State Substance Abuse Treatment Gaps

Abstract

This study estimated the adequacy of state substance abuse treatment rates relative to treatment needs. The investigators created composite drug and alcohol treatment need indexes from explicit-mention mortality and substance-defined arrest rates. The indexes were reliable and had evidence of construct validity, but alternative population-at-risk and survey-based need measures did not fair as well. States varied substantially in per capita alcohol and drug treatment needs, although the two did not correlate with each other. While the need indexes correlated significantly with state treatment rates, the adequacy of state treatment rates varied greatly. States with the largest treatment gaps were in the South, Southwest, and northern plains and mountain regions. The failure of the Block Grant formula to reflect the needs of rural states with high-risk minority populations may contribute to disparities in access to services.

Racial and Ethnic Diversity Among a Heroin and Cocaine Using Population

“…This brief (30 minute) interaction, designed to assist patients to recognize and change behaviors that pose significant health risks, was first adapted in 1994, with assistance from Dr. Stephen Rollnick, for Emergency Department use. 5 Principles and techniques for this strategy are based on the FRAMES model and readiness-to-change constructs, as described in TIPS #35. 15 Individuals in the intervention group who requested placement in detoxification or drug treatment, such as methadone, received an active referral to facilitate access and free transportation to available programs.…”

“…Although differences in pattern of use have been identified for specific demographic characteristics, current levels of knowledge about the functional meaning of these differences and their affect on access to treatment is insufficient for effective program and policy development. [1][2][3][4][5][6] This report describes racial and ethnic differences in standard measures of addiction and contact with the substance abuse treatment system among 1175 heroin and cocaine using patients encountered in the Urgent Care Clinic at an inner city hospital. This data set was developed by surveying 23,000 clinic patients (1998)(1999)(2000)(2001) as part of a randomized, controlled trial of a peer-led, motivational intervention to reduce drug use and associated health consequences, reported separately.…”

Barriers and Facilitators to Substance Use Treatment in the Rural South: A Qualitative Study

“…38 In addition to the unique challenges of service delivery to individuals with substance use disorders in rural communities, there are also regional variations in the prevalence of disorders (including the type of substance used) and need for services. 5,[41][42][43][44][45][46][47][48][49] The southern United States has the greatest substance use services disparity. 41,42 Accordingly, research must target southern rural populations to better understand the unique needs of this population and maximize the delivery of services.…”

Sources of Biased Inference in Alcohol and Drug Services Research: An Instrumental Variable Approach

“…Biased inference is among the most crucial methodological concerns for applied research (Babbie, 1983), particularly if fl awed approaches are propagated across numerous studies, thereby leading to the erroneous conclusion that fi ndings are robust. Services research is the policymaker's window into the underlying sources of unmet need and helps to guide real-world efforts to close the alcohol and drug "treatment gap" (McAuliffe et al, 2003;Offi ce of Applied Studies, 2002;Woodward et al, 1997).…”