Is buprenorphine treatment availability associated with decreases in substantiated cases of child maltreatment?

Abstract

Objectives

Buprenorphine utilization is an effective treatment for opioid use disorder (OUD). Given the recent increase in child maltreatment reports related to parental substance use, research should explore the correlation between buprenorphine treatment and child maltreatment–related outcomes.

Methods

The study team drew the data for the study from 2016 to 2018 administrative records on buprenorphine waivered providers and child welfare caseloads in 25 states. Multivariable linear regression models with county and year fixed effects were estimated to examine the correlation between changes in buprenorphine treatment capacity (defined as the total patient limit of all providers with a buprenorphine waiver in a county) and the total number of children reported for maltreatment in a county, and the case determinations of those children.

Results

An increase in buprenorphine treatment capacity did not have a significant impact on the total number of children reported to child welfare agencies for maltreatment but was associated with a reduction in the number of substantiated cases. Specifically, an increase in capacity of 1 patient per 100 residents was associated with a −0.9% decrease in the probability that a report will be substantiated following an investigation.

Conclusions

Increased buprenorphine treatment capacity was correlated with lower rates of substantiated cases of maltreatment, suggesting that OUD treatment is effective in reducing immediate risk to children. Increased treatment for OUD has a positive externality in the child welfare context. Increases in buprenorphine treatment are likely to provide parents not only with the needed treatment for their OUD but also act as a support mechanism to fulfill their parental roles.