Referrals and Treatment Completion for Prescription Opioid Admissions: Five Years of National Data

Marie, Barbara St.; Sahker, Ethan; Arndt, Stephan

doi:10.1016/j.jsat.2015.07.010

Cited by 25 publications

(16 citation statements)

References 27 publications

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“…First, we compared individuals with and without psychiatric comorbidity in our sample by examining which characteristics had a greater than 5 percentage point risk difference, which is consistent with thresholds that other authors have used to assess clinically meaningful risk differences in the large TEDS datasets (Marie et al, 2015; Sahker et al, 2015). Statistical significant differences were assessed using chi-square tests.…”

Section: Methodsmentioning

confidence: 66%

The association of psychiatric comorbidity with treatment completion among clients admitted to substance use treatment programs in a U.S. national sample

Krawczyk

Feder

Saloner

et al. 2017

Drug and Alcohol Dependence

101

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Background Psychiatric disorders are highly comorbid with substance use disorders and play an important role in their course and recovery. However, the impact of comorbidity on treatment outcomes has not been examined in a U.S. national sample. This study explores the impact of psychiatric comorbidity on treatment completion among individuals admitted to publicly funded substance use treatment facilities across the United States. Methods Using data on first-time treatment episodes in the U.S. from the Treatment Episode Dataset-Discharges (TEDS-D) for the years 2009–2011, logistic regression was used to assess the association between psychiatric comorbidity and treatment non-completion, and Cox proportional hazards regression was used to assess the association between comorbidity and rate of attrition. Analyses were performed for all substances together and then stratified by primary substance of abuse (alcohol, cannabis, stimulants, or opioids). Results Of 856,385 client treatment episodes included in our analysis, 28% had a psychiatric comorbidity and 38% did not complete treatment. After adjusting for socio-demographic and treatment characteristics, clients with psychiatric comorbidity had higher odds of not completing treatment relative to those without comorbidity [OR = 1.28 (1.27–1.29)], and had an earlier time to attrition [HR = 1.14 (1.13–1.15)]. Psychiatric comorbidity was most strongly associated with treatment non-completion and rate of attrition in those admitted primarily for alcohol [OR = 1.37 (1.34–1.39); HR = 1.19 (1.17–1.21), respectively]. Conclusions Individuals with psychiatric comorbidities receiving treatment for substance use disorders face unique challenges that impact their ability to complete treatment. The findings call for further efforts to integrate treatment for psychiatric comorbidities in substance use treatment settings.

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Section: Methodsmentioning

confidence: 66%

The association of psychiatric comorbidity with treatment completion among clients admitted to substance use treatment programs in a U.S. national sample

Krawczyk

Feder

Saloner

et al. 2017

Drug and Alcohol Dependence

101

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show abstract

“…Consistent with previous studies that have used this dataset (Marie et al, 2015), we limited analyses to observations in which a client had no prior treatment episodes to assure each record represents one unique client, as the possibility exists that the same client may be admitted to treatment more than once in a given year. We also excluded states that did not report information about whether OAT was used (Georgia, West Virginia, and Wyoming), or did not record OAT use in any treatment episodes (Idaho, Kansas, Montana, North Dakota, Oklahoma and Virginia).…”

Section: Methodsmentioning

confidence: 99%

Racial and ethnic differences in opioid agonist treatment for opioid use disorder in a U.S. national sample

Krawczyk

Feder

Fingerhood

et al. 2017

Drug and Alcohol Dependence

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Background Opioid Agonist Treatment (OAT) is the standard of care for the treatment of opioid use disorders. However, most people in treatment do not receive OAT. This study evaluated whether there are racial and/or ethnic differences in OAT receipt among adults entering specialty treatment for opioid use disorders in publicly-funded treatment programs across the U.S. Methods Using data from the national Treatment Episode Data Base, odds of OAT receipt were compared among black, Hispanic and white clients. Mediation analyses were used to explore whether any racial/ethnic differences in OAT receipt were explained by variation in clinical need or by other treatment, sociodemographic, or geographic characteristics. Interaction terms were used to assess whether this association was modified by primary opioid type. Results Only 28.7% of clients received OAT. Odds of OAT receipt were significantly higher odds among blacks (OR: 2.27(2.14–2.41)) and Hispanics (OR: 1.98(1.88–2.09)), compared to whites. Differences in clinical need accounted for a substantial portion of this difference (76.79% and 49.74%, respectively). Differences persisted after accounting for other potential explanatory variables (adjusted OR: 1.37 (1.24–1.52); 1.21(1.11–1.32)), but were only evident for primary heroin users (adjusted OR: 1.50 (1.34- 1.69); 1.29 (1.17–1.42)) and not other opioid users. Conclusions OAT receipt in treatment programs is low overall and particularly lacking among white heroin users. Differences in OAT receipt cannot be fully explained by differences in clinical need. More research is needed to understand and address barriers that underpin these differences so more patients with opioid use disorder can access evidenced-based treatment.

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“…In this study, we aim to show that individuals with opioid use disorder (OUD) who are court mandated to treatment are more likely to successfully complete the treatment process as compared to those not mandated even when considering the alternative of incarceration or selfreferral. We posit court-mandated treatment may reduce fatalities due to the increased likelihood of treatment completion which clinically relates to successful long-term outcomes (Marie, Sahker, & Arndt, 2015). Results from data collected over a three-year period (2015, 2016, and 2017) from Treatment Episode Data Set-Discharges (TEDS-D) suggest that the mode of referral, court mandated, shows a high number of successful treatment completions for individuals with OUD.…”

Section: Introductionmentioning

confidence: 98%

Court-Mandated Treatment Outcomes for Prescribed Opioid Use Disorder: A Gender Based Study

Lucabeche

Quinn

2021

Journal of Drug Issues

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This study provides empirical information suggesting court-mandated treatment may be a more effective treatment pathway for opioid use disorder (OUD). To examine the effects of mandated treatment for prescription opioid users, we consider the differences in discharge completion rates for court-mandated and non-mandated treatment for both males and females. We use the Treatment Episode Data Set-Discharges (TEDS-D) from 2015 to 2017 with 13,239, 14,765, and 15,433 cases, respectively, to study successful completion rates for males and females with OUD. Logistic regression analysis confirms a greater completion rate for mandated treatment episodes. Of all mandated females, 59% completed treatment in each of the 3 years as compared to the 59%, 65%, and 64% of successful completion for mandated males, respectively, from 2015 to 2017. Our results suggest court-mandated treatment pathways are more effective on treatment completion for individuals with OUD, yet treatment completion disparity between sexes increases even when females are mandated.

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Referrals and Treatment Completion for Prescription Opioid Admissions: Five Years of National Data

Cited by 25 publications

References 27 publications

The association of psychiatric comorbidity with treatment completion among clients admitted to substance use treatment programs in a U.S. national sample

The association of psychiatric comorbidity with treatment completion among clients admitted to substance use treatment programs in a U.S. national sample

Racial and ethnic differences in opioid agonist treatment for opioid use disorder in a U.S. national sample

Court-Mandated Treatment Outcomes for Prescribed Opioid Use Disorder: A Gender Based Study

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