January 28, 2026

The percentage of U.S. counties with at least one substance use disorder treatment facility (SUDTF) offering medication for alcohol use disorder (MAUD) increased from 34.1% in 2017 to 43.8% in 2021, according to a recent study. Growth then plateaued in 2022 and 2023. SUDTFs located in counties that are rural/rural-remote, have fewer individuals aged 65 years or older and a lower proportion of non-Hispanic White individuals, and that are socioeconomically disadvantaged were much less likely to have MAUD.

Researchers analyzed data from the Mental Health and Addiction Treatment Tracking Repository, which includes longitudinal data on licensed SUDTFs and whether they offer MAUD. The goal was to quantify trends in MAUD availability at SUDTFs from January 2017 through December 2023.

SUDTFs in rural areas were 22.40 percentage points less likely to offer MAUD compared to the likelihood for metropolitan counties. In rural remote regions, SUDTFs were 23.64 percentage points less likely to offer MAUD.

Counties with a greater prevalence of binge drinking were 1.90 percentage points more likely to have an SUDTF offering MAUD. Counties with a higher percentage of college-educated individuals were 1.28 percentage points more likely to have an SUDTF offering MAUD.

In 2023, 28.9 million people aged 12 and older in the United States had alcohol use disorder. MAUD includes three FDA-approved treatments: naltrexone, acamprosate, and disulfiram.

“A continuation of efforts to expand the availability of facilities offering MAUD may be warranted,” the researchers concluded. “Policymakers may be interested in focusing their efforts to expand the presence of SUDTFs offering MAUD in rural counties with lower overall socioeconomic status.”

These findings were reported in Medication Availability for Alcohol Use Disorder in Substance Use Disorder Treatment Facilities by Yuji Mizushima, Ph.D.; Jonathan Cantor, Ph.D.; Ryan K. McBain, Ph.D., MPH; and colleagues.