Race/Ethnicity and Geographic Access to Medicaid Substance Use Disorder Treatment Facilities in the United States

Cummings, Janet R.; Wen, Hefei; Ko, Michelle J; Druss, Benjamin G.

doi:10.1001/jamapsychiatry.2013.3575

Cited by 163 publications

(114 citation statements)

References 26 publications

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“…Stigma (Farley-Toombs, 2012), a tendency to externalize responsibility for their behavior (Olfson et al, 1998; Wang et al, 2005), low perceived need for treatment (Mojtabai et al, 2002), and limited availability of treatment facilities (Cummings et al, 2014) may contribute to low treatment-seeking by individuals with SUD. A focus on the short-term euphoric effects of drug use and negligence of longer-term negative consequences may also diminish motivation to seek treatment.…”

Section: Discussionmentioning

confidence: 99%

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Probability and predictors of treatment-seeking for substance use disorders in the U.S

Blanco

Iza

Rodríguez-Fernández

et al. 2015

Drug and Alcohol Dependence

118

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Background Little is known about to what extent treatment-seeking behavior varies across individuals with alcohol abuse, alcohol dependence, drug abuse, and drug dependence. Methods The sample included respondents from the Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) who reported a lifetime diagnosis alcohol abuse, alcohol dependence, drug abuse, or drug dependence. Unadjusted and adjusted hazard ratios are presented for time to first treatment contact by sociodemographic characteristics and comorbid psychiatric disorders. Individuals were censored from the analyses if their condition remitted prior to seeking treatment. Results In the first year after disorder onset, rates of treatment-seeking were 13% for drug dependence, 5% for alcohol dependence, 2% for drug abuse, and 1% for alcohol abuse. The lifetime probability of seeking treatment among individuals who did not remit was also highest for drug dependence (90%), followed by drug abuse (60%), alcohol dependence (54%), and alcohol abuse (16%). Having had previous treatment contact for a substance use disorder (SUD) increased the probability of seeking treatment for another SUD. By contrast, an early age of SUD onset, belonging to an older cohort, and a higher level of education decreased the lifetime probability of treatment contact for SUD. The role of comorbid mental disorders was more complex, with some disorders increasing and other decreasing the probability of seeking treatment. Conclusions Given high rates of SUD and their substantial health and economic burden, these patterns suggest the need for innovative approaches to increase treatment access for individuals with SUD.

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Section: Discussionmentioning

confidence: 99%

“…There is a need to systematically examine how to most appropriately define objective need for the treatment. Third, information on some potentially important determinants of help-seeking, such as local availability of SUD treatment services (Cummings et al, 2014), was