Private equity firms have acquired more than one-third of U.S. methadone clinics but have not expanded access to the medication or built new treatment facilities, according to research by a healthcare economist at Brown University.
Methadone treats opioid addiction and cuts fatal overdose risk by roughly half, yet only 22% of people with opioid use disorder receive it. More than 120 people a day died from opioid overdoses in 2025 according to federal estimates.
The research found that within two years of a private equity firm entering a county, it typically controlled 67% of the local methadone treatment market. In more than a quarter of counties studied, a single firm controlled all of it. Despite this market consolidation, private equity acquisitions did not result in new clinic construction or increased methadone treatment. Methadone shipments and opioid-related deaths remained unchanged during the study period.
As of October 2026, there are 1,572 methadone clinics registered with the Centers for Medicare and Medicaid Services. Nationally, 35% of opioid treatment providers are affiliated with private equity firms. In 19 states and the District of Columbia, more than half of providers have private equity owners.
U.S. Sen. Maggie Hassan, D-N.H., is investigating three of the country's largest methadone clinic operators, citing concerns that they oppose expanding treatment access for financial reasons.
Community Medical Services, owned by private equity, operates the Sierra Vista, Arizona clinic where patient Amber Titus receives treatment. The company has expanded from 14 clinics in four states before private equity investment to 79 clinics in 14 states, according to CEO Nick Stavros. He said 49 of those new clinics represent genuine expansion, though he noted that building a new clinic costs about $2.5 million, more than many rural areas can support.