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Oregon Substance Use Disorder Services Inventory and Gap Analysis

In collaboration with Oregon Health Authority and Oregon Alcohol and Drug Policy Commission (ADPC), researchers from the Oregon Health and Science University - Portland State University School of Public Health (OHSU-PSU SPH) conducted an inventory and gap analysis of service delivery resources available in Oregon to address substance use disorder prevention, harm reduction, treatment, and recovery.

Key Findings 

• All 36 Oregon counties showed violent crime, high alcohol outlet density, and low social association rates as Oregon’s most substantial contributors to risk of hospitalization for a substance use disorder.

• There is a 49% gap in substance use disorder services needed by Oregonians. 

• Most substance use disorder service providers lack capacity to meet demand for services. 

• Statewide gaps in equity and access include insufficient provision of culturally relevant services to protected classes, language interpretation and translation services, and a workforce that does not represent the demographics of the state. 

• Barriers to substance use disorder services persist in both transportation and technology. 

• Among Oregon Health Plan members, rates of substance use disorder diagnoses suggest that less than half of those with a use disorder have been diagnosed or treated. 

• There is a 51% gap in healthcare providers authorized to prescribe buprenorphine. Among surveyed facilities offering medications for opioid use disorder, half dispensed buprenorphine or naltrexone, while less than one in five reported certified Opioid Treatment Programs licensed to dispense methadone. 

• Around one in five surveyed providers offering harm reduction reported that they provided drug checking, or syringe services.


• Treat encounters in the emergency department, hospital, shelters and justice systems as opportunities for connection to community treatment and naloxone distribution. 

• Incentivize equitable distribution of linguistically and culturally relevant services. 

• Address gaps in substance use disorder workforce, including both prescribers and credentialed staff providing essential prevention services and recovery supports. 

• Increase support for service organizations to employ and bill for certified peer support specialists across the continuum of substance use disorder care. 

• Invest in syringe service and other harm reduction programs, including drug checking. 

• Expand access to medications for opioid use disorder through provider training, telemedicine, mobile services, and reduced wait times and insurance pre-authorization. 

• Prioritize strategies that target affordable housing, education, and employment to reduce risk of substance use disorders and their consequences and to support long term recovery.