possibly, the systemic or structural barriers associated with being a Medicaid recipient contribute to individuals not being able to complete intensive outpatient treatment, while completing non-intensive outpatient treatment. However, intensive outpatient treatment is the equivalent time commitment of a part-time job at approximately twenty hours of treatment/week; patients receiving intensive outpatient treatment are not in a residential facility and therefore responsible for their own meals, housing, and transportation. That Medicaid recipients are statistically significantly less likely to successfully complete intensive outpatient treatment services than similar individuals with no insurance highlights the plight of the working poor with potentially the fractured transportation, childcare, and affordable housing systems as well as a lack of a support network contributing to their decreased odds of successful treatment completion. With Medicaid the most common form of health insurance among individuals with SUD and more than half of the study population having a co-occurring mental health diagnosis, our findings point to the additional support services individuals earning 138% or less of the federal poverty level require to successfully complete OUD treatment. Researchers describe the United States as having a MOUD treatment gap because of provider shortages, stigma, fragmented care system, and insufficient insurance coverage of MOUD including too low payment rates to providers ( 16 , 27 ). The greater the cost sharing to patients, the less likely patients were to complete treatment ( 28 ). OUD is an Affordable Care Act-defined “Essential Benefit” ( 29 ), however, limited numbers of covered days plus deductibles, copayments, and coinsurance can make treatment costs prohibitive, even if a provider who accepts insurance is found. Furthermore, the conundrum of some OUD patients requiring inpatient care that results in unpaid leave, plus the prohibitively expensive cost of treatment, puts treatment out of reach for many OUD patients. For OUD patients receiving Medicaid (ie., the majority of OUD patients), the expense of treatment may be covered, but the loss of income while on FMLA, and the expense of traveling to nonresidential treatment may prevent a patient from successfully completing treatment. The majority of our sample population received non-residential treatment (45,792 in intensive and 185,619 in non-intensive nonresidential treatment). Though Medicaid remains the predominant form of health insurance among individuals with a SUD, fewer than half of a survey of OUD facilities accent Medicaid as a payer and only 15% offer MOUD and accept Medicaid ( 30 ). Medicaid recipients experience longer wait times to receive SUD treatment than individuals with other forms of insurance and have limited access to specialty mental health providers is they have co-occurring mental health diagnoses ( 31 ). We found that Medicaid recipients who received MOUD were less likely to complete intensive non-residential treatment than uninsured individuals without MOUD potentially demonstrating the impact of poverty and paying for basic needs like rent and food on the ability to successfully complete OUD treatment On January 1 2027, able-bodied Medicaid recipients will be required to work, volunteer, or go to school for 80 or more hours per week unless they are actively in a SUD residential treatment facility. Approximately 80% of our study population is not in a residential treatment facility and few facilities accept Medicaid insurance as a payer, so the H.R. 1 law is unlikely to encourage SUD patients to participate in treatment unless more residential treatment facilities agree to accept Medicaid insurance. Furthermore, 88% of our study population is unemployed or not in the labor force. Participating in an outpatient treatment facility amounts to a part-time job; adding on another part-time job or school requirement to maintain Medicaid insurance benefits may prove calamitous. The majority of our study population experienced co-occurring mental health diagnoses, a history of poly substance abuse, and at least one previous OUD treatment episode, none of which contribute to an increased likelihood of successful OUD treatment completion. Limitations This study has several important limitations. First, we were unable to account for facility-level variation. Key organizational characteristics—including ownership type, facility size, patient-to-provider ratio, service availability, and other structural features—were not captured in the TEDS-D, limiting our ability to assess how such factors may influence treatment completion. Second, although we were able to identify whether MOUD was included in an individual’s treatment plan, we could not assess medication adherence, an important determinant of treatment outcomes. Third, the unit of analysis in TEDS-D is the treatment episode rather than the individual. As a result, the same individual may contribute multiple observations within a given year, potentially introducing dependence across observations. Finally, the generalizability of our findings may be limited by the exclusion of states that did not meet the minimum 75% reporting threshold for health insurance status. Conclusion OUD is a chronic, multifactorial condition that often requires ongoing and repeated cycles of treatment. In this national analysis, both MOUD receipt and insurance coverage were associated with treatment completion, but effects varied across levels of care. MOUD alone was not consistently associated with higher completion rates, underscoring the importance of contextual and structural factors in treatment retention. Private insurance was linked to higher completion in residential settings, whereas Medicaid coverage was associated with lower completion in intensive outpatient care. These findings suggest that insurance coverage alone is insufficient to ensure sustained engagement in treatment. Strengthening Medicaid policies and programmatic supports is necessary to reduce structural barriers and improve treatment retention among individuals with OUD. Abbreviations Adjusted odds ratio (aOR) Medication for opioid use disorder (OUD) Opioid use disorder (OUD) Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Episode Dataset–Discharge (TEDS-D) Declarations Ethics approval and consent to participate The 2022 Treatment Episode Dataset-Discharge (TEDS-D) are a publicly available deidentified (anonymized) public-use administrative dataset not requiring IRB approval to use. Consent for publication Not applicable Availability of data and materials The datasets generated and/or analyzed during the current study are available in the [Substance Abuse and Mental Health Services Administration: Treatment Episode Data Set (TEDS) 2022: Admissions to and Discharges from Substance Use Treatment Services Reported by Single State Agencies] repository, [https://www.samhsa.gov/data/data-we-collect/teds-treatment-episode-data-set] Competing interests The authors declare that they have no competing interests. Funding This project received funding from CMS: Project Name: Studying SUD and MH Services in the Bronx Grant #: 42453-00 01 Authors' contributions AW: Contributed to data interpretation, and wrote the background, results, and conclusion. JM: Performed the statistical analyses, wrote the results, and reviewed and edited the manuscript. Both authors approved the final manuscript. Acknowledgements The authors acknowledge Dr. Maria Isabel Roldos, CMS Grant PI. References Johnson K, Jones C, Compton W, Baldwin G, Fan J, Mermin J, et al. Federal response to the opioid crisis. Curr HIV/AIDS Rep. 2018;15(4):293–301. doi:10.1007/s11904-018-0398-8 Substance Abuse and Mental Health Services Administration. What Is Substance Use Disorder? [Internet]. 2023. Available from: https://www.samhsa.gov/substance-use/what-is-sud Centers for Disease Control and Prevention. Overdose Prevention [Internet]. 2025 [cited 2025 Oct 12]. Understanding the opioid overdose epidemic. Available from: https://www.cdc.gov/overdose-prevention/about/understanding-the-opioid-overdose-epidemic.html Keyes K, Rutherford C, Hamilton A, Barocas J, Gelberg K, Mueller P, et al. What is the prevalence of and trend in opioid use disorder in the United States from 2010 to 2019? Using multiplier approaches to estimate prevalence for an unknown population size. Drug Alcohol Depend Rep. 2022;3:100052. doi:10.1016/j.dadr.2022.100052 Carley JA, Oesterle T. Therapeutic approaches to opioid use disorder: What is the current standard of care? Int J Gen Med. 2021;14:2305–11. doi:10.2147/IJGM.S295461 Wakeman SE. Opioid use disorder diagnosis and management. NEJM Evid. 2022;1.4. doi:DOI: 10.1056/EVIDra2200038 Torres‐Lockhart KE, Lu TY, Weimer MB, Stein MR, Cunningham CO. Clinical management of opioid withdrawal. Addiction. 2022;117.9:2540–50. doi:doi.org/10.1111/add.15818 McCarty D, Braude L, Lyman DR, et al. Substance abuse intensive outpatient programs: Assessing the evidence. Psychiatr Serv. 2014;65(6):718–26. doi:10.1176/appi.ps.201300249 Wakeman SE, Larochelle MR, Ameli O, et al. Comparative effectiveness of different treatment pathways for opioid use disorder. JAMA Netw Open. 2020;3(2):e1920622. doi:10.1001/jamanetworkopen.2019.20622 de Andrade D, Elphinston RA, Quinn C, Allan J, Hides L. The effectiveness of residential treatment services for individuals with substance use disorders: A systematic review. Drug Alcohol Depend. 2019;201:227–35. Hubbard RL, Craddock SG, Anderson J. Overview of 5-year follow-up outcomes in the Drug Abuse Treatment Outcome Studies (DATOS). J Subst Abuse Treat. 2003;25(3):125–34. National Academies of Sciences E and Medicine. Medications for opioid use disorder save lives. Washington, DC: National Academies Press; 2019. doi:10.17226/25310 Sordo L, Barrio G, Bravo MJ, et al. Mortality risk during and after opioid substitution treatment: Systematic review and meta-analysis of cohort studies. BMJ. 2017;357:j1550. doi:10.1136/bmj.j1550 Stahler GJ, Mennis J. The effect of medications for opioid use disorder (MOUD) on residential treatment completion and retention in the US. Drug Alcohol Depend. 2020;212:108067. doi:10.1016/j.drugalcdep.2020.108067 Huhn AS, Hobelmann JG, Strickland JC, et al. Differences in availability and use of medications for opioid use disorder in residential treatment settings in the United States. JAMA Netw Open. 2020;3(2):e1920843. doi:10.1001/jamanetworkopen.2019.20843 McGinty EE, White SA, Eisenberg MD, Palmer NR, Brown CH, Saloner BK. US payment policy for medications to treat opioid use disorder: Landscape and opportunities. Health Aff Sch. 2024;2(3):qxae024. doi:10.1093/haschl/qxae024 Onuoha E, Leff J, Schackman B, et al. Economic evaluations of pharmacologic treatment for opioid use disorder: A systematic literature review. Value Health. 2021;24(7):1068–83. doi:10.1016/j.jval.2020.12.023 Orgera K, Tolbert J. The opioid epidemic and Medicaid’s role in facilitating access to treatment [Internet]. San Francisco, CA: Kaiser Family Foundation; 2019. Report No. Available from: https://www.kff.org/medicaid/the-opioid-epidemic-and-medicaids-role-in-facilitating-access-to-treatment/ Saunders H, Diana A, Hinton E, Rudowitz R. Implications of Medicaid work and reporting requirements for adults with mental health or substance use disorders [Internet]. San Francisco, CA: Kaiser Family Foundation; 2025. Report No. Available from: https://www.kff.org/medicaid/implications-of-medicaid-work-and-reporting-requirements-for-adults-with-mental-health-or-substance-use-disorders/ Williams E, Mudumala A, Hinton E, Rudowitz R. Medicaid enrollment and spending growth: FY 2025 & 2026 [Internet]. San Francisco, CA: Kaiser Family Foundation; 2025. Report No. Available from: https://www.kff.org/medicaid/medicaid-enrollment-spending-growth-fy-2025-2026/ Substance Abuse and Mental Health Services Administration. Treatment Episode Data Set (TEDS) 2022: Admissions to and Discharges from Substance Use Treatment Services Reported by Single State Agencies. