This project evaluated needs assessment methodologies for substance use disorder (SUD) treatment capacity, highlighting best practices and identifying gaps and opportunities for improvement. In 2017, 7.6% of the population age 12 or older needed treatment for an SUD treatment, as defined by the National Survey of Drug Use and Health; however only 1.5% of the population received any substance use treatment in the past year. Moreover, 94.3% of the individuals identified as needing substance use treatment did not perceive a need for treatment. A needs assessment can help close some of the treatment gap, by pinpointing service system and workforce needs that can help best address the need for treatment. An environmental scan conducted for the project found that SUD treatment system needs assessments are conducted widely, for purposes of state and local policy initiatives or in conjunction with federal grant programs. A review of a sample from diverse geographical areas indicated that a wide variety of topics such as specific substances, sub-populations, and system issues, are addressed. Data sources typically include a combination of federal and local sources of prevalence and utilization data along with qualitative information obtained from focus groups and stakeholder interviews. Needs assessment of SUD treatment capacity is faced with a number significant challenges including the complexity of the treatment system with multiple provider types, settings and treatment modalities, which lack standard definitions. Additionally, there is no standard definition or measurement of need for treatment. This study found that further research needs to be undertaken to uncover the relationship between prevalence of SUD and the need for specific types of services, as well as the staffing levels needed to support these services. While the American Society of Addiction Medicine Levels of Care Criteria can be used as a standard of a continuum of care, it is not yet in full use in SUD treatment capacity planning. In addition, while some federal data sources are available to answer pressing questions about the current capacity of the system, they are incomplete. This study concluded that more research will be necessary to standardize and validate needs assessment methodologies.
This report was prepared under contract #HHSP233201600015I between HHS's ASPE/DALTCP and the Human Services Research Institute. For additional information about this subject, you can visit the DALTCP home page at https://aspe.hhs.gov/office-disability-aging-and-long-term-care-policy-daltcp or contact the ASPE Project Officer, Judith Dey, at HHS/ASPE/DALTCP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C. 20201. Her e-mail address is: Judith.Dey@hhs.gov.
DISCLAIMER: The opinions and views expressed in this report are those of the authors. They do not reflect the views of the Department of Health and Human Services, the contractor or any other funding organization. This report was completed and submitted on December 2018.