# Lifting eviction moratoria shifted treatment for substance use disorders

## TL;DR

Ending eviction protections in the U.S. was linked to increased outpatient care for substance use disorders, but not hospital care.

## Contribution

This study is the first to show how housing policies like eviction moratoria affect the use of substance use disorder treatment services.

## Key findings

- Ending moratoria was linked to a 4.9% rise in outpatient SUD visits after federal protections ended.
- Medication treatment for opioid or alcohol use disorder increased by 2.5% when state protections remained.
- Inpatient SUD care and hospital-based treatment for opioid use disorder were not significantly affected.

## Abstract

About 2.7 million U.S. households face an eviction filing each year. The effect of eviction policy on substance use disorder (SUD) treatment is uncertain.

We used IQVIA all-payer claims, Jan 2020–Dec 2021, in a difference-in-differences design. Phase 1 compared states where moratoria expired March–August 2020 with states that kept protections. Phase 2 examined the August 2021 end of the federal moratorium, contrasting states with ongoing state moratoria vs none. The population was people with a mental health or SUD diagnosis. Outcomes were state-week counts of unique patients with outpatient SUD visits, inpatient SUD stays, medications for opioid or alcohol use disorder, and opioid use disorder (OUD)-specific outpatient and inpatient care.

Ending moratoria was associated with more patients receiving outpatient SUD care: +3.3% (95% CI −0.5% to 7.2%; P = 0.09) in Phase 1 and +4.9% (95% CI 1.8% to 8.0%; P = 0.002) in Phase 2. We observed no change in inpatient SUD care. In Phase 2, medication treatment increased by 2.5% (95% CI 0.3% to 4.7%; P = 0.03). OUD-specific results were similar.

The return of eviction risk coincided with greater use of clinic-based SUD services but not hospital care. Housing policy may shift where and how people seek SUD treatment.