Correlates of specialty substance use treatment among adults with opioid use disorders
Graduate School of Biomedical Sciences, Clinical and Population Health Research Program; Department of Quantitative Health Sciences; Department of Family Medicine and Community Health
Epidemiology | Health Services Research | Substance Abuse and Addiction
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.
Heroin, Opioid use disorders, Prescription opioids, Specialty substance use treatment, Substance use treatment
DOI of Published Version
Addict Behav. 2018 Mar 11. pii: S0306-4603(18)30132-1. doi: 10.1016/j.addbeh.2018.03.012. Link to article on publisher's site
Romo E, Ulbricht CM, Clark RE, Lapane KL. (2018). Correlates of specialty substance use treatment among adults with opioid use disorders. Population and Quantitative Health Sciences Publications. https://doi.org/10.1016/j.addbeh.2018.03.012. Retrieved from https://escholarship.umassmed.edu/qhs_pp/1181