Alcohol Abuse Treatment Programs Research Articles

Patterns in Geographic Distribution of Substance Use Disorder Treatment Facilities in the US and Accepted Forms of Payment From 2010 to 2021

The drug overdose crisis is a continuing public health problem and is expected to grow substantially in older adults. Understanding the geographic accessibility to a substance use disorder (SUD) treatment facility that accepts Medicare can inform efforts to address this crisis in older adults. To assess whether geographic accessibility of services was limited for older adults despite the increasing need for SUD and opioid use disorder treatments in this population. This longitudinal cross-sectional study obtained data on all licensed SUD treatment facilities for all US counties and Census tracts listed in the National Directory of Drug and Alcohol Abuse Treatment Programs from 2010 to 2021. Measures included the national proportion of treatment facilities accepting Medicare, Medicaid, private insurance, or cash as a form of payment; the proportion of counties with a treatment facility accepting each form of payment; and the proportion of the national population with Medicare, Medicaid, private insurance, or cash payment residing within a 15-, 30-, or 60-minute driving time from an SUD treatment facility accepting their form of payment in 2021. A total of 11 709 SUD treatment facilities operated across the US per year between 2010 and 2021 (140 507 facility-year observations). Cash was the most commonly accepted form of payment (increasing slightly from 91.0% in 2010 to 91.6% by 2021), followed by private insurance (increasing from 63.5% to 75.3%), Medicaid (increasing from 54.0% to 71.8%), and Medicare (increasing from 32.1% to 41.9%). The proportion of counties with a treatment facility that accepted Medicare as a form of payment also increased over the same study period from 41.2% to 53.8%, whereas the proportion of counties with a facility that accepted Medicaid as a form of payment increased from 53.5% to 67.1%. The proportion of Medicare beneficiaries with a treatment facility that accepted Medicare as a form of payment within a 15-minute driving time increased from 53.3% to 57.0%. The proportion of individuals with a treatment facility within a 15-minute driving time that accepted their respective form of payment was 73.2% for those with Medicaid, 69.8% for those with private insurance, and 71.4% for those with cash payment in 2021. Results of this study suggest that Medicare beneficiaries have less geographic accessibility to SUD treatment facilities given that acceptance of Medicare is low compared with other forms of payment. Policy makers need to consider increasing reimbursement rates and using additional incentives to encourage the acceptance of Medicare.

Population-based estimates of geographic accessibility of medication for opioid use disorder by substance use disorder treatment facilities from 2014 to 2020

BackgroundUnderstanding whether individuals have geographic accessibility to a substance use disorder treatment facility and a treatment facility that offers medication treatment for opioid use disorder (MOUD) can inform efforts to address the ongoing opioid crisis. MethodsWe used data from the National Directory of Drug and Alcohol Abuse Treatment Programs. First, we calculate the national share of treatment facilities that offer one type of MOUD or all forms of MOUD using a novel dataset of providers. Second, we quantify the share of counties with a treatment facility offering at least one type of MOUD. Finally, we calculate the share of the national population residing within a 10-mile radius of a treatment facility. ResultsThe share of counties with a treatment facility offering a MOUD as a form of treatment rose from 30% to 45% from 2014 to 2020 while the share of counties with facilities offering all three forms of MOUD increased from 4% to 9%. Over 83% of the population lives within 10 miles of a facility offering MOUD treatment, and 42% of the population have a treatment facility that offers all three forms of MOUD within a 10-mile radius. Much of the difference between the county- and population-based measures is explained by more population dense areas having higher rates of facilities providing MOUD. ConclusionsWhile the share of facilities within a county offering a MOUD is relatively small, the share of the population within 10 miles of such a facility is higher.

Completion rates of clients discharged from drug and alcohol treatment programs in Washington State.

