Opioid use disorder medication treatment in residential settings increased 2017-2021, but sustaining it following stays remains an issue.

INTRODUCTION: Residential treatment is part of the care continuum for opioid use disorder (OUD). However, use of OUD medications (MOUD) has been historically low in this setting. The goal of this study was to assess changes in MOUD during residential treatment stays and the 12-month period surrounding them. METHODS: We used national Medicaid claims data for the year 2017-2021 and descriptive as well as regression analyses. RESULTS: Between 2017 and 2021, the rate of MOUD treatment in residential settings increased from 30.4 to 58.5 percentage points. By contrast, the rate of MOUD treatment 6 months before residential treatment stays and 5 months following residential treatment stays was low in 2017 and increased only slightly. Changes were similar in states that implemented a substance use disorder waiver compared to non-waiver states. Most states exhibited similar changes. New York was the only state where MOUD rates before and after residential treatment stays increased markedly. CONCLUSIONS: Our study suggests that use of MOUD during residential treatment stays increased substantially 2017-2021, but that this increase was not sustained during the months following stays. Improving retention in MOUD treatment following residential treatment stays could be an important future policy goal.