GAO report: nearly one-third of U.S. counties have no substance use treatment available

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A new report out by the Government Accountability Office (GAO) finds that most U.S. counties do not have all levels of substance abuse disorder treatment available, and for nearly one-third of the counties in the United States, there are no levels of treatment are available.

As part of a report to the U.S. Senate about substance use disorder (SUD) treatment capacity, the GAO looked at what is known about SUD treatment facilities, services and capacity; and examines the information the Substance Abuse and Mental Health Services Administration (SAMHSA) uses to assess the effect of grant programs on access to SUD treatment.

By analyzing data on SUD treatment facilities and providers, and reviewing studies that assess treatment capacity, as well as reviewing documentation for SAMHSA’s largest grant programs and interviewing SAMHSA officials and stakeholders, the GAO was able to determine that while the number of treatment facilities and services has increased since 2009, the gaps in treatment capacity remain.

“For example, SAMHSA data show that, as of May 2020, most counties did not have all levels of SUD treatment available, including outpatient, residential, and hospital inpatient services; nearly one-third of counties had no levels of treatment available. Stakeholders GAO interviewed said it is important to have access to each level for treating individuals with varying SUD severity,” the agency said in its report.

Since SAMHSA relies on the number of individuals served to assess the effectiveness of its largest grant programs on access to SUD treatment and recovery support services, information about that data is key in their evaluation. But the GAO found that SAMHSA lacks reliable data for the number of individuals served under the Substance Abuse Prevention and Treatment Block Grant (SABG) program.

The report found that grantee reporting included individuals served outside of the program, limiting SAMHSA’s ability to measure the program’s relevance or assessment of access.

The GAO recommended that the Assistant Secretary for Mental Health and Substance Use should “identify and implement changes to the SABG program’s data collection efforts to improve two elements of reliability—consistency, and relevance—of data collected” on individuals who receive SUD treatment and recovery support services funding through SABG programs.

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