TY - JOUR
T1 - State-Targeted funding and technical assistance to increase access to medication treatment for opioid use disorder
AU - Abraham, Amanda J.
AU - Andrews, Christina M.
AU - Grogan, Colleen M.
AU - Pollack, Harold A.
AU - D’Aunno, Thomas
AU - Humphreys, Keith
AU - Friedmann, Peter D.
N1 - Funding Information:
The research reported in this study was supported by National Institute on Drug Abuse Grant R01-DA-034634. These views represent the opinions of the authors and not necessarily those of the National Institutes of Health.
Funding Information:
Substance use disorder treatment in the United States is delivered by the more than 14,000 programs that compose the specialty substance use disorder treatment system. Approximately two-thirds of specialty treatment programs rely on Substance Abuse Prevention and Treatment block grant funding provided by the Substance Abuse and Mental Health Services Administration (SAMHSA) and administered through each state’s single-state agency (SSA) (39–42). SSAs are state governmental organizations responsible for overseeing and licensing substance use disorder treatment programs. Each state’s SSA organizes and administers the distribution of the block grant, including determining treatment provider qualifications, payment methods and rates, and reporting requirements (39,43,44).
Publisher Copyright:
© 2018 American Psychiatric Association. All Rights Reserved.
PY - 2018/4/1
Y1 - 2018/4/1
N2 - Objective: As the United States grapples with an opioid epidemic, expanding access to effective treatment for opioid use disorder is a major public health priority. Identifying effective policy tools that can be used to expand access to care is critically important. This article examines the relationship between state-targeted funding and technical assistance and adoption of three medications for treating opioid use disorder: oral naltrexone, injectable naltrexone, and buprenorphine. Methods: This study draws from the 2013–2014 wave of the National Drug Abuse Treatment System Survey, a nationally representative, longitudinal study of substance use disorder treatment programs. The sample includes data from 695 treatment programs (85.5% response rate) and representatives from single-state agencies in 49 States and Washington, D.C. (98% response rate). Logistic regression was used to examine the relationships of single-state agency targeted funding and technical assistance to availability of opioid use disorder medications among treatment programs. Results: State-targeted funding was associated with increased program-level adoption of oral naltrexone (adjusted odds ratio [AOR]=3.14, 95% confidence interval [CI]=1.49–6.60, p=.004) and buprenorphine (AOR=2.47, 95% CI=1.31–4.67, p=.006). Buprenorphine adoption was also correlated with state technical assistance to support medication provision (AOR=1.18, 95% CI=1.00–1.39, p=.049). Conclusions: State-targeted funding for medications May be a viable policy lever for increasing access to opioid use disorder medications. Given the historically low rates of opioid use disorder medication adoption in treatment programs, single-state agency targeted funding is a potentially important tool to reduce mortality and morbidity associated with opioid disorders and misuse.
AB - Objective: As the United States grapples with an opioid epidemic, expanding access to effective treatment for opioid use disorder is a major public health priority. Identifying effective policy tools that can be used to expand access to care is critically important. This article examines the relationship between state-targeted funding and technical assistance and adoption of three medications for treating opioid use disorder: oral naltrexone, injectable naltrexone, and buprenorphine. Methods: This study draws from the 2013–2014 wave of the National Drug Abuse Treatment System Survey, a nationally representative, longitudinal study of substance use disorder treatment programs. The sample includes data from 695 treatment programs (85.5% response rate) and representatives from single-state agencies in 49 States and Washington, D.C. (98% response rate). Logistic regression was used to examine the relationships of single-state agency targeted funding and technical assistance to availability of opioid use disorder medications among treatment programs. Results: State-targeted funding was associated with increased program-level adoption of oral naltrexone (adjusted odds ratio [AOR]=3.14, 95% confidence interval [CI]=1.49–6.60, p=.004) and buprenorphine (AOR=2.47, 95% CI=1.31–4.67, p=.006). Buprenorphine adoption was also correlated with state technical assistance to support medication provision (AOR=1.18, 95% CI=1.00–1.39, p=.049). Conclusions: State-targeted funding for medications May be a viable policy lever for increasing access to opioid use disorder medications. Given the historically low rates of opioid use disorder medication adoption in treatment programs, single-state agency targeted funding is a potentially important tool to reduce mortality and morbidity associated with opioid disorders and misuse.
UR - http://www.scopus.com/inward/record.url?scp=85044845622&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85044845622&partnerID=8YFLogxK
U2 - 10.1176/appi.ps.201700196
DO - 10.1176/appi.ps.201700196
M3 - Article
C2 - 29241428
AN - SCOPUS:85044845622
VL - 69
SP - 448
EP - 455
JO - Hospital and Community Psychiatry
JF - Hospital and Community Psychiatry
SN - 1075-2730
IS - 4
ER -