States Policies to Expand Access to Substance Use Disorder Treatment during COVID-19

Updated: Mar 11

New Data from the Justice Community Opioid Innovation Network (JCOIN)'s Brown University Clinical Research Center


By Braeden Kelly


The Prescription Drug Abuse Policy System (PDAPS) is an online resource, developed by a team at the Center for Public Health Law Research at Temple University, through a supplement to JCOIN’s Brown University Clinical Research Center (Hub), that provides data and information on state policies and laws aimed at responding to substance use disorders, including topics related to justice-involved populations, naloxone access, medication for opioid use disorder (MOUD), prescription drug monitoring programs, and more


PDAPS has recently published datasets that capture state responses to expand access to MOUD during the COVID-19 pandemic in correctional facilities, through telehealth, and by utilizing Medicaid Waivers to remove prior authorization barriers.


The new datasets and key findings include:

  • COVID-19 Mitigation Laws at State Correctional Facilities Relating to Opioid Use Disorder Treatment: Before COVID-19, 18 states had existing policies to provide MOUD in correctional facilities, and of those, eight states continued treatment during release. During the pandemic, 11 states adjusted their policies to provide MOUD during release, primarily due to the early release orders.

  • COVID-19 State Medicaid Waivers for Substance Use Disorder Treatment: States can use three Medicaid Waivers to modify Medicaid programs to increase flexibility, support, and access to health care services during emergency situations. These include Section 1115 Waivers, Section 1135 Waivers, and Section 1915(c), Appendix K Modifications which allow states to remove prior authorization barriers to substance use disorder treatment and increase the availability of telehealth services. During COVID-19, 17 states adopted all three waivers, but only five states utilized the Section 1115 Waiver specifically for substance use disorder services.

  • Increasing Access to Buprenorphine and Methadone During COVID-19: Throughout the pandemic, federal guidance was issued that allowed states to lessen telehealth requirements, extend take-home doses of MOUD, and co-prescribe naloxone. However, only a handful of states implemented these measures to increase MOUD availability. Six states removed in-person requirements to initiate MOUD, only two states permanently removed prior authorization, and four states extended take-home doses of MOUD during the pandemic.

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Read the official press release.