Lead: Medicaid Managed Care Plan Alignment With State Substance Use Disorder Treatment Coverage RequirementsLead: Medicaid Managed Care Plan Alignment With State Substance Use Disorder Treatment Coverage Requirements
This Week in Addiction Medicine from ASAM
Zach Caruso presents a rapid tour of recent addiction medicine research covering Medicaid coverage gaps, OUD care patterns, harm reduction tools, sleep issues, and methadone diversion. The episode highlights how policy, clinical practice, and simple tools like vending machines and brief measures can affect access to and quality of substance use treatment.
7:11•5 May 2026
Medicaid Gaps, Harm Reduction Tech, and New Evidence in Addiction Care
Episode Overview
- Medicaid managed care plans in some states, particularly Republican-leaning ones, often do not align with state requirements for covering AUD and OUD medications.
- Among Medicaid beneficiaries, OUD diagnosis rates decreased while the proportion receiving medication for OUD rose, but long-term treatment continuity declined.
- Less than half of pregnant women with OUD received medication for opioid use disorder, highlighting missed opportunities for evidence-based perinatal care.
- Symptom-based dosing for neonatal opioid withdrawal shortened time to medical readiness for discharge without worsening safety outcomes.
- Smart harm reduction vending machines successfully distributed naloxone, drug testing strips, and other health items, engaging thousands of registered and non-registered users.
“Efforts to increase access to medications for AUD and OUD will need to address misalignment between managed care plans and state policy, and not just focus on making changes to state policy.”
What are the common struggles and victories in addiction recovery? This news-focused episode of *This Week in Addiction Medicine from ASAM* gives you a brisk tour through fresh research that shapes how treatment is funded, delivered, and measured across the United States. Hosted by Zach Caruso, the show is aimed at clinicians, policy-minded professionals, and anyone who likes their addiction medicine updates short, evidence-heavy, and politics-aware.
You’ll hear about a lead study from *The Milbank Quarterly* showing that Medicaid managed care plans often fall short of state requirements for covering medications for alcohol use disorder (AUD) and opioid use disorder (OUD), especially in Republican-leaning states.
As Caruso explains, “efforts to increase access to medications for AUD and OUD will need to address misalignment between managed care plans and state policy, and not just focus on making changes to state policy.” From there, the episode runs through large-scale data on the OUD “cascade of care” for Medicaid beneficiaries, where diagnosis rates are dropping, medication use is climbing, but long-term continuity of medication still lags.
Pregnant women with OUD also come into focus, with research showing that fewer than half receive medication for opioid use disorder, despite it being described as the gold standard for treatment. You’ll also get a snapshot of clinical innovations: symptom-based dosing for neonatal opioid withdrawal that shortens hospital stays, smart harm reduction vending machines distributing naloxone, drug testing strips, and hygiene kits, and simple single-item patient-reported measures that might make routine outcome monitoring less of a chore.
Sleep disruption in substance use disorders and the tricky topic of methadone diversion round out a packed briefing. If you’re looking for concise, research-driven insights to inform practice, policy, or personal advocacy around addiction treatment and harm reduction, this episode packs a lot into just a few minutes. Which study might change how you think about access to life-saving medications?
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