Limited data exist regarding the prevalence of substance use disorders or utilization of mental health care during the COVID-19 pandemic. Our study aims to specifically identify trends in the utilization of behavioral health units (BHU) in those with substance use disorders (SUD). Patient electronic health records (EHR) were analyzed from fourteen hospitals principally located in the US mid-Atlantic region. To compare SUD admissions before and after COVID-19 quarantine time periods, patient

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... from BHUs were collected from two time-periods: February 1st, 2019 to May 31st, 2019, and February 1st, 2020 to May 31st, 2020. The number of SUD admissions to BHUs did not change from 2019 to 2020 but there was a statistically significant difference in the proportion of SUD patients admitted to BHUs (χ2 = 83.47, p < .001, V = 0.06). We also detected a significant difference in the proportion of SUD severity between 2019 and 2020 with a small but significant overall decrease in the proportion of moderate/severe cases (χ2 = 5.70, p < .001, V = 0.05) in SUD patients. Our data suggest that even during the times of a global pandemic when there is a decline in health care utilization in other settings, the need for inpatient substance use treatment should not be expected to decrease and increased use of telemedicine may be beneficial for this vulnerable population.