The Diffusion of Acamprosate for the Treatment of Alcohol Use Disorder: Results From a National Longitudinal Study

• We examined diffusion of acamprosate for alcohol use disorder in treatment centers.
• Availability of acamprosate did not change over time.
• Centers more reliant on Medicaid revenues were more likely to use acamprosate.
• Centers more reliant on private insurance were more likely to offer acamprosate.

To consider how the Affordable Care Act may impact the diffusion of acamprosate, an evidence-based treatment for alcohol use disorder (AUD), the present study estimated the associations between acamprosate availability, Medicaid revenues, and private insurance revenues. Data were collected from organizational leaders of national samples of 307 specialty treatment centers in 2009–2012 and 372 treatment centers in 2011–2013. Notably, there was not a significant change in the percentage of organizations offering acamprosate over the study period. However, greater reliance on Medicaid and private insurance as sources of revenue was positively associated with the availability of acamprosate. In addition, acamprosate availability was positively associated with access to physicians and the presence of on-site primary medical care, while centers that placed greater emphasis on confrontational group therapy were significantly less likely to offer acamprosate for AUD treatment. To the extent that the ACA is expanding the number of insured individuals enrolled in Medicaid and commercial insurance sold through health insurance exchanges, this study suggests that the ACA may hold promise for expanding the availability of this EBP for AUD treatment. Future research is needed to measure whether this potential impact actually occurs within the specialty treatment system over time.