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Focus Areas

Treating Substance Use and Misuse

Life-changing, effective treatments to break the cycle of substance use

More than 24 million people in the United States over the age of 12 met the criteria for a drug-related substance use disorder (SUD) in 2021, according to the National Survey on Drug Use and Health. Of those, only about 10% received treatment for their SUD in 2021.

The continued stigma of substance use is a contributing factor to the reluctance to seek treatment for millions of Americans. Research has shown that stigma negatively impacts the health outcomes of people struggling with addiction and leads to substandard care in clinical settings.

However, SUDs can be treated effectively through a combination of medication, behavioral therapy, and counseling—making full recovery possible.

Medications for opioid use disorder (MOUD)—including buprenorphine, methadone, and naltrexone—are a particularly powerful tool for treating substance use, as studies have proven it to reduce death rates by nearly 50%. Despite the ability of MOUD to curtail substance use mortality, these medications remain underutilized due to lack of knowledge among health care providers and insufficient availability.

There is also not equitable access to MOUD to treat substance use. In a 2022 study, RTI International researchers conducted a literature review that demonstrated a racial disparity in access to and use of MOUD. The paper found that 16 of 21 peer-reviewed studies showed that Black populations had lower rates of access to and use of MOUD than did white populations. This disparity—demonstrated in 11 of 16 studies—was most pronounced for buprenorphine.

RTI researchers are utilizing numerous methodologies to gather key data, conduct essential research, and help inform data-driven public policies to promote equitable access to evidence-based treatments.

To improve the availability of state-level data that measures the effectiveness of opioid use disorder (OUD) treatment, RTI expert Tami Mark, PhD, collaborated with The Pew Charitable Trusts to develop an implementation toolkit. The core measures highlighted in the toolkit follow the “cascade of care” framework and can be used to identify which OUD treatment programs are working well and which need additional resources.

Our team of multidisciplinary researchers are performing economic evaluations of substance use treatment to inform public policy changes. In a recent study, RTI researchers found that expanding Medicare coverage to include SUD treatment would cost $1.9 billion but would then save $1.6 billion annually through reduced health care spending. This change would result in a total impact of $362 million per year, or 0.04% of the total Medicare budget, while granting millions of Medicare enrollees struggling with addiction access to life-saving treatment.

With decades of experience as a foundation, RTI’s experts are continually researching strategies to improve SUD treatment and promote full recovery. Learn more about how we can support you in developing, improving, and evaluating substance use treatment programs.

Bringing Unique Perspectives to Overdose Research to Improve Health Equity

Experts from RTI International were featured in a StoryCorps podcast episode that delves into the critical issue of access disparities among racial groups for opioid treatment. The episode moderated by RTI researcher Rebecca Perry, PhD, features fellow RTI expert Tami Mark, PhD, and colleagues Gary McMurtrie and Lara Weinstein who shed light on the multifaceted challenges faced by communities of color in accessing adequate opioid treatment resources. The researchers also elaborate on their recommendations for future studies to utilize critical race theory to better understand why they are seeing the differences and how they can be deliberate in looking at intersectionality.

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