Increased prevalence of substance use disorder (SUD) can increase the use of health services and costs associated with treatment, drug overdoses, drug-related injuries, and chronic health conditions. This brief uses 2018 all-payer claims data from seven states to describe the lengths and costs of inpatient hospital stays for SUDs and examines whether there were differences between stays for rural and urban residents.

Key Findings:

• Medicare and Medicaid were the primary payers for a higher proportion of rural inpatients, while urban inpatients were more likely to have private insurance coverage for inpatient hospital stays.
• The percentage of inpatient stays for primary SUD diagnosis admitted through court or law enforcement channels was four and a half times higher for rural residents than for urban residents.
• The proportion of rural inpatients who resided in areas with no access to buprenorphine waivered physicians was more than nine times higher than for urban inpatients.