Understanding SUD treatment bed availability and population health outcomes

The National Institute on Drug Abuse awarded Oak Ridge Associated Universities, Incorporated $358,096 on September 1, 2026, under the Drug Use and Addiction Research Programs (CFDA 93.279) to conduct research on substance use disorder treatment bed availability and population health outcomes.

The recipient will estimate annual trends in national county-level SUD treatment bed capacity, need, and availability; explore how these trends vary by county-level geographic and economic characteristics; and assess whether state-level factors and investments in expanding SUD treatment bed capacity are associated with improvements in bed capacity and declines in drug-related emergency department admissions and overdose deaths. The research addresses a knowledge gap: while national data on SUD treatment bed capacity exist, they lack geographic identifiers below the state level, preventing linkage to county-level characteristics or public health outcomes and hindering efforts by public health officials to identify counties requiring increased SUD treatment bed capacity.

Work is performed in Oak Ridge, Tennessee. The period of performance runs from September 1, 2026, through June 30, 2031. Oak Ridge Associated Universities is a nonprofit research organization and consortium of over 120 Ph.D.-granting universities that provides scientific research and technical services to federal agencies.

Abstract

In 2023, out of the 48.5 million people diagnosed with a substance use disorder (SUD), only 12.8 million received treatment. One reason for the low treatment rates is the lack of available SUD treatment services, particularly for inpatient and residential beds within SUD treatment facilities. SUD treatment beds are a critical resource for those who are at increased risk of overdose and death resulting from suds. Currently, the understanding of the supply and demand for SUD treatment beds in the U.S., as well as their impact on public health outcomes, is limited. Although national data on SUD treatment bed capacity are available, they lack specific geographic identifiers below the state level, preventing linkage to county-level geographic and economic characteristics or public health outcomes such as drug-related emergency department admissions and overdose deaths. As a result, clinicians and public health officials are hindered when attempting to identify which counties require SUD treatment bed capacity to be increased. This knowledge GAP complicates efforts by public health officials to identify counties in need of increased SUD treatment bed capacity. Considering these critical gaps in knowledge, the study team proposes to: 1) estimate annual trends in national county-level SUD treatment bed capacity, need, and availability. 2) explore how the trends in SUD treatment bed capacity, need, and availability vary by county-level geographic and economic characteristics. 3) estimate whether state-level factors and investments in expanding SUD treatment bed capacity are associated with improvements in bed capacity and declines in drug-related ED admissions and overdose deaths; also, determine the extent to which changes in county-level health outcomes related to state-level programs vary based on county-level geographic and economic characteristics. The study team will utilize their past experience in conducting needs-based analyses for SUD treatment beds. Specifically, they will administer an annual survey to all licensed SUD treatment facilities nationwide, employing a new method to derive an accurate and comprehensive estimate of SUD treatment bed need. They will then monitor changes in SUD treatment bed need across counties over time, identifying significant differences based on urbanicity and economic characteristics. Additionally, the team will investigate the relationship between state-level programs, SUD treatment bed availability, and population health outcomes. The measures of SUD treatment bed capacity, along with a predictive model based on the study results, will be made publicly available. The findings and publicly released data from this study will enable clinicians and public health officials to make informed decisions about where and how many SUD treatment beds to build, and to understand the implications of these decisions on health outcomes.