Initiation and Engagement of Substance Use Disorder Treatment (IET)

The percentage of new substance use disorder (SUD) episodes that result in treatment initiation and engagement. Two rates are reported:  

  • Initiation of SUD Treatment. The percentage of new SUD episodes that result in treatment initiation through an inpatient SUD admission, outpatient visit, intensive outpatient encounter, partial hospitalization, telehealth visit or medication treatment within 14 days.  
  • Engagement of SUD Treatment. The percentage of new SUD episodes that have evidence of treatment engagement within 34 days of initiation. 

Why It Matters

In 2022, 48.7 million individuals in the U.S. 12 years of age or older (approximately 17.3% of the population) were classified as having had an SUD within the past year (1). Individuals with SUDs are at increased risk of overdose, injury, soft tissue infections and mortality (2). In 2021, drug overdose accounted for 106,699 deaths, representing a 14% increase in overdose deaths compared to 2020 (3). Similarly, over 140,000 people die each year from excessive alcohol use (4).  

Evidence-based treatment for SUD includes both psychosocial supports and, for opioid and alcohol use disorders, medication (5,6,7,8). However, despite known and effective treatments, less than 20% of individuals with SUD receive specialty care (9,10).  

Early treatment engagement is a critical step between accessing care and completing a full course of treatment. Individuals who engage in early SUD treatment have been found to have decreased odds of negative outcomes, including mortality (11,12). The intent of this measure is to assess access to evidence-based SUD treatment for individuals beginning a new episode of treatment. 

Historical Results – National Averages

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References

  1. Substance Abuse and Mental Health Services Administration. 2023. “Key Substance Use and mental Health Indicators in the United States: Results from the 2022 National Survey on Drug Use and Health.” HHS Publication No. PEP23-07-01-006, NSDUH Series H-58. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/sites/default/files/reports/rpt42731/2022-nsduh-nnr.pdf 
  2. Bahorik, A.L., D.D. Satre, A.H. Kline-Simon, C.M. Weisner, C.L. Campbell. (2017). Alcohol, Cannabis, and Opioid Use Disorders, and Disease Burden in an Integrated Health Care System. J Addiction Medicine 11(1),3–9. 
  3. Centers for Disease Control and Prevention. 2023. “Drug Overdose Deaths.” https://www.cdc.gov/drugoverdose/deaths/index.html 
  4. Centers for Disease Control and Prevention. 2022. “Deaths from Excessive Alcohol Use.” https://www.cdc.gov/alcohol/features/excessive-alcohol-deaths.html#:~:text= More%20than%20140%2C000%20people%20die,in%20the%20U.S.%20each%20year 
  5. Kampman, K., K. Freedman. 2020. “American Society of Addiction Medicine (ASAM) National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update.” Journal of Addiction Medicine 14, no. 2S: 1–91, https://doi.org/10.1097/ADM.0000000000000633. 
  6.   Reus, V. et al. 2018. “Practice Guideline for the Pharmacological Treatment of Patients with Alcohol Use Disorder.” American Journal of Psychiatry 175(1), 86–90. doi:10.1176/appi.ajp.2017.1750101  
  7.   Department of Veteran Affairs, Department of Defense. 2015. VA/DoD Clinical Practice Guideline for the Management of Substance Use Disorders. Washington DC: Department of Veterans Affairs, Department of Defense. 
  8.   Michigan Quality Improvement Consortium. August 2015. Screening, diagnosis and referral for substance use disorders. Southfield (MI): Michigan Quality Improvement Consortium. 1 p. 
  9.   Substance Abuse and Mental Health Services Administration (SAMHSA). 2019. Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health. https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.htm#mhisud 
  10.   Williams, E.C., T.E. Matson, & A.H. Harris. 2019. “Strategies to Increase Implementation of Pharmacotherapy for Alcohol Use Disorders: A Structured Review of Care Delivery and Implementation Interventions.” Addiction Science & Clinical Practice 14(1), 6. 

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