Changes in Opioid Treatment Program Staffing from 2011 to 2016
U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration
- The number of full-time equivalent staff per 1,000 clients increased for all staff types from 2011 to 2016. The most significant increases were among doctoral-level counselors and pharmacists.
- The share of OTP facilities offering a broader set of ancillary services, a broader set of mental health services and programs for special groups such as adult men, seniors, and criminal justice clients increased over the five-year period.
- The types of medication offered at OTPs evolved from 2011 to 2016. Fewer facilities offered methadone only in 2016, and a higher share offered buprenorphine and injectable naltrexone.
- There was a small increase in the average number of clients served in a facility.
Adequate medical, counseling, and support staff in opioid treatment programs (OTPs) are critical for safe and effective treatment. Federal guidelines require OTPs to provide a broad range of services, including medical, counseling, vocational, educational, and other assessment and treatment services appropriate to meet the needs of the patients they serve. Specifically, federal guidelines state that an OTP must provide each client with a treatment plan and “an adequate number of competent, qualified, and experienced professional clinical staff to implement and supervise the treatment plan, consistent with patient needs.” Federal guidelines thus acknowledge that OTP staffing will vary according to the needs of the patients served. The guidelines also allow facilities to address components of a client’s treatment plan on-site or through formal arrangements with other organizations. For this reason, OTP staffing is also expected to vary depending on the services offered at the program itself rather than through a partnering provider.