  Effective treatment strategies exist for substance use disorder (SUD),
however severe hurdles remain in ensuring adequacy of the SUD treatment (SUDT)
workforce as well as improving SUDT affordability, access and stigma. Although
evidence shows recent increases in SUD medication access from expanding
Medicaid availability under the Affordable Care Act, it is yet unknown whether
these policies also led to a growth in the changes in the nature of hiring in
SUDT related workforce, partly due to poor data availability. Our study uses
novel data to shed light on recent trends in a fast-evolving and
policy-relevant labor market, and contributes to understanding the current SUDT
related workforce and the effect of Medicaid expansion on hiring attempts in
this sector. We examine attempts over 2010-2018 at hiring in the SUDT and
related behavioral health sector as background for estimating the causal effect
of the 2014-and-beyond state Medicaid expansion on these outcomes through
"difference-in-difference" econometric models. We use Burning Glass
Technologies (BGT) data covering virtually all U.S. job postings by employers.
Nationally, we find little growth in the sector's hiring attempts in 2010-2018
relative to the rest of the economy or to health care as a whole. However, this
masks diverging trends in subsectors, which saw reduction in hospital based
hiring attempts, increases towards outpatient facilities, and changes in
occupational hiring demand shifting from medical personnel towards counselors
and social workers. Although Medicaid expansion did not lead to any
statistically significant or meaningful change in overall hiring attempts,
there was a shift in the hiring landscape.
