February 10, 2026

During 2023, the median 30-day retention rate for opioid treatment programs (OTPs) was 61%, according to a recent study. By 90 days, the retention rate dropped to just 42%, and by six months, only 28% of consumers remained in treatment.

The researchers analyzed data from over 261,000 Medicaid beneficiaries who received care at 1,138 OTPs nationwide. More than 400,000 treatment episodes (period of service at a facility) occurred for these individuals.

Among treatment episodes included in the 30-day retention measure, a subset of beneficiaries had received medication for opioid use disorder prior to OTP treatment initiation. Specifically, 26.0% of episodes involved methadone dispensed in the 60 days prior to treatment initiation, and 24.0% involved buprenorphine, including consumer-filled buprenorphine prescriptions. Diagnoses documented prior to OTP treatment initiation included:

• Alcohol use disorder was diagnosed 60 days prior to treatment initiation in 6.8% of episodes.
• Drug use disorder other than opioid use disorder (OUD) was diagnosed 60 days prior to treatment initiation in 21.4% of episodes.
• A mental health disorder was diagnosed 60 days prior to OTP treatment initiation in 26.8% of episodes.

These findings were reported in Opioid Treatment Programs’ Medicaid Patient Retention Rates by Dylan E. DeLisle, MPH; Tami L. Mark, Ph.D.; Chelsea Katz, Ph.D.; and colleagues. The goal was to develop a standardized case mix-adjusted measure for evaluating Medicaid consumer retention in OTPs, according to the study.