Individual and system influences on waiting time for substance abuse treatment

Abstract

Waiting time is a contemporary reality of many drug abuse treatment programs, resulting in substantial problems for substance users and society. Individual and system factors that influence waiting time are diverse and may vary at different points in the treatment continuum. This study assessed waiting time preceding clinical assessment at a centralized intake unit and during the period after the assessment but before treatment entry. The present study included 577 substance abusers who were enrolled in a large clinical trial of two brief treatment interventions in a midsize metropolitan area in Ohio. Bivariate analyses identified individual and system factors that influenced preassessment and postassessment waiting time, as well as total wait to treatment services. Multivariate analyses demonstrated that longer wait time for an assessment is influenced by being court referred, less belief in having a substance abuse problem, and less desire for change. A shorter wait to actually enter treatment is predicted by having a case manager, being more ready for treatment, and having less severe employment and alcohol problems. The different influences present during the two waiting periods suggest that assessment and treatment programs need to implement system changes and entry enhancement interventions that are specific to the needs of substance abusers at each waiting period.

Inability to Access Addiction Treatment Among Street-Involved Youth in a Canadian Setting

“…Personal barriers associated with homelessness, such as having no transportation, no phone and no consistent residence for reliable contact can hinder successful follow-up and entry into treatment (Farabee et al, 1998). These barriers may be especially problematic for individuals who are waitlisted for addiction services, where follow-up is essential before entry to treatment can be achieved (Carr et al, 2008). Our findings indicate the need for low threshold treatment and that addressing the housing needs of street-involved youth may help facilitate successful engagement with addiction treatment.…”

Access to substance use treatment among young adults who use prescription opioids non-medically

“…Finally, participants were asked to report their main barriers to accessing addiction treatment. The list of possible response options was generated based on a review of past literature that has examined barriers to substance use treatment among young adults, and included primarily health care system barriers, such as waiting lists, issues with health insurance, and programs that were not youth-friendly or otherwise turned individuals down [36, 40]. Participants could also state barriers that were not listed.…”

“…Furthermore, waiting lists represent a critical barrier to accessing treatment [39, 40]. There is often a wide divergence between expected wait time among NMPO users and the actual wait times that exist.…”

“…A survey of 85 daily or almost daily opioid users conducted in New Zealand showed that participants eligible for opioid substitution therapy estimated waiting times on average to be 6.5 days, whereas the actual mean waiting time was 4.4 months [38]. Total waiting times for substance use treatment in the United States can also reach over two months [40]. In young adult NMPO-using populations, waiting times, particularly for methadone clinics, remain understudied [29].…”

The Role of Jails in Engaging PLWHA in Care: From Jail to Community

“…The Antiretrovirus Treatment Access Study (ARTAS) [23], sponsored by the Centers for Disease Control and Prevention, provided a five session intervention delivered over a maximum of 90 days to newly diagnosed HIV positive persons in four metropolitan areas—Los Angeles, Atlanta, Baltimore and Miami—compared to a comparison group that received usual care in the form of a paper referral. The intervention, ARTAS Linkage Case Management (ALCM), emphasized client strengths and client-driven goal-setting, adapted from a similar brief intervention that was successful in improving substance abusers’ linkage with treatment [24, 25]. During the first 6 month period, 78 % of ARTAS case managed participants, compared to 60 % of non-case managed participants, were linked to care, an adjusted 37 % difference.…”