"Facility Operation
"Table 2.2 and Figure 2. The operational structure of the substance abuse treatment system (i.e., the types of entities responsible for operating facilities) had some notable changes between 2010 and 2020.
"● Private non-profit organizations operated 58 percent of all facilities in 2010, decreasing to 50 percent in 2020 [Table 2.2 and Figure 2].
"● Private for-profit organizations operated 30 percent of facilities in 2010, increasing to 41 percent of facilities in 2020 [Table 2.2 and Figure 2].
"● Local, county, or community governments operated 6 percent of facilities in 2010, decreasing to 4 percent in 2020 [Table 2.2 and Figure 2].
"● State governments operated 3 percent of facilities in 2010, decreasing to 2 percent in 2020 [Table 2.2 and Figure 2].
"● The federal government operated 2 to 3 percent of facilities each year between 2010 and 2020 [Table 2.2 and Figure 2].5
"● Tribal governments operated 1 to 2 percent of facilities each year between 2010 and 2020 [Table 2.2 and Figure 2].
"Type of Care Offered6
"Table 2.3 and Figure 3. The proportions of facilities that offered outpatient, residential (non-hospital), and hospital inpatient care were stable between 2010 and 2020. OTPs, certified by SAMHSA, provide MAT with methadone, buprenorphine, and naltrexone. Facilities with OTPs can be associated with any type of care. Facilities with OTPs made up 8 to 11 percent of all facilities between 2010 and 2020 [Table 2.4].
"● Outpatient treatment was provided by 81 to 83 percent of facilities during this period [Table 2.3].
"● Residential (non-hospital) treatment was provided by 24 to 26 percent of facilities in this period [Table 2.3].
"● Hospital inpatient treatment was provided by 5 to 6 percent of facilities during this time period [Table 2.3].
"● Outpatient treatment was provided by 90 to 95 percent of facilities with OTPs between 2010 and 2020 [Table 2.3].
"● Residential (non-hospital) treatment was provided by 7 to 9 percent of facilities with OTPs between 2010 and 2020 [Table 2.3].
"● Hospital inpatient treatment was provided by 7 to 10 percent of facilities with OTPs between 2010 and 2020 [Table 2.3].
"Facilities That Use MAT
"Table 2.4. MAT includes the use of methadone or buprenorphine for the treatment of opioid use disorder (OUD) and the use of naltrexone for relapse prevention in OUD. Methadone for OUD is available only at the OTPs that are certified by SAMHSA’s Center for Substance Abuse Treatment.7 Buprenorphine may be prescribed by physicians or other authorized medical practitioners (physicians, physician assistants, and nurse practitioners) who have received Drug Addiction Treatment Act of 2000 (DATA 2000) specific training and received a waiver to prescribe the medication for treatment of OUD; some of these authorized medical practitioners are affiliated with facilities (either OTPs or other). All medical practitioners with prescribing privileges can prescribe injectable naltrexone.
"● The proportion of OTPs that provided methadone-only treatment decreased from 52 percent of all facilities with OTPs in 2010 to 17 percent of all facilities with OTPs in 2020 [Table 2.4].
"● The proportion of OTPs that provided only methadone and buprenorphine treatment decreased from 47 percent of all facilities with OTPs in 2010 to 42 percent in 2020. Between 2012 and 2020, the proportion of facilities with OTPs that offered methadone, buprenorphine, and injectable naltrexone increased from 12 percent in 2012 to 31 percent in 2020; over the same period, the proportion of facilities that offered only buprenorphine and injectable naltrexone increased from less than 1 percent to 6 percent [Table 2.4].8
"● The proportion of facilities (either OTP or non-OTP) that provided any buprenorphine services increased from 18 percent of all facilities in 2010 to 44 percent of all facilities in 2020 [Table 2.4].
"● The percentage of all facilities that provided any extended-release injectable naltrexone treatment increased from 10 percent in 2012 to 37 percent in 2020 [Table 2.4]."
Substance Abuse and Mental Health Services Administration, National Survey of Substance Abuse Treatment Services (N-SSATS): 2020. Data on Substance Abuse Treatment Facilities. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2021.
