Improve Access to Medications for Opioid Use Disorder in Hospitals

Although regulatory changes have removed some barriers to prescribing medications for substance use disorders — such as the elimination of thefederal X-waiver requirement for buprenorphine [1] — access to MOUD and MAUD remains limited, particularly among older adults and those transitioning out ofhospital settings. Recent research finds that only 5% of individuals with opioid use disorder (OUD) discharged from inpatient hospitalization receive MOUD, and just 2% of individuals with alcohol use disorder (AUD) receive MAUD after hospitalization.[2] Hospitals and post-acute settings represent critical intervention points for initiating or continuing evidence-based medications for addiction treatment, particularly for aging adults, whose rates of substance use and overdose have been steadily rising.[3] Requiring MOUD and MAUD availability as part of Medicare’s Conditions of Participation (CoPs) would standardize MOUD/MAUD access across institutions and improve continuity of care after discharge — addressing one of the most consequential gaps in the SUD treatment continuum. This structural change would ensure systemic accountability and promote widespread uptake of effective treatments.