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration; 2024. Report No. Substance Abuse and Mental Health Services Administration. Treatment Episode Data Set Discharges (TEDS-D) 2022: Public Use File (PUF) Codebook [Internet]. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration; 2024. Report No. Available from: https://www.samhsa.gov/data/ Mutter R, Ali M, Smith K, Strashny A. Factors associated with substance use treatment completion in residential facilities. Drug Alcohol Depend. 2015;154:291–5. doi:10.1016/j.drugalcdep.2015.07.004 Saunders H, Panchal N, Rudowitz R. Opioid Overdose Deaths: National Trends and Variation by Demographics and States [Internet]. Kaiser Family Foundation; 2026 [cited 2026 Jan 28]. Available from: https://www.kff.org/mental-health/opioid-overdose-deaths-national-trends-and-variation-by-demographics-and-states/ Chwastiak LA, Graupensperger S, Ringeisen H, et al. Impact of insurance type on outpatient mental health treatment of US adults. PLOS Ment Health. 2025;2(5):e0000299. doi:10.1371/journal.pmen.0000299 Khatri UG, Lopez C, Yen YT, Ling EJ, Richardson LD, Ngai KM. Receipt of buprenorphine and naltrexone for opioid use disorder by race and ethnicity and insurance type. JAMA Netw Open. 2025;8(6):e2518493. doi:10.1001/jamanetworkopen.2025.18493 Mauro PM, Gutkind S, Annunziato EM, Samples H. Use of medication for opioid use disorder among US adolescents and adults with need for opioid treatment, 2019. JAMA Netw Open. 2022;5(3):e223821. doi:10.1001/jamanetworkopen.2022.3821 Eisenberg MD, Kennedy Hendricks A, Schilling C, Busch AB, Huskamp HA, Stuart EA. The impact of HDHPs on service use and spending for substance use disorders. Am J Manag Care. 2022;28(10):530–6. doi:10.37765/ajmc.2022.89250 HealthCare.gov. Mental health and substance abuse health coverage options [Internet]. 2019 [cited 2026 Feb 12]. Available from: https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage/ Beetham T, Newton H, Ndumele CD, Fiellin DA, Busch S. Medicaid: Increased patient access to MOUD in residential treatment associated with facility openings and closures, 2012–22. Health Aff Millwood. 2025;44(9):1122–30. doi:10.1377/hlthaff.2025.00348 Geissler KH, Evans EA. Changes in Medicaid acceptance by substance abuse treatment facilities after implementation of federal parity. Med Care. 2020;58(2):101–7. doi:10.1097/MLR.0000000000001242 References Johnson K, Jones C, Compton W, Baldwin G, Fan J, Mermin J, et al. Federal response to the opioid crisis. Curr HIV/AIDS Rep. 2018;15(4):293–301. doi:10.1007/s11904-018-0398-8. Substance Abuse and Mental Health Services Administration. What is substance use disorder? 2023 [cited 2025 Oct 12]. Available from: https://www.samhsa.gov/substance-use/what-is-sud. Centers for Disease Control and Prevention. Understanding the opioid overdose epidemic. Overdose Prevention. 2025 [cited 2025 Oct 12]. Available from: https://www.cdc.gov/overdose-prevention/about/understanding-the-opioid-overdose-epidemic.html. Keyes K, Rutherford C, Hamilton A, Barocas J, Gelberg K, Mueller P, et al. What is the prevalence of and trend in opioid use disorder in the United States from 2010 to 2019? Using multiplier approaches to estimate prevalence for an unknown population size. Drug Alcohol Depend Rep. 2022;3:100052. doi:10.1016/j.dadr.2022.100052. Carley JA, Oesterle T. Therapeutic approaches to opioid use disorder: What is the current standard of care? Int J Gen Med. 2021;14:2305–2311. doi:10.2147/IJGM.S295461. McCarty D, Braude L, Lyman DR, et al. Substance abuse intensive outpatient programs: Assessing the evidence. Psychiatr Serv. 2014;65(6):718–726. doi:10.1176/appi.ps.201300249. Wakeman SE, Larochelle MR, Ameli O, et al. Comparative effectiveness of different treatment pathways for opioid use disorder. JAMA Netw Open. 2020;3(2):e1920622. doi:10.1001/jamanetworkopen.2019.20622. de Andrade D, Elphinston RA, Quinn C, Allan J, Hides L. The effectiveness of residential treatment services for individuals with substance use disorders: A systematic review. Drug Alcohol Depend. 2019;201:227–235. Hubbard RL, Craddock SG, Anderson J. Overview of 5-year follow-up outcomes in the Drug Abuse Treatment Outcome Studies (DATOS). J Subst Abuse Treat. 2003;25(3):125–134. National Academies of Sciences, Engineering, and Medicine. Medications for opioid use disorder save lives. Washington (DC): National Academies Press; 2019. doi:10.17226/25310. Sordo L, Barrio G, Bravo MJ, et al. Mortality risk during and after opioid substitution treatment: Systematic review and meta-analysis of cohort studies. BMJ. 2017;357:j1550. doi:10.1136/bmj.j1550. Stahler GJ, Mennis J. The effect of medications for opioid use disorder (MOUD) on residential treatment completion and retention in the US. Drug Alcohol Depend. 2020;212:108067. doi:10.1016/j.drugalcdep.2020.108067. Huhn AS, Hobelmann JG, Strickland JC, et al. Differences in availability and use of medications for opioid use disorder in residential treatment settings in the United States. JAMA Netw Open. 2020;3(2):e1920843. doi:10.1001/jamanetworkopen.2019.20843. McGinty EE, White SA, Eisenberg MD, Palmer NR, Brown CH, Saloner BK. US payment policy for medications to treat opioid use disorder: Landscape and opportunities. Health Aff Scholar. 2024;2(3):qxae024. doi:10.1093/haschl/qxae024. Onuoha E, Leff J, Schackman B, et al. Economic evaluations of pharmacologic treatment for opioid use disorder: A systematic literature review. Value Health. 2021;24(7):1068–1083. doi:10.1016/j.jval.2020.12.023. Orgera K, Tolbert J. The opioid epidemic and Medicaid’s role in facilitating access to treatment. San Francisco (CA): Kaiser Family Foundation; 2019. Available from: https://www.kff.org/medicaid/the-opioid-epidemic-and-medicaids-role-in-facilitating-access-to-treatment/. Saunders H, Diana A, Hinton E, Rudowitz R. Implications of Medicaid work and reporting requirements for adults with mental health or substance use disorders. San Francisco (CA): Kaiser Family Foundation; 2025. Available from: https://www.kff.org/medicaid/implications-of-medicaid-work-and-reporting-requirements-for-adults-with-mental-health-or-substance-use-disorders/. Williams E, Mudumala A, Hinton E, Rudowitz R. Medicaid enrollment and spending growth: FY 2025 & 2026. San Francisco (CA): Kaiser Family Foundation; 2025. Available from: https://www.kff.org/medicaid/medicaid-enrollment-spending-growth-fy-2025-2026/. Substance Abuse and Mental Health Services Administration. Treatment Episode Data Set Discharges (TEDS-D) 2022: Public Use File (PUF) Codebook. Rockville (MD): Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration; 2024. Available from: https://www.samhsa.gov/data/. Substance Abuse and Mental Health Services Administration. Treatment Episode Data Set (TEDS) 2022: Admissions to and Discharges from Substance Use Treatment Services Reported by Single State Agencies. Publication No. PEP 24-07-023. Rockville (MD): Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration; 2024. StataCorp. Stata Statistical Software: Release 18. College Station (TX): StataCorp LLC; 2023. Mutter R, Ali M, Smith K, Strashny A. Factors associated with substance use treatment completion in residential facilities. Drug Alcohol Depend. 2015;154:291–295. doi:10.1016/j.drugalcdep.2015.07.004. Chwastiak LA, Graupensperger S, Ringeisen H, et al. Impact of insurance type on outpatient mental health treatment of US adults. PLOS Ment Health. 2025;2(5):e0000299. doi:10.1371/journal.pmen.0000299. Khatri UG, Lopez C, Yen YT, Ling EJ, Richardson LD, Ngai KM. Receipt of buprenorphine and naltrexone for opioid use disorder by race and ethnicity and insurance type. JAMA Netw Open. 2025;8(6):e2518493. doi:10.1001/jamanetworkopen.2025.18493. Mauro PM, Gutkind S, Annunziato EM, Samples H. Use of medication for opioid use disorder among US adolescents and adults with need for opioid treatment, 2019. JAMA Netw Open. 2022;5(3):e223821. doi:10.1001/jamanetworkopen.2022.3821. Eisenberg MD, Kennedy Hendricks A, Schilling C, Busch AB, Huskamp HA, Stuart EA. The impact of HDHPs on service use and spending for substance use disorders. Am J Manag Care. 2022;28(10):530–536. doi:10.37765/ajmc.2022.89250. HealthCare.gov. Mental health and substance abuse health coverage options. 2019 [cited 2026 Feb 12]. Available from: https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage/. Beetham T, Newton H, Ndumele CD, Fiellin DA, Busch S. Medicaid: Increased patient access to MOUD in residential treatment associated with facility openings and closures, 2012–22. Health Aff (Millwood). 2025;44(9):1122–1130. doi:10.1377/hlthaff.2025.00348. Geissler KH, Evans EA. Changes in Medicaid acceptance by substance abuse treatment facilities after implementation of federal parity. Med Care. 2020;58(2):101–107. doi:10.1097/MLR.0000000000001242. Footnotes Note : The analytic sample included the following states and jurisdictions: Alabama, Alaska, Arizona, Arkansas, Colorado, Connecticut, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Kentucky, Louisiana, Maine, Massachusetts, Mississippi, Missouri, Montana, Nebraska, Nevada, New Jersey, North Dakota, Ohio, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wyoming, and Puerto Rico. Tables Table 1. Sample characteristics (N=175,942) # % Age 18-24 years 11,953 6.79 25-34 years 67,744 38.5 35-44 years 56,120 31.90 45-54 years 25,037 14.23 55 years and older 15,088 8.58 Sex Female 64,824 36.87 Male 110,987 63.13 Race and Ethnicity AAPI 1,297 0.75 American Indian/Alaska Native 1,043 0.60 Black 22,255 12.89 Hispanic 18,882 10.94 White 124,331 72.02 Other 4,821 2.79 Relationship Status Never married 118,487 70.02 Married 20,108 11.88 Separated, divorced, or widowed 30,625 18.1 Education Status Less than high school degree 41,010 24.34 High school degree or GED 92,904 55.13 College or higher 34,589 20.53 Employment Status Full-time (≥35 hours) 28,145 16.52 Part-time employment (<35 hours) 9,963 5.85 Unemployed 72,905 42.78 Not in labor force 59,387 34.85 Insurance Status Medicaid 104,247 62.24 Medicare 10,141 6.05 Private 9,876 5.90 None 43,238 25.81 Living Situation Homeless 28,714 17.12 Dependent Living 29,860 17.81 Independent Living 109,112 65.07 Mandated to Treatment 25,255 14.92 Any Polysubstance Use (primary SUD and any other SUD) 110,045 64.04 Any Co-Occurring MH+SUD (primary MH/SUD and any other MH/SUD) 82,722 51.28 At least 1+ Prior Treatment Episodes 125,765 73.16 Medication for Opioid Use Disorder in Treatment Plan 63,509 41.51 Substance Use Service Setting Resid Short-term 16,968 12.4 Resid Long-term 12,412 9.07 Intensive Outpatient 25,408 18.58 Non-intensive Outpatient 81,998 59.95 Reason for Discharge Treatment completed 53,655 30.5 Dropped out of treatment 58,318 33.15 Terminated by facility 11,245 6.39 Transferred to another facility 34,937 19.86 Incarcerated 3,147 1.79 Death 1,182 0.67 Other 13,458 7.65 Region Northeast 82,450 47.19 Midwest 21,752 12.45 South 51,345 29.39 West 19,164 10.97 Table 2. Unadjusted, Main Effects, and Interaction Effects Models Unadjusted Models Main Effects Models Interaction Effects Models OR 95% CI p-value aOR 95% CI p-value aOR 95% CI p-value Short-Term Residential Treatment MOUD 0.95 [0.83-1.08] 0.397 0.98 [0.84-1.14] 0.809 Medicaid 0.93 [0.82-1.04] 0.202 1.12 [0.96-1.31] 0.152 Medicare 1.13 [0.95-1.35] 0.162 1.30 [1.06-1.61] 0.013 Private 1.91 [1.61-2.27] 0.000 2.36 [1.87-2.98] 0.000 MOUD | Medicaid 1.27 [0.89-1.82] 0.195 MOUD | Medicare 1.33 [0.79-2.25] 0.287 MOUD | Private 2.45 [1.62-2.66] 0.007 Long-Term Residential Treatment MOUD 0.98 [0.87-1.11] 0.728 1.10 [0.96-1.27] 0.161 Medicaid 0.83 [0.73-0.95] 0.007 0.96 [0.82-1.12] 0.595 Medicare 0.77 [0.62-0.95] 0.015 0.84 [0.66-1.07] 0.149 Private 1.57 [1.29-1.92] 0.000 1.43 1.04-1.97] 0.028 MOUD | Medicaid 1.29 [0.92-1.82] 0.143 MOUD | Medicare 1.28 [0.72-2.29] 0.401 MOUD | Private 1.65 [0.71-3.85] 0.245 Intensive Outpatient Treatment MOUD 0.66 [0.56-0.76] 0.000 0.90 [0.75-1.07] 0.230 Medicaid 0.77 [0.70-0.86] 0.000 0.82 [0.71-0.92] 0.005 Medicare 1.38 [1.14-1.67] 0.001 1.42 [1.13-1.79] 0.003 Private 1.28 [1.11-1.47] 0.000 1.37 [1.12-1.68] 0.002 MOUD | Medicaid 0.69 [0.51-0.92] 0.012 MOUD | Medicare 0.95 [0.58-1.56] 0.834 MOUD | Private 0.89 [0.59-1.35] 0.592 Non-Intensive Outpatient Treatment MOUD 0.54 [0.51-0.57] 0.000 0.67 [0.63-0.72] 0.000 Medicaid 0.74 [0.69-0.79] 0.000 0.76 [0.70-0.82] 0.000 Medicare 0.79 [0.71-0.87] 0.000 0.79 [0.70-0.88] 0.000 Private 1.25 [1.13-1.37] 0.000 1.18 [1.05-1.34] 0.007 MOUD | Medicaid 1.29 [1.12-1.48] 0.000 MOUD | Medicare 1.35 [1.09-1.69] 0.007 MOUD | Private 1.17 [0.93-1.31] 0.273 Notes: Dependent variable is whether the client completed treatment at discharge. Results reported are adjusted odds ratio from the multilevel random effects logistic regression. Covariates were included in the model, but the results are not reported here. Reference categories are no MOUD and uninsured. