Browsing by keyword "Substance use treatment"

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    • Correlates of specialty substance use treatment among adults with opioid use disorders
      Romo, Eric; Ulbricht, Christine M.; Clark, Robin E.; Lapane, Kate L. (2018-03-11)
      AIMS: To identify factors associated with the receipt of specialty substance use treatment among adults with opioid use disorders (OUD). DESIGN: Cross-sectional study based on 2010-2014 National Surveys on Drug Use and Health (NSDUH). SETTING AND PARTICIPANTS: Adults with a past-year OUD (n=2488). The sample is representative of non-institutionalized US adults. MEASUREMENTS: Past-year OUD was determined using DSM-IV criteria. Past-year specialty substance use treatment was defined as receiving treatment for drug use at any of the following locations: rehabilitation facilities, hospitals (inpatient only), outpatient mental health centers, private doctors' offices, or methadone clinics. Multivariable logistic regression models were used to measure the independent association between potential correlates and specialty substance use treatment receipt. FINDINGS: Of adults with an OUD, 8.3% received past-year specialty substance use treatment. In a fully adjusted logistic regression model, the following factors were associated with increased odds of receiving specialty substance use treatment: > /=35years old (adjusted Odds Ratio (aOR)=2.55, 95% Confidence Interval (CI)=1.04-6.26); unemployment (aOR=1.92, 95% CI=1.02-3.61); not in the labor force (aOR=2.16, 95% CI=1.15-4.06); never been married (aOR=2.14, 95% CI=1.04-4.39); arrested in past 12months (aOR=4.43, 95% CI=2.45-7.99); opioid dependence (aOR=3.82, 95% CI=2.06-7.10); alcohol use disorder (aOR=2.44, 95% CI=1.44-4.11); and another drug use disorder (aOR=3.22, 95% CI=1.95-5.32). Living in a non-metropolitan county (aOR=0.29, 95% CI=0.12-0.68) and fair/poor health (aOR=0.38, 95% CI=0.17-0.86) were associated with decreased odds of receiving specialty substance use treatment. CONCLUSIONS: These findings suggest a need for the following efforts: strategies to increase individuals' recognition of their need for OUD treatment, expansion of insurance coverage for substance use treatment, expansion of earlier intervention services, adoption of a chronic care approach to substance use treatment, and an expansion of treatment capacity for rural communities.

    • Feasibility of audit methods to study access to substance use treatment
      Abar, Beau W.; Abar, Caitlin C.; Boudreaux, Edwin D. (2013-11-01)
      Audit studies represent an emerging method for examining disparities in access to care, like substance use treatment, whereby fake patients (i.e., actors) attempt to procure a service with one or more characteristics isolated across condition. This allows for manipulation of variables, like insurance status, that are normally fixed or impossible to standardize with precision when studying actual patients. This pilot study explored whether these methods were feasible for the examination of community-based substance use treatment access. Masked telephone calls (n=48) were made to providers (k=8) in a single city seeking an appointment. A male and female "patient" made calls in three insurance status conditions: no insurance, state-funded insurance, and private insurance. All other subject characteristics were held constant. Results showed an audit design to be a feasible method for examining disparities in access and demonstrated substantial barriers to voluntary treatment. Implications and future directions are discussed.