The primary goal of this study was to analyze completion rates of clients in drug and alcohol abuse treatment programs in Washington State and to assess the factors associated with treatment completion. A secondary goal was to examine the utility of a state information system as a source of evaluative data. Analyses were conducted of 5827 client records contained in the Washington State Substance Abuse Monitoring System, representing a census of public clients discharged during the last quarter of 1990 from all state-funded alcohol and drug treatment programs in four treatment modalities. Logistic regression was performed to determine the independent predictors of treatment completion. Completion rates were highest for intensive inpatient alcohol treatment (75%) and lowest for intensive outpatient drug programs (18%). Factors associated with treatment completion included screening at a referral assessment center, education, age, ethnicity, and existence of a secondary drug problem. The fit between clients and treatment programs may be an important factor explaining why some clients complete treatment and others drop out. State client information systems are an important source of data for analyzing treatment completion and other outcomes.

Additional psychiatric illness by diagnostic interview schedule in male alcoholics

Seventy-four male veterans entering an alcohol abuse treatment program were screened for additional psychiatric diagnoses using the Diagnostic Interview Schedule (DIS). Fifty-four of these also completed a questionnaire on personal and family drinking history. Over half (54.1%) had another diagnosis. The most common syndromes other than substance abuse were antisocial personality disorder, phobic disorder, and depression. In each of these cases, the presence of the additional disorder accelerated the course of the alcohol problem significantly. The difference in course between syndromes was dwarfed by the time of presentation by the difference between “pure” alcoholism and alcoholism with another diagnosis. The primary versus secondary distinction appeared to account for only a part of this effect.

A driving record analysis of suspension and revocation effects on the drinking-driving offender

Past studies have demonstrated that license suspension or revocation reduces subsequent DUI convictions and traffic accidents of multiple DUI offenders to a greater degree than jail sentences and fines alone, or participation in an alternative alcohol abuse treatment program. This study describes the duration of the impact of recidivism-Ievel-specific licensing actions on DUI offenders at three recidivism levels. Results indicate that the first DUI offender (who receives no licensing action) represents a DUI recidivism and accident risk comparable to the suspended second DUI offender during the year following their respective DUI convictions. Furthermore, additional record entries indicate that at least 32% of suspended second offenders drive during the period of the licensing action; at least 61% of revoked third offenders acquire a record entry during the licensing action. In addition to the results, major program recommendations concerning the first offender and the use of restricted licenses are outlined.

The traffic safety impact of alcohol abuse treatment as an alternative to mandated licensing controls

Driving records were compared for drivers who were convicted of multiple driving-under-the-influence offenses (DUI). Two groups of drivers were identified in four demonstration counties which offered a 12-month alcohol abuse treatment program as an alternative to mandatory license suspension or revocation. The first group participated in the program and thereby retained their driving privilege while the second did not participate thus receiving the mandated licensing action. Since legislation prevented drivers from being randomly assigned to treatment or licensing action, a third group of suspended or revoked drivers were identified in four systematically selected comparison counties. Analysis of covariance and survival rate analytical procedures were employed to analyze the driving records 12 months subsequent to their entrance into the alcohol abuse treatment program or receipt of the licensing action. In general it was found that the multiple offender alcohol abuse treatment program, during the period of treatment, demonstrated no advantages over mandatory licensing controls.

Privacy rights and record confidentiality in drug and alcohol abuse treatment programs.

(1976). Privacy Rights and Record Confidentiality in Drug and Alcohol Abuse Treatment Programs. Journal of Psychedelic Drugs: Vol. 8, No. 4, pp. 325-327.

The referral problem in the field of alcohol abuse.

This paper reports on referral sources and the disposition of 409 problem drinkers who were contacted over a two-year period for participation in a 17-week alcohol abuse treatment program. A longitudinal follow-up design was used with 103 persons to evaluate various learning-based techniques in moderating their drinking habits. Referrals were analyzed by source (75% were legal referrals), percentage completing the program (70%, 72%, and 69% for self, legal, and mental health referrals), and "success" at one year. Legal referrals reported a significantly smaller pretreatment alcohol intake than self and mental health referrals. However, the decrease in alcohol intake for legal and nonlegal referrals were almost identical. The stigma of alcoholism as a disease and the coercion associated with referral by legal agencies were considered to be factors in acceptance of treatment and in treatment outcome.