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 11 May, 2026 Reviewers agreed at journal 04 May, 2026 Reviewers invited by journal 01 May, 2026 Editor assigned by journal 10 Mar, 2026 Submission checks completed at journal 10 Mar, 2026 First submitted to journal 06 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9051451","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":635714137,"identity":"cb3cc5de-c47c-40be-b0cf-cc4783fc7ada","order_by":0,"name":"Amy S. White","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABFUlEQVRIie3NMUvDQBjG8fc4uDpcmvUNAfsVrhSioJKv0lLoFMEujjVQeLfuZhC/QlxC3SKBdomOItyiFOqqS0GwYFsMKCSlo+D94Za7+/EAmEx/MLE63AoRoDacAAt/vqXlxP4mCHLS24044YYAAgbebkQ95opb48OBDcEC3sdJ4wD43O0T7Nef2uVEB4qf5ohOeJ+wKNfN21B4bkTQcrYSQlR3o4RbpFmcSuFaBJ24gvgF8TM550vSfkEuqshmZbleEVJwRrpTkLaqJL2z7IrQucyFx0aku3EmWkfyAZtR/lxBujcziwa2fT17ffsgfRJPhy9anh836tPyFYA9lf6+4KvDBFZ8X1crnf/cIkwmk+m/9QVAkmESVvIoQQAAAABJRU5ErkJggg==","orcid":"","institution":"Lehman College","correspondingAuthor":true,"prefix":"","firstName":"Amy","middleName":"S.","lastName":"White","suffix":""},{"id":635714138,"identity":"a0ea96f7-9b9c-4b92-9b49-a26b79971bc1","order_by":1,"name":"Jennifer I. Manuel","email":"","orcid":"","institution":"University of Connecticut","correspondingAuthor":false,"prefix":"","firstName":"Jennifer","middleName":"I.","lastName":"Manuel","suffix":""}],"badges":[],"createdAt":"2026-03-06 14:09:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9051451/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9051451/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":109150163,"identity":"877a518f-1c1c-49e0-8a93-b089271a47cd","added_by":"auto","created_at":"2026-05-13 05:27:42","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":133732,"visible":true,"origin":"","legend":"\u003cp\u003ePRISMA Diagram\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-9051451/v1/581e1c6c1604cb0e9a075e20.png"},{"id":109150315,"identity":"cdfbc9b3-304d-4d4b-9b1b-d5ffd1998039","added_by":"auto","created_at":"2026-05-13 05:28:05","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":513523,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9051451/v1/30fc9bba-d517-49f2-96f8-a2c9369944c3.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Health Insurance and MOUD: Predicting OUD Treatment Success","fulltext":[{"header":"Background","content":"\u003cp\u003eSince 2017, the United States determined that the country was in a public health crisis because of the high rates of addiction, overdose, and death from opioids(1). Opioid use disorder (OUD) is a chronic, relapsing disease of addiction that alters brain chemistry, resulting in cyclical use, treatment readmission, and relapse cycles (2). Opioids are the deadliest category of drugs, accounting for approximately 76% of drug overdose deaths (3). Estimates of OUD prevalence in the United States range from six to over eight million reportedly misusing opioid pills (4). \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTreatment Options\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo single treatment is effective for all individuals with OUD, and successful treatment completion is shaped by complex, multifactorial processes. OUD treatment may include diagnosis and assessment, overdose or withdrawal management, pharmacotherapy, counseling or behavioral therapy, and community-based supports (5–7). Services are delivered across outpatient and inpatient (residential) settings and are commonly categorized by treatment intensity: non-intensive outpatient care (fewer than nine hours per week), intensive outpatient care (nine to 20 hours per week), short-term residential treatment (21–45 days), and long-term residential treatment (up to 90 days) (8).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe course of treatment is usually sequential, with individuals often beginning in high-intensity residential or inpatient care and stepping down to outpatient services as clinical stability improves. Individuals may start out in a more intensive residential or inpatient treatment and over time, step down the level of intensity receiving treatment in an outpatient setting (9). Clinical guidelines generally recommend residential treatment for individuals with moderate to severe OUD (8, 9). In addition, evidence-based care for OUD includes one of three medications for opioid use disorder (MOUD) – methadone, buprenorphine, or naltrexone – which are considered the standard of care (12). MOUD is most effective when combined with counseling and behavioral therapies and has been shown to reduce overdose risk and support sustained recovery (10, 11, 13). However, evidence regarding treatment completion is mixed. For example, Stahler and Mennis (2020) found that MOUD use was associated with higher completion rates in short-term residential treatment but lower completion\u0026nbsp;in long-term residential treatment\u0026nbsp;(14).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDespite evidence supporting the integration of residential treatment and MOUD, most individuals receive MOUD in outpatient rather than residential treatment (15). Approximately 60 percent of residential treatment programs do not offer MOUD (15), limiting access within these settings. This disconnect between clinical recommendations and service availability—compounded by regulatory constraints that restrict certain medications, such as methadone, to opioid treatment programs (16) — may undermine treatment continuity and patient outcomes. Geographic considerations, including the proximity of home, work, and treatment facilities, may further constrain treatment access and influence decisions about whether and where to seek care.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHealth Insurance Coverage and MOUD Treatment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOUD treatment is costly. Treatment capacity remains insufficient to meet demand, and program costs frequently exceed insurance coverage limits (17). Among the nonelderly adult receiving OUD treatment, more than half receive Medicaid while 26% have private insurance (18). In total, Medicaid provides benefits for 20% of all OUD patients (19). In the past five years, Medicaid enrollment has decreased from post-COVID\u0026nbsp;Medicaid unwinding and other spending reductions, resulting in 7.6% Medicaid enrollment decline in 2025\u0026nbsp;(20). \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWe hypothesized that individuals prescribed MOUD, with reliable insurance, would have better discharge outcomes (lowering relapse risk) than those without MOUD and insurance. Because ongoing access to MOUD and behavioral treatment often depends on health insurance coverage, access to insurance plays a critical role in treatment completion and continuity. Considering the impending Medicaid eligibility changes, we conducted a secondary analysis of Treatment Episode Dataset-Discharge (TEDS-D) data to examine the relationship between MOUD and treatment completion among individuals with OUD receiving four different types of rehabilitation, and whether insurance status moderates the relationship between MOUD and treatment completion. This study contributes to the literature by comparing individuals across insurance type and MOUD status. We offer a nuanced perspective on how structural and individual factors interact to influence treatment completion. This is especially important considering the impending changes to Medicaid eligibility criteria, with expected challenges in accessing OUD treatment.\u0026nbsp;\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cem\u003eData source and sample\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe primary data source for this analysis was the 2022 Treatment Episode Dataset-Discharge (TEDS-D), a publicly available administrative dataset containing treatment admissions collected annually by Substance Abuse and Mental Health Services Administration (SAMHSA) from state health agencies (21). The TEDS-D reports publicly-funded substance use treatment admissions, which are de-identified data collected by state data systems. It is important to note that the unit of analysis for TEDS-D is discharges rather than individuals. TEDS-D represents discharge data from publicly funded treatment facilities across the United States.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWe analyzed 175,942 treatment episodes by adult individuals aged 18 years and older whose primary substance at admission was heroin, non-prescription methadone, or other opiates and synthetics (i.e., opioid use) and receiving treatment from residential and outpatient programs in 2022, the most recent year of data available at the time of the analysis. We examined treatment completion by treatment type given the treatment philosophy and services differ between these settings. We excluded hospital inpatient and detoxification settings given the acute nature of hospital-based substance use treatment and the fact that detoxification is not recognized as a formal treatment modality on its own (22). Because health insurance status was a primary independent variable, analyses were restricted to the 35 states and jurisdictions that reported insurance information for at least 75% of discharges\u003csup\u003e[1]\u003c/sup\u003e (23). The study did not qualify as human subjects research given the data are de-identified and accessible to the public and thus was approved as exempt by the institutional review board.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eStudy variables\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eOur primary dependent variable was treatment completion (yes/no). We operationalized non-completion as discharge episodes classified as (1) dropped out, (2) transferred to another facility, (3) terminated by the facility, (4) incarcerated, (5) death, or (6) other.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eOur primary independent variables of interest included access to medications for opioid use disorder (MOUD) and health insurance status. MOUD was defined whether the treatment plan at admission included methadone, buprenorphine, and/or naltrexone (yes/no). The original health insurance variable included mutually exclusive categories for private, Medicaid, Medicare, and uninsured. The TEDS-D does not distinguish among Medicare, Tricare, Civilian Health and Medical Program of the Uniformed Services, and other related programs. Uninsured was the reference category in the analysis.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003ePotentially confounding variables that have been shown in the literature to be correlated with treatment completion included demographic and clinical characteristics. Demographic variables included age, sex, race and ethnicity, relationship status, education status, employment status, and living situation. Clinical variables included whether the patient was mandated to treatment, any polysubstance use, any co-occurring mental health need, prior treatment episodes, and treatment type, including residential short-term, residential long-term, intensive outpatient, and non-intensive outpatient treatment. We also included state opioid overdose death rates, specifically the 2022 opioid overdose date rates of states where patients were discharged from treatment. We obtained these rates from Kaiser Family Foundation (2022) (24).