The landscape of substance use disorder (SUD) treatment in 2024 was a tapestry of challenges, technological disruptions and unexpected breakthroughs.
A staggering data leak exposed the personal information of 100 million patients. Economic pressures forced some SUD providers to retreat from certain state markets, and long-anticipated regulatory changes were once again delayed, leaving the industry in a state of uncertainty. The proliferation of highly potent illicit drugs, especially fentanyl and emerging synthetic opioids, continued to pose significant challenges to treatment protocols.
Yet, amidst this turbulence, hope shone through. The number of U.S. drug overdose deaths declined for the first time in five years – which some industry experts attribute to improved access to evidence-based treatments like medications for opioid use disorder (MOUDs).
To recap a year of towering highs and unexpected lows, Addiction Treatment Business called on top industry executives to report what they thought were some of the most impactful trends and events in 2024.
Many of the highlighted incidents will continue to impact the SUD treatment industry in 2025, including the unknowns of the DEA’s decision regarding controlled substance prescribing via telehealth appointments, evolving reimbursement rates and global revenue cycle problems.
Read on to learn what trends and events providers saw as the most impactful in 2024.
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“The ransomware attack on Change Healthcare, which left insurers unable to process claims for months, was one of the most notable occurrences in 2024. While it impacted all of healthcare, it was keenly felt in the SUD treatment industry where it created challenges both operationally and to organizational sustainability.
For some organizations, it created issues with financing, cash-on-hand, inability to meet payrolls or pay bills. Because it took months for the system to normalize, we saw some good providers leave the market, especially in vulnerable areas where resources were scarce or they consolidated with other providers. We also saw providers delay investments and expansion of services. In addition, this attack compounded the strains between payors and providers, as inflation and a shrinking number of qualified workers have driven up the cost of treatment in an industry where bias and stigma still make it difficult for individuals to get the help they need at the proper level of care.”
– John Driscoll, President and CEO, Caron Treatment Centers
“U.S. drug overdose deaths declined 15% in the past year, the first signal of a reversal to the multi-year surge that began in 2018. It is clear that expanded access to medication-assisted treatment (MAT) for opioid use disorder has been a major driver of this progress, enabled by policy in recent years to deregulate barriers for providers and patients – including allowing MAT medications to be prescribed via telehealth.
While access to MAT remains far too low today (the CDC estimates only 25% of the 10 million Americans with OUD can get it), the decline in overdose deaths suggests that policy efforts have been successful. Continued momentum in the fight against the overdose epidemic depends on maintaining these policies and expanding upon them to remove barriers to life-saving care that remain in place today.”
– Zack Gray, CEO and founder of Ophelia
“In 2024, the Change Healthcare data breach brought attention to revenue cycle issues at the start of the year – and rightfully so – but there have been other more global revenue cycle problems driving up accounts receivables for many providers across healthcare for the past few years. From an equity standpoint, these kinds of problems disproportionately impact smaller organizations, and we should take note of the distortions they cause for a healthy competitive landscape.”
– Dr. Joe Lee, president and CEO of Hazelden Betty Ford Foundation
“One of the most critical and transformative developments in the substance use disorder (SUD) field, particularly for opioid use disorder (OUD) treatment, is the updated SAMHSA guidelines released in February 2024, which took effect in April with compliance required by October. These changes represent a significant step forward in modernizing care delivery and improving access. By promoting clinician and provider autonomy, eliminating stigmatizing and outdated language, and emphasizing a patient-centered approach, the guidelines aim to reduce barriers to treatment and expand and enhance overall care quality.”
– Jacob Cooper, comprehensive treatment center group president of Acadia Healthcare
“For the first time since 2018, the United States’ overall overdose death rate declined year over year. We’re proud to say that Groups Recover Together has been a driving force behind this progress. In Maine and Indiana — where Groups is the largest provider of treatment for Substance Use Disorder — overdose deaths decreased by an astounding 18% and 19%, respectively, two of the largest declines in the nation. We are proud of the critical role we’ve played in helping save lives and drive this positive momentum. We’re hopeful that this trend continues in the years to come.”
– Cooper Zelnick, chief strategy officer of Groups Recover Together
“A leaked DEA proposal this year revealed an attempt to roll back telemedicine access for buprenorphine but was met with widespread resistance from physicians, health advocates, and bipartisan members of Congress. Telemedicine access has been temporarily extended for another year. In 2025, we need legislation to make this critical modality for addiction medicine permanent. We hope the TREATS Act will gain momentum.”
– Stephanie Strong, CEO and founder of Boulder Care
“The most significant development in the substance use disorder (SUD) treatment space goes back to the DEA’s decision in 2023 to eliminate the waiver requirement for providers to prescribe Suboxone. Previously, only SUD treatment providers who completed a specific training course and obtained the waiver could prescribe this particular medication. These providers also faced restrictions on the number of patients they could treat, with a cap of 200, and were required to maintain detailed patient records. Now, any SUD treatment provider with a DEA license can prescribe Suboxone without a patient cap. This change has greatly expanded patients’ ability to access services.
Another exciting thing that occurred in 2024 is that SAMHSA/CMS added 10 new states to the Certified Community Behavioral Health (CCBHC) demonstration program, more than doubling the program’s size. As a result, participating providers will receive cost-based reimbursement for providing a higher level of integrated care that includes mental health and SUD treatment. Nationwide, once a provider becomes a CCBHC they increase access to SUD services, including MAT.”
– David C. Guth, Jr., CEO of Centerstone
“High interest rates and a lack of investment meant that 2024 was another tough year for accessing capital. I’ve seen several SUD providers exit states because they couldn’t make it work. In 2025, I do expect we’ll begin seeing which companies have cracked the code on creating sustainable business models. Those companies will be able to scale to provide access where others could not.”
– Ankit Gupta, founder and CEO of Bicycle Health
“The fentaAddiction Treatment in 2024: Navigating Privacy Challenges, Telehealth Shifts, Reimbursement Reformsnyl crisis continues to pose significant challenges. The drug’s high potency and the rapid onset of its effects make it difficult to manage within traditional treatment frameworks. Additionally, the emergence of synthetic opioids, even more potent than fentanyl, has raised concerns about the potential for increased overdose deaths and the need to evolve treatment interventions to treat patients using these substances more effectively.”
