Citation

Abraham AJ, Andrews CM, Grogan CM, Pollack HA, D'Aunno T, Humphreys K, Friedmann PD. Psychiatr. Serv. 2018; 69(4): 448-455.

Affiliation

Dr. Abraham is with the Department of Public Administration and Policy, University of Georgia, Athens. Dr. Andrews is with the College of Social Work, University of South Carolina, Columbia. Dr. Grogan and Dr. Pollack are with the School of Social Service Administration, University of Chicago, Chicago. Dr. D'Aunno is with the Wagner Graduate School of Public Service, New York University, New York. Dr. Humphreys is with the School of Medicine, Stanford University, Palo Alto, California. Dr. Friedmann is with the Department of Medicine, University of Massachusetts-Baystate and Baystate State Health System, Springfield, Massachusetts.

Copyright

(Copyright © 2018, American Psychiatric Association)

DOI

10.1176/appi.ps.201700196

PMID

29241428

Abstract

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.

Language: en

Keywords

Medications; Opioid use disorder; State policy; Substance use disorder treatment