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAnalyses\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eStata/SE version 18.0 was used for all statistical analyses. Descriptive statistics were computed for all variables in the analysis. To address the primary study objective, we used multilevel random effects logistic regression to assess the associations among MOUD, health insurance, and treatment completion, controlling for demographic and clinical characteristics. States were treated as random effects to account for variability among states even after controlling for measurable state-level opioid overdose rates. We included two-way interaction terms for MOUD by health insurance status to examine whether the relationship between MOUD and treatment completion varied as a function of health insurance status. Because discharges due to incarceration, death, or other may reflect circumstances beyond the treatment episode itself and are often excluded in prior research (23), we conducted a sensitivity analysis removing these cases to assess the robustness of our findings. The results were substantively unchanged. Accordingly, we present results from the primary analysis to preserve statistical power and retain a larger, more representative sample. We report coefficients as significant if p \u0026lt;0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eSample Characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOur study sample included individuals with an OUD diagnosis who participated in residential or outpatient substance use treatment (n = 175,942). Figure 1 presents the PRISMA diagram showing how the final sample was determined.\u003c/p\u003e\n\u003cp\u003eTable 1 provides descriptive statistics for the discharges we analyzed. The majority are male (63%) and white (72%); almost a third (32%) were between 35-44 years old. \u0026nbsp;Less than a quarter (21%) of the sample had a college degree or higher, and 22% percent were employed (50% are unemployed) at the time of admission. Almost half of the sample resided in the northeastern region of the U.S. Like previously cited sources, the majority of the sample population had Medicaid (62%). \u0026nbsp;About 42 percent of the study population were prescribed MOUD in their treatment plan. The majority of the sample (60%) received treatment as non-intensive outpatients. Considering the goal of treatment, 31% of the total sample completed treatment while a third dropped out and another third were transferred to another facility.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePredicting Treatment Completion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable 2 presents the multilevel random effects logistic regression models examining the associations of MOUD, insurance status, and treatment completion stratified by treatment type.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eShort-Term Residential Treatment\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIn the main effects model, patients with Medicare had higher odds of treatment completion compared to uninsured patients (aOR: 1.30; 95% CI: 1.06–1.61), although no significant interaction between MOUD and Medicare was observed. In both unadjusted and adjusted main effects models, private insurance was associated with higher odds of completion.\u003c/p\u003e\n\u003cp\u003eIn the interaction model, patients receiving MOUD with private insurance had significantly greater odds of completing short-term residential treatment relative to uninsured patients not receiving MOUD (aOR: 2.45; 95% CI: 1.62–3.85). No significant association was observed for Medicaid, and no significant MOUD-by-Medicare interaction was found.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eLong-Term Residential Treatment\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIn the adjusted analyses, private insurance was associated with higher odds of treatment completion (aOR: 1.43; 95% CI: 1.04–1.97). However, no significant interaction between MOUD and private insurance was found. No statistically significant associations were observed between other forms of insurance and treatment completion in long-term residential settings. Although interaction estimates suggested a trend toward higher completion rates among patients with insurance and MOUD relative to the reference group, these findings did not reach statistical significance.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eIntensive Outpatient Treatment\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIn the interaction model, Medicaid recipients receiving MOUD had 31% lower odds of treatment completion compared to uninsured patients not receiving MOUD (aOR: 0.69; 95% CI: 0.51–0.92). Conversely, patients with Medicare (aOR: 1.42; 95% CI: 1.13–1.79) or private insurance (aOR: 1.37; 95% CI: 1.12–1.68) had significantly higher odds of completion in adjusted analyses; however, interactions between MOUD and these insurance types were not statistically significant.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eNon-Intensive Outpatient Treatment\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIn the main effects model, receipt of MOUD and coverage by Medicaid or Medicare were each associated with lower odds of treatment completion (p \u0026lt; 0.001), whereas private insurance was associated with higher odds of completion (aOR: 1.18; 95% CI: 1.05–1.34). In the interaction model, however, Medicaid and Medicare beneficiaries receiving MOUD had significantly greater odds of completing treatment compared to uninsured patients not receiving MOUD (Medicaid: aOR: 1.29; 95% CI: 1.12–1.48; Medicare: aOR: 1.35; 95% CI: 1.09–1.69).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eOur study findings suggest that MOUD and health insurance influence the likelihood of treatment completion in varying ways, depending on the treatment type. Contrary to expectation, MOUD alone in the models did not increase individual\u0026rsquo;s treatment completion. Across the models, insurance coverage was a stronger predictor of OUD patient treatment completion. Private insurance was consistently associated with treatment completion. Results from public insurance showed mixed effects. Insurance influences the relationship between MOUD and treatment completion which in turn vary by treatment type.\u003c/p\u003e \u003cp\u003eModeling the interaction of MOUD and insurance in short-term residential and non-intensive outpatient treatment settings predicted OUD patients had significantly increased odds of completing treatment. Conversely, our study found that Medicaid was associated with significantly decreased odds of intensive outpatient treatment completion. The finding that individuals with insurance were less successful at completing treatment than those with no health insurance is counterintuitive and contradicts other studies of the impact of health insurance on successful treatment (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). Within non-intensive outpatient treatment, the finding reverses and patients on MOUD plus Medicaid or Medicare insurance were significantly more likely to complete treatment. Possibly, the systemic or structural barriers associated with being a Medicaid recipient contribute to individuals not being able to complete intensive outpatient treatment, while completing non-intensive outpatient treatment.\u003c/p\u003e \u003cp\u003eHowever, intensive outpatient treatment is the equivalent time commitment of a part-time job at approximately twenty hours of treatment/week; patients receiving intensive outpatient treatment are not in a residential facility and therefore responsible for their own meals, housing, and transportation. That Medicaid recipients are statistically significantly \u003cem\u003eless\u003c/em\u003e likely to successfully complete intensive outpatient treatment services than similar individuals with no insurance highlights the plight of the working poor with potentially the fractured transportation, childcare, and affordable housing systems as well as a lack of a support network contributing to their decreased odds of successful treatment completion. With Medicaid the most common form of health insurance among individuals with SUD and more than half of the study population having a co-occurring mental health diagnosis, our findings point to the additional support services individuals earning 138% or less of the federal poverty level require to successfully complete OUD treatment.\u003c/p\u003e \u003cp\u003eResearchers describe the United States as having a MOUD treatment gap because of provider shortages, stigma, fragmented care system, and insufficient insurance coverage of MOUD including too low payment rates to providers (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). The greater the cost sharing to patients, the less likely patients were to complete treatment (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). OUD is an Affordable Care Act-defined \u0026ldquo;Essential Benefit\u0026rdquo; (\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e29\u003c/span\u003e), however, limited numbers of covered days plus deductibles, copayments, and coinsurance can make treatment costs prohibitive, even if a provider who accepts insurance is found. Furthermore, the conundrum of some OUD patients requiring inpatient care that results in unpaid leave, plus the prohibitively expensive cost of treatment, puts treatment out of reach for many OUD patients.\u003c/p\u003e \u003cp\u003eFor OUD patients receiving Medicaid (ie., the majority of OUD patients), the expense of treatment may be covered, but the loss of income while on FMLA, and the expense of traveling to nonresidential treatment may prevent a patient from successfully completing treatment. The majority of our sample population received non-residential treatment (45,792 in intensive and 185,619 in non-intensive nonresidential treatment). Though Medicaid remains the predominant form of health insurance among individuals with a SUD, fewer than half of a survey of OUD facilities accent Medicaid as a payer and only 15% offer MOUD and accept Medicaid (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). Medicaid recipients experience longer wait times to receive SUD treatment than individuals with other forms of insurance and have limited access to specialty mental health providers is they have co-occurring mental health diagnoses (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). We found that Medicaid recipients who received MOUD were less likely to complete intensive non-residential treatment than uninsured individuals without MOUD potentially demonstrating the impact of poverty and paying for basic needs like rent and food on the ability to successfully complete OUD treatment\u003c/p\u003e \u003cp\u003eOn January 1 2027, able-bodied Medicaid recipients will be required to work, volunteer, or go to school for 80 or more hours per week unless they are actively in a SUD residential treatment facility. Approximately 80% of our study population is not in a residential treatment facility and few facilities accept Medicaid insurance as a payer, so the H.R. 1 law is unlikely to encourage SUD patients to participate in treatment unless more residential treatment facilities agree to accept Medicaid insurance. Furthermore, 88% of our study population is unemployed or not in the labor force. Participating in an outpatient treatment facility amounts to a part-time job; adding on another part-time job or school requirement to maintain Medicaid insurance benefits may prove calamitous. The majority of our study population experienced co-occurring mental health diagnoses, a history of poly substance abuse, and at least one previous OUD treatment episode, none of which contribute to an increased likelihood of successful OUD treatment completion.