Nearly 90% of Medicare Beneficiaries Who Need Addiction Treatment Don’t Receive Care

A new study indicates that few Medicare patients with a substance use disorder (SUD) who need treatment actually receive that care.

The newly published research from nonprofits RTI International and the Legal Action Center studied the 1.7 million Medicare beneficiaries that were estimated to have SUDs between 2015 and 2019. Using data from the National Survey of Drug Use and Health, researchers found that only 11% of those 1.7 million Americans received SUD treatment.

“Unfortunately, this study suggests that a low rate of Medicare beneficiaries are receiving much-needed treatment, which means many of them are facing the serious ramifications of an untreated substance use disorder,” the study lead’s author and RTI health economist William Parish said in a statement on Monday.


The most common reasons that survey respondents cited for not receiving SUD treatment were financial barriers (33% of respondents) and being worried about what others would think of them (24%).

“Our findings point to a need for a multi-pronged approach that focuses on closing coverage gaps and reducing stigma,” said Parish.

Treating addiction is crucial to also treating physical and mental health. Organizations like Acadia Healthcare have opened community resource centers to help youths with suicide prevention and opioid addiction as opioids have been present in 20% of deaths by suicide.


This bears out in the results from the new study, which discovered that Medicare beneficiaries with SUDs were twice as likely to report serious psychological distress compared to beneficiaries without SUDs. Suicidal ideation was also more than twice as common among benefiicaries with SUDs versus those without SUDs.

Ellen Weber, Legal Action Center’s vice president for health initiatives, criticized Medicare’s limited and outdated SUD treatment for making treatment hard to access.

”It is unconscionable that nearly 90% of Medicare beneficiaries who would benefit from addiction treatment don’t receive the care they need,” said Weber in a statement. “Amidst the escalating overdose crisis, it is critical that we expand access to care significantly and break down the barriers that impede peoples’ access, including insurance barriers like those we see in Medicare.”

Written by Sloane Airey