The Clinical and Health-System Case for Expanding Long-Acting Injectable Treatment in Behavioral Health

This evidence brief examines the clinical and health-system evidence supporting long-acting injectable (LAI) medications in the treatment of serious mental illness (SMI) and substance use disorders (SUD). Drawing on systematic reviews, meta-analyses, and randomized clinical trials, the authors describe how LAIs can reduce reliance on daily medication-taking and support adherence, treatment persistence, and continuity of care. Evidence is strongest for schizophrenia, where LAI antipsychotics have been associated with improved medication adherence and reductions in hospitalization and emergency department utilization compared with oral antipsychotics. This brief also considers LAI therapies for bipolar and schizoaffective disorders, opioid use disorder, and alcohol use disorder, as well as their potential role in reducing treatment interruptions and supporting transitions between care settings. While the strength of evidence varies by diagnosis and medication, the evidence brief suggests that appropriate LAI use may support more consistent treatment and reduce reliance on acute-care services without necessarily increasing overall healthcare expenditures.

Download the full report here.