\u003c/p\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eThis study has several important limitations. First, we were unable to account for facility-level variation. Key organizational characteristics\u0026mdash;including ownership type, facility size, patient-to-provider ratio, service availability, and other structural features\u0026mdash;were not captured in the TEDS-D, limiting our ability to assess how such factors may influence treatment completion. Second, although we were able to identify whether MOUD was included in an individual\u0026rsquo;s treatment plan, we could not assess medication adherence, an important determinant of treatment outcomes. Third, the unit of analysis in TEDS-D is the treatment episode rather than the individual. As a result, the same individual may contribute multiple observations within a given year, potentially introducing dependence across observations. Finally, the generalizability of our findings may be limited by the exclusion of states that did not meet the minimum 75% reporting threshold for health insurance status.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eOUD is a chronic, multifactorial condition that often requires ongoing and repeated cycles of treatment. In this national analysis, both MOUD receipt and insurance coverage were associated with treatment completion, but effects varied across levels of care. MOUD alone was not consistently associated with higher completion rates, underscoring the importance of contextual and structural factors in treatment retention. Private insurance was linked to higher completion in residential settings, whereas Medicaid coverage was associated with lower completion in intensive outpatient care. These findings suggest that insurance coverage alone is insufficient to ensure sustained engagement in treatment. Strengthening Medicaid policies and programmatic supports is necessary to reduce structural barriers and improve treatment retention among individuals with OUD.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAdjusted odds ratio (aOR)\u003c/p\u003e\n\u003cp\u003eMedication for opioid use disorder (OUD)\u003c/p\u003e\n\u003cp\u003eOpioid use disorder (OUD)\u003c/p\u003e\n\u003cp\u003eSubstance Abuse and Mental Health Services Administration (SAMHSA)\u003c/p\u003e\n\u003cp\u003eTreatment Episode Dataset\u0026ndash;Discharge (TEDS-D)\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe 2022 Treatment Episode Dataset-Discharge (TEDS-D) are a publicly available deidentified (anonymized) public-use administrative dataset not requiring IRB approval to use.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are available in the [Substance Abuse and Mental Health Services Administration: Treatment Episode Data Set (TEDS) 2022: Admissions to and Discharges from Substance Use Treatment Services Reported by Single State Agencies] repository, [https://www.samhsa.gov/data/data-we-collect/teds-treatment-episode-data-set]\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis project received funding from CMS: Project Name: Studying SUD and MH Services in the Bronx Grant #: 42453-00 01\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAW: Contributed to data interpretation, and wrote the background, results, and conclusion.\u003c/p\u003e\n\u003cp\u003eJM: Performed the statistical analyses, wrote the results, and reviewed and edited the manuscript.\u003c/p\u003e\n\u003cp\u003eBoth authors approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors acknowledge Dr. Maria Isabel Roldos, CMS Grant PI.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eJohnson K, Jones C, Compton W, Baldwin G, Fan J, Mermin J, et al. Federal response to the opioid crisis. Curr HIV/AIDS Rep. 2018;15(4):293\u0026ndash;301. doi:10.1007/s11904-018-0398-8\u003c/li\u003e\n\u003cli\u003eSubstance Abuse and Mental Health Services Administration. What Is Substance Use Disorder? [Internet]. 2023. Available from: https://www.samhsa.gov/substance-use/what-is-sud\u003c/li\u003e\n\u003cli\u003eCenters for Disease Control and Prevention. Overdose Prevention [Internet]. 2025 [cited 2025 Oct 12]. Understanding the opioid overdose epidemic. Available from: https://www.cdc.gov/overdose-prevention/about/understanding-the-opioid-overdose-epidemic.html\u003c/li\u003e\n\u003cli\u003eKeyes K, Rutherford C, Hamilton A, Barocas J, Gelberg K, Mueller P, et al. What is the prevalence of and trend in opioid use disorder in the United States from 2010 to 2019? Using multiplier approaches to estimate prevalence for an unknown population size. Drug Alcohol Depend Rep. 2022;3:100052. doi:10.1016/j.dadr.2022.100052\u003c/li\u003e\n\u003cli\u003eCarley JA, Oesterle T. Therapeutic approaches to opioid use disorder: What is the current standard of care? Int J Gen Med. 2021;14:2305\u0026ndash;11. doi:10.2147/IJGM.S295461\u003c/li\u003e\n\u003cli\u003eWakeman SE. Opioid use disorder diagnosis and management. NEJM Evid. 2022;1.4. doi:DOI: 10.1056/EVIDra2200038\u003c/li\u003e\n\u003cli\u003eTorres‐Lockhart KE, Lu TY, Weimer MB, Stein MR, Cunningham CO. Clinical management of opioid withdrawal. Addiction. 2022;117.9:2540\u0026ndash;50. doi:doi.org/10.1111/add.15818\u003c/li\u003e\n\u003cli\u003eMcCarty D, Braude L, Lyman DR, et al. Substance abuse intensive outpatient programs: Assessing the evidence. Psychiatr Serv. 2014;65(6):718\u0026ndash;26. doi:10.1176/appi.ps.201300249\u003c/li\u003e\n\u003cli\u003eWakeman SE, Larochelle MR, Ameli O, et al. Comparative effectiveness of different treatment pathways for opioid use disorder. JAMA Netw Open. 2020;3(2):e1920622. doi:10.1001/jamanetworkopen.2019.20622\u003c/li\u003e\n\u003cli\u003ede Andrade D, Elphinston RA, Quinn C, Allan J, Hides L. The effectiveness of residential treatment services for individuals with substance use disorders: A systematic review. Drug Alcohol Depend. 2019;201:227\u0026ndash;35.\u003c/li\u003e\n\u003cli\u003eHubbard RL, Craddock SG, Anderson J. Overview of 5-year follow-up outcomes in the Drug Abuse Treatment Outcome Studies (DATOS). J Subst Abuse Treat. 2003;25(3):125\u0026ndash;34.\u003c/li\u003e\n\u003cli\u003eNational Academies of Sciences E and Medicine. Medications for opioid use disorder save lives. Washington, DC: National Academies Press; 2019. doi:10.17226/25310\u003c/li\u003e\n\u003cli\u003eSordo L, Barrio G, Bravo MJ, et al. Mortality risk during and after opioid substitution treatment: Systematic review and meta-analysis of cohort studies. BMJ. 2017;357:j1550. doi:10.1136/bmj.j1550\u003c/li\u003e\n\u003cli\u003eStahler GJ, Mennis J. The effect of medications for opioid use disorder (MOUD) on residential treatment completion and retention in the US. Drug Alcohol Depend. 2020;212:108067. doi:10.1016/j.drugalcdep.2020.108067\u003c/li\u003e\n\u003cli\u003eHuhn AS, Hobelmann JG, Strickland JC, et al. Differences in availability and use of medications for opioid use disorder in residential treatment settings in the United States. JAMA Netw Open. 2020;3(2):e1920843. doi:10.1001/jamanetworkopen.2019.20843\u003c/li\u003e\n\u003cli\u003eMcGinty EE, White SA, Eisenberg MD, Palmer NR, Brown CH, Saloner BK. US payment policy for medications to treat opioid use disorder: Landscape and opportunities. Health Aff Sch. 2024;2(3):qxae024. doi:10.1093/haschl/qxae024\u003c/li\u003e\n\u003cli\u003eOnuoha E, Leff J, Schackman B, et al. Economic evaluations of pharmacologic treatment for opioid use disorder: A systematic literature review. Value Health. 2021;24(7):1068\u0026ndash;83. doi:10.1016/j.jval.2020.12.023\u003c/li\u003e\n\u003cli\u003eOrgera K, Tolbert J. The opioid epidemic and Medicaid\u0026rsquo;s role in facilitating access to treatment [Internet]. San Francisco, CA: Kaiser Family Foundation; 2019. Report No. Available from: https://www.kff.org/medicaid/the-opioid-epidemic-and-medicaids-role-in-facilitating-access-to-treatment/\u003c/li\u003e\n\u003cli\u003eSaunders H, Diana A, Hinton E, Rudowitz R. Implications of Medicaid work and reporting requirements for adults with mental health or substance use disorders [Internet]. San Francisco, CA: Kaiser Family Foundation; 2025. Report No. Available from: https://www.kff.org/medicaid/implications-of-medicaid-work-and-reporting-requirements-for-adults-with-mental-health-or-substance-use-disorders/\u003c/li\u003e\n\u003cli\u003eWilliams E, Mudumala A, Hinton E, Rudowitz R. Medicaid enrollment and spending growth: FY 2025 \u0026amp; 2026 [Internet]. San Francisco, CA: Kaiser Family Foundation; 2025. Report No. Available from: https://www.kff.org/medicaid/medicaid-enrollment-spending-growth-fy-2025-2026/\u003c/li\u003e\n\u003cli\u003eSubstance Abuse and Mental Health Services Administration. Treatment Episode Data Set (TEDS) 2022: Admissions to and Discharges from Substance Use Treatment Services Reported by Single State Agencies. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration; 2024. Report No.\u003c/li\u003e\n\u003cli\u003eSubstance Abuse and Mental Health Services Administration. Treatment Episode Data Set Discharges (TEDS-D) 2022: Public Use File (PUF) Codebook [Internet]. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration; 2024. Report No. Available from: https://www.samhsa.gov/data/\u003c/li\u003e\n\u003cli\u003eMutter R, Ali M, Smith K, Strashny A. Factors associated with substance use treatment completion in residential facilities. Drug Alcohol Depend. 2015;154:291\u0026ndash;5. doi:10.1016/j.drugalcdep.2015.07.004\u003c/li\u003e\n\u003cli\u003eSaunders H, Panchal N, Rudowitz R. Opioid Overdose Deaths: National Trends and Variation by Demographics and States [Internet]. Kaiser Family Foundation; 2026 [cited 2026 Jan 28]. Available from: https://www.kff.org/mental-health/opioid-overdose-deaths-national-trends-and-variation-by-demographics-and-states/\u003c/li\u003e\n\u003cli\u003eChwastiak LA, Graupensperger S, Ringeisen H, et al. Impact of insurance type on outpatient mental health treatment of US adults. PLOS Ment Health. 2025;2(5):e0000299. doi:10.1371/journal.pmen.0000299\u003c/li\u003e\n\u003cli\u003eKhatri UG, Lopez C, Yen YT, Ling EJ, Richardson LD, Ngai KM. Receipt of buprenorphine and naltrexone for opioid use disorder by race and ethnicity and insurance type. JAMA Netw Open. 2025;8(6):e2518493. doi:10.1001/jamanetworkopen.2025.18493\u003c/li\u003e\n\u003cli\u003eMauro PM, Gutkind S, Annunziato EM, Samples H. Use of medication for opioid use disorder among US adolescents and adults with need for opioid treatment, 2019. JAMA Netw Open. 2022;5(3):e223821. doi:10.1001/jamanetworkopen.2022.3821\u003c/li\u003e\n\u003cli\u003eEisenberg MD, Kennedy Hendricks A, Schilling C, Busch AB, Huskamp HA, Stuart EA. The impact of HDHPs on service use and spending for substance use disorders. Am J Manag Care. 2022;28(10):530\u0026ndash;6. doi:10.37765/ajmc.2022.89250\u003c/li\u003e\n\u003cli\u003eHealthCare.gov. Mental health and substance abuse health coverage options [Internet]. 2019 [cited 2026 Feb 12]. Available from: https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage/\u003c/li\u003e\n\u003cli\u003eBeetham T, Newton H, Ndumele CD, Fiellin DA, Busch S. Medicaid: Increased patient access to MOUD in residential treatment associated with facility openings and closures, 2012\u0026ndash;22. Health Aff Millwood. 2025;44(9):1122\u0026ndash;30. doi:10.1377/hlthaff.2025.00348\u003c/li\u003e\n\u003cli\u003eGeissler KH, Evans EA. Changes in Medicaid acceptance by substance abuse treatment facilities after implementation of federal parity. Med Care. 2020;58(2):101\u0026ndash;7. doi:10.1097/MLR.0000000000001242\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cbr clear=\"all\"\u003e\u003cstrong\u003eReferences\u003c/strong\u003e\u003c/p\u003e\n\u003col\u003e\n\u003cli\u003e\u003cstrong\u003eJohnson K, Jones C, Compton W, Baldwin G, Fan J, Mermin J, et al.\u003c/strong\u003e Federal response to the opioid crisis. \u003cem\u003eCurr HIV/AIDS Rep.\u003c/em\u003e 2018;15(4):293\u0026ndash;301. doi:10.1007/s11904-018-0398-8.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eSubstance Abuse and Mental Health Services Administration.\u003c/strong\u003e What is substance use disorder? 2023 [cited 2025 Oct 12]. Available from: https://www.samhsa.gov/substance-use/what-is-sud.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eCenters for Disease Control and Prevention.\u003c/strong\u003e Understanding the opioid overdose epidemic. \u003cem\u003eOverdose Prevention.\u003c/em\u003e 2025 [cited 2025 Oct 12]. Available from: https://www.cdc.gov/overdose-prevention/about/understanding-the-opioid-overdose-epidemic.html.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eKeyes K, Rutherford C, Hamilton A, Barocas J, Gelberg K, Mueller P, et al.\u003c/strong\u003e What is the prevalence of and trend in opioid use disorder in the United States from 2010 to 2019? Using multiplier approaches to estimate prevalence for an unknown population size. \u003cem\u003eDrug Alcohol Depend Rep.\u003c/em\u003e 2022;3:100052. doi:10.1016/j.dadr.2022.100052.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eCarley JA, Oesterle T.\u003c/strong\u003e Therapeutic approaches to opioid use disorder: What is the current standard of care? \u003cem\u003eInt J Gen Med.\u003c/em\u003e 2021;14:2305\u0026ndash;2311. doi:10.2147/IJGM.S295461.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eMcCarty D, Braude L, Lyman DR, et al.\u003c/strong\u003e Substance abuse intensive outpatient programs: Assessing the evidence. \u003cem\u003ePsychiatr Serv.\u003c/em\u003e 2014;65(6):718\u0026ndash;726. doi:10.1176/appi.ps.201300249.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eWakeman SE, Larochelle MR, Ameli O, et al.\u003c/strong\u003e Comparative effectiveness of different treatment pathways for opioid use disorder. \u003cem\u003eJAMA Netw Open.\u003c/em\u003e 2020;3(2):e1920622. doi:10.1001/jamanetworkopen.2019.20622.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003ede Andrade D, Elphinston RA, Quinn C, Allan J, Hides L.\u003c/strong\u003e The effectiveness of residential treatment services for individuals with substance use disorders: A systematic review. \u003cem\u003eDrug Alcohol Depend.\u003c/em\u003e 2019;201:227\u0026ndash;235.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eHubbard RL, Craddock SG, Anderson J.\u003c/strong\u003e Overview of 5-year follow-up outcomes in the Drug Abuse Treatment Outcome Studies (DATOS). \u003cem\u003eJ Subst Abuse Treat.\u003c/em\u003e 2003;25(3):125\u0026ndash;134.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eNational Academies of Sciences, Engineering, and Medicine.\u003c/strong\u003e \u003cem\u003eMedications for opioid use disorder save lives.\u003c/em\u003e Washington (DC): National Academies Press; 2019. doi:10.17226/25310.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eSordo L, Barrio G, Bravo MJ, et al.\u003c/strong\u003e Mortality risk during and after opioid substitution treatment: Systematic review and meta-analysis of cohort studies. \u003cem\u003eBMJ.\u003c/em\u003e 2017;357:j1550. doi:10.1136/bmj.j1550.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eStahler GJ, Mennis J.\u003c/strong\u003e The effect of medications for opioid use disorder (MOUD) on residential treatment completion and retention in the US. \u003cem\u003eDrug Alcohol Depend.\u003c/em\u003e 2020;212:108067. doi:10.1016/j.drugalcdep.2020.108067.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eHuhn AS, Hobelmann JG, Strickland JC, et al.\u003c/strong\u003e Differences in availability and use of medications for opioid use disorder in residential treatment settings in the United States. \u003cem\u003eJAMA Netw Open.\u003c/em\u003e 2020;3(2):e1920843. doi:10.1001/jamanetworkopen.2019.20843.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eMcGinty EE, White SA, Eisenberg MD, Palmer NR, Brown CH, Saloner BK.\u003c/strong\u003e US payment policy for medications to treat opioid use disorder: Landscape and opportunities. \u003cem\u003eHealth Aff Scholar.\u003c/em\u003e 2024;2(3):qxae024. doi:10.1093/haschl/qxae024.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eOnuoha E, Leff J, Schackman B, et al.\u003c/strong\u003e Economic evaluations of pharmacologic treatment for opioid use disorder: A systematic literature review. \u003cem\u003eValue Health.\u003c/em\u003e 2021;24(7):1068\u0026ndash;1083. doi:10.1016/j.jval.2020.12.023.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eOrgera K, Tolbert J.\u003c/strong\u003e \u003cem\u003eThe opioid epidemic and Medicaid\u0026rsquo;s role in facilitating access to treatment.\u003c/em\u003e San Francisco (CA): Kaiser Family Foundation; 2019. Available from: https://www.kff.org/medicaid/the-opioid-epidemic-and-medicaids-role-in-facilitating-access-to-treatment/.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eSaunders H, Diana A, Hinton E, Rudowitz R.\u003c/strong\u003e \u003cem\u003eImplications of Medicaid work and reporting requirements for adults with mental health or substance use disorders.\u003c/em\u003e San Francisco (CA): Kaiser Family Foundation; 2025. Available from: https://www.kff.org/medicaid/implications-of-medicaid-work-and-reporting-requirements-for-adults-with-mental-health-or-substance-use-disorders/.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eWilliams E, Mudumala A, Hinton E, Rudowitz R.\u003c/strong\u003e \u003cem\u003eMedicaid enrollment and spending growth: FY 2025 \u0026amp; 2026.\u003c/em\u003e San Francisco (CA): Kaiser Family Foundation; 2025. Available from: https://www.kff.org/medicaid/medicaid-enrollment-spending-growth-fy-2025-2026/.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eSubstance Abuse and Mental Health Services Administration.\u003c/strong\u003e \u003cem\u003eTreatment Episode Data Set Discharges (TEDS-D) 2022: Public Use File (PUF) Codebook.\u003c/em\u003e Rockville (MD): Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration; 2024. Available from: https://www.samhsa.gov/data/.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eSubstance Abuse and Mental Health Services Administration.\u003c/strong\u003e \u003cem\u003eTreatment Episode Data Set (TEDS) 2022: Admissions to and Discharges from Substance Use Treatment Services Reported by Single State Agencies.\u003c/em\u003e Publication No. PEP 24-07-023. Rockville (MD): Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration; 2024.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eStataCorp.\u003c/strong\u003e \u003cem\u003eStata Statistical Software: Release 18.\u003c/em\u003e College Station (TX): StataCorp LLC; 2023.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eMutter R, Ali M, Smith K, Strashny A.\u003c/strong\u003e Factors associated with substance use treatment completion in residential facilities. \u003cem\u003eDrug Alcohol Depend.\u003c/em\u003e 2015;154:291\u0026ndash;295. doi:10.1016/j.drugalcdep.2015.07.004.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eChwastiak LA, Graupensperger S, Ringeisen H, et al.\u003c/strong\u003e Impact of insurance type on outpatient mental health treatment of US adults. \u003cem\u003ePLOS Ment Health.\u003c/em\u003e 2025;2(5):e0000299. doi:10.1371/journal.pmen.0000299.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eKhatri UG, Lopez C, Yen YT, Ling EJ, Richardson LD, Ngai KM.\u003c/strong\u003e Receipt of buprenorphine and naltrexone for opioid use disorder by race and ethnicity and insurance type. \u003cem\u003eJAMA Netw Open.\u003c/em\u003e 2025;8(6):e2518493. doi:10.1001/jamanetworkopen.2025.18493.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eMauro PM, Gutkind S, Annunziato EM, Samples H.\u003c/strong\u003e Use of medication for opioid use disorder among US adolescents and adults with need for opioid treatment, 2019. \u003cem\u003eJAMA Netw Open.\u003c/em\u003e 2022;5(3):e223821. doi:10.1001/jamanetworkopen.2022.3821.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eEisenberg MD, Kennedy Hendricks A, Schilling C, Busch AB, Huskamp HA, Stuart EA.\u003c/strong\u003e The impact of HDHPs on service use and spending for substance use disorders. \u003cem\u003eAm J Manag Care.\u003c/em\u003e 2022;28(10):530\u0026ndash;536. doi:10.37765/ajmc.2022.89250.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eHealthCare.gov.\u003c/strong\u003e Mental health and substance abuse health coverage options. 2019 [cited 2026 Feb 12]. Available from: https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage/.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eBeetham T, Newton H, Ndumele CD, Fiellin DA, Busch S.\u003c/strong\u003e Medicaid: Increased patient access to MOUD in residential treatment associated with facility openings and closures, 2012\u0026ndash;22. \u003cem\u003eHealth Aff (Millwood).\u003c/em\u003e 2025;44(9):1122\u0026ndash;1130. doi:10.1377/hlthaff.2025.00348.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eGeissler KH, Evans EA.\u003c/strong\u003e Changes in Medicaid acceptance by substance abuse treatment facilities after implementation of federal parity. \u003cem\u003eMed Care.\u003c/em\u003e 2020;58(2):101\u0026ndash;107. doi:10.1097/MLR.0000000000001242.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Footnotes","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003e \u003cb\u003eNote\u003c/b\u003e: The analytic sample included the following states and jurisdictions: Alabama, Alaska, Arizona, Arkansas, Colorado, Connecticut, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Kentucky, Louisiana, Maine, Massachusetts, Mississippi, Missouri, Montana, Nebraska, Nevada, New Jersey, North Dakota, Ohio, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wyoming, and Puerto Rico.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"619\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eTable 1. Sample characteristics (N=175,942)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 99px;\"\u003e\n \u003cp\u003e#\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 79px;\"\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 99px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 79px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003e18-24 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e11,953\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e6.79\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003e25-34 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e67,744\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e38.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003e35-44 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e56,120\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e31.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003e45-54 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e25,037\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e14.23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003e55 years and older\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e15,088\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e8.58\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 99px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 79px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e64,824\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e36.87\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e110,987\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e63.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eRace and Ethnicity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 99px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 79px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eAAPI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e1,297\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eAmerican Indian/Alaska Native\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e1,043\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.60\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eBlack\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e22,255\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e12.89\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eHispanic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e18,882\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e10.94\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eWhite\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e124,331\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e72.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e4,821\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e2.79\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eRelationship Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eNever married\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e118,487\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e70.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e20,108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e11.88\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eSeparated, divorced, or widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e30,625\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e18.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eEducation Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 99px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 79px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eLess than high school degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e41,010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e24.34\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eHigh school degree or GED\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e92,904\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e55.13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eCollege or higher\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e34,589\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e20.53\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eEmployment Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 99px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 79px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eFull-time (\u0026ge;35 hours)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e28,145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e16.52\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003ePart-time employment (\u0026lt;35 hours)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e9,963\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e5.85\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eUnemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e72,905\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e42.78\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eNot in labor force\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e59,387\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e34.85\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eInsurance Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eMedicaid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e104,247\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e62.24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eMedicare\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e10,141\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e6.05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003ePrivate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e9,876\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e5.90\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e43,238\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e25.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eLiving Situation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 99px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"top\" style=\"width: 79px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eHomeless\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e28,714\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e17.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eDependent Living\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e29,860\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e17.81\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eIndependent Living\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e109,112\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e65.07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eMandated to Treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e25,255\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e14.92\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eAny Polysubstance Use (primary SUD and any other SUD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e110,045\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e64.04\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eAny Co-Occurring MH+SUD (primary MH/SUD and any other MH/SUD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e82,722\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e51.28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eAt least 1+ Prior Treatment Episodes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e125,765\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e73.16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eMedication for Opioid Use Disorder in Treatment Plan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e63,509\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e41.51\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eSubstance Use Service Setting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eResid Short-term\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e16,968\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e12.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eResid Long-term\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e12,412\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e9.07\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eIntensive Outpatient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e25,408\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e18.58\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eNon-intensive Outpatient\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e81,998\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e59.95\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eReason for Discharge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eTreatment completed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e53,655\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e30.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eDropped out of treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e58,318\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e33.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eTerminated by facility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e11,245\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e6.39\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eTransferred to another facility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e34,937\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e19.86\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eIncarcerated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e3,147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e1.79\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eDeath\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e1,182\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e13,458\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e7.65\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eRegion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eNortheast\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e82,450\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e47.19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eMidwest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e21,752\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e12.45\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eSouth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e51,345\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e29.39\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 442px;\"\u003e\n \u003cp\u003eWest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 99px;\"\u003e\n \u003cp\u003e19,164\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 79px;\"\u003e\n \u003cp\u003e10.97\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"901\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"12\" style=\"width: 901px;\"\u003e\n \u003cp\u003eTable 2. Unadjusted, Main Effects, and Interaction Effects Models\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"3\" style=\"width: 219px;\"\u003e\n \u003cp\u003eUnadjusted Models\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"3\" style=\"width: 219px;\"\u003e\n \u003cp\u003eMain Effects Models\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"3\" style=\"width: 219px;\"\u003e\n \u003cp\u003eInteraction Effects Models\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\n \u003cp\u003eOR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e95% CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 71px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003eaOR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e95% CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 60px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003eaOR\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e95% CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 60px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eShort-Term Residential Treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" colspan=\"2\" valign=\"bottom\" style=\"width: 85px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMOUD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e[0.83-1.08]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.397\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[0.84-1.14]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.809\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMedicaid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\n \u003cp\u003e0.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e[0.82-1.04]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.202\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e1.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[0.96-1.31]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMedicare\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\n \u003cp\u003e1.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e[0.95-1.35]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.162\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e1.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[1.06-1.61]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003ePrivate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\n \u003cp\u003e1.91\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e[1.61-2.27]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e2.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[1.87-2.98]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMOUD | Medicaid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e1.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[0.89-1.82]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.195\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMOUD | Medicare\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e1.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[0.79-2.25]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.287\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMOUD | Private\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e2.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[1.62-2.66]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eLong-Term Residential Treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMOUD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\n \u003cp\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e[0.87-1.11]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.728\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e1.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[0.96-1.27]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.161\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMedicaid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\n \u003cp\u003e0.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e[0.73-0.95]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[0.82-1.12]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.595\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMedicare\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\n \u003cp\u003e0.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e[0.62-0.95]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[0.66-1.07]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.149\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003ePrivate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\n \u003cp\u003e1.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e[1.29-1.92]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e1.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e1.04-1.97]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.028\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMOUD | Medicaid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e1.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[0.92-1.82]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.143\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMOUD | Medicare\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e1.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[0.72-2.29]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.401\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMOUD | Private\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e1.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[0.71-3.85]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.245\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eIntensive Outpatient Treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMOUD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\n \u003cp\u003e0.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e[0.56-0.76]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[0.75-1.07]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.230\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMedicaid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\n \u003cp\u003e0.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e[0.70-0.86]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[0.71-0.92]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMedicare\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\n \u003cp\u003e1.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e[1.14-1.67]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e1.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[1.13-1.79]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003ePrivate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\n \u003cp\u003e1.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e[1.11-1.47]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e1.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[1.12-1.68]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMOUD | Medicaid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[0.51-0.92]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMOUD | Medicare\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[0.58-1.56]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.834\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMOUD | Private\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[0.59-1.35]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.592\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eNon-Intensive Outpatient Treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMOUD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\n \u003cp\u003e0.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e[0.51-0.57]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[0.63-0.72]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMedicaid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\n \u003cp\u003e0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e[0.69-0.79]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[0.70-0.82]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMedicare\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e[0.71-0.87]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[0.70-0.88]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003ePrivate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\n \u003cp\u003e1.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\n \u003cp\u003e[1.13-1.37]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e1.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[1.05-1.34]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMOUD | Medicaid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e1.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[1.12-1.48]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMOUD | Medicare\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e1.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[1.09-1.69]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd nowrap=\"\" valign=\"bottom\" style=\"width: 215px;\"\u003e\n \u003cp\u003eMOUD | Private\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 43px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 105px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 15px;\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 71px;\"\u003e\n \u003cp\u003e1.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 88px;\"\u003e\n \u003cp\u003e[0.93-1.31]\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd nowrap=\"\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.273\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"12\" valign=\"top\" style=\"width: 901px;\"\u003e\n \u003cp\u003eNotes: Dependent variable is whether the client completed treatment at discharge. Results reported are adjusted odds ratio from the multilevel random effects logistic regression. Covariates were included in the model, but the results are not reported here. Reference categories are no MOUD and uninsured.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"substance-abuse-treatment-prevention-and-policy","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"satp","sideBox":"Learn more about [Substance Abuse Treatment, Prevention, and Policy](http://substanceabusepolicy.biomedcentral.com)","snPcode":"13011","submissionUrl":"https://submission.nature.com/new-submission/13011/3","title":"Substance Abuse Treatment, Prevention, and Policy","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"MOUD, TEDS-D, Opioid use disorder, Medicaid, insurance","lastPublishedDoi":"10.21203/rs.3.rs-9051451/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9051451/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eOpioid use disorder (OUD) is a chronic condition with low rates of treatment completion; access to medication for OUD (MOUD) is inconsistent across treatment settings, particularly within residential programs. The purpose of the study was to examine the independent and interactive associations of MOUD and health insurance coverage with treatment completion across residential and outpatient treatment settings.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe conducted multilevel random-effects logistic regression analyses of the 2022 Treatment Episode Dataset\u0026ndash;Discharge (TEDS-D) to estimate associations among MOUD receipt, insurance status (Medicaid, Medicare, private insurance, uninsured), and treatment completion. Models adjusted for demographic and clinical characteristics and stratified by treatment setting. The sample included 175,942 treatment episodes among adults aged 18 years and older whose primary substance at admission was heroin, non-prescription methadone, or other opiates and synthetics.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAssociations between MOUD, insurance status, and treatment completion varied by treatment setting. In short-term residential treatment, private insurance\u0026mdash;particularly in combination with MOUD\u0026mdash;was associated with significantly higher odds of completion relative to uninsured individuals not receiving MOUD (aOR: 2.45; 95% CI: 1.62\u0026ndash;3.85). In long-term residential treatment, private insurance was associated with higher odds of completion, although interaction effects were not significant. In intensive outpatient treatment, Medicaid recipients receiving MOUD had significantly lower odds of completion compared to the reference group (aOR: 0.69; 95% CI: 0.51\u0026ndash;0.92), whereas Medicare and privately insured patients had higher odds of completion. In non-intensive outpatient treatment, private insurance was associated with higher odds of completion in main effects models (aOR: 1.18; 95% CI: 1.05\u0026ndash;1.34); however, interaction analyses indicated that Medicaid (aOR: 1.29; 95% CI: 1.12\u0026ndash;1.48) and Medicare (aOR: 1.35; 95% CI: 1.09\u0026ndash;1.69) beneficiaries receiving MOUD had greater odds of completion than uninsured patients not receiving MOUD.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eInsurance coverage and MOUD receipt are differentially associated with treatment completion across care settings. Private insurance is consistently linked to higher completion in residential treatment, while Medicaid coverage is associated with lower completion in intensive outpatient care. Insurance expansion alone may be insufficient to improve treatment retention, underscoring the need for Medicaid-focused policies and supports that address barriers to accessing OUD treatment.\u003c/p\u003e","manuscriptTitle":"Health Insurance and MOUD: Predicting OUD Treatment Success","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-13 05:26:03","doi":"10.21203/rs.3.rs-9051451/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"168669449607776013436375516756049276118","date":"2026-05-11T19:54:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"32231840787212188029402383410653617152","date":"2026-05-04T11:41:53+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-05-01T17:19:58+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-10T09:56:34+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-10T09:56:01+00:00","index":"","fulltext":""},{"type":"submitted","content":"Substance Abuse Treatment, Prevention, and Policy","date":"2026-03-06T14:03:19+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"substance-abuse-treatment-prevention-and-policy","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"satp","sideBox":"Learn more about [Substance Abuse Treatment, Prevention, and Policy](http://substanceabusepolicy.biomedcentral.com)","snPcode":"13011","submissionUrl":"https://submission.nature.com/new-submission/13011/3","title":"Substance Abuse Treatment, Prevention, and Policy","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"7f7d4bfd-5273-4ec8-ac80-dd4c275dab06","owner":[],"postedDate":"May 13th, 2026","published":true,"recentEditorialEvents":[{"type":"reviewerAgreed","content":"168669449607776013436375516756049276118","date":"2026-05-11T19:54:40+00:00","index":18,"fulltext":""},{"type":"reviewerAgreed","content":"32231840787212188029402383410653617152","date":"2026-05-04T11:41:53+00:00","index":14,"fulltext":""},{"type":"reviewersInvited","content":"6","date":"2026-05-01T17:19:58+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-13T05:26:03+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-13 05:26:03","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9051451","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9051451","identity":"rs-9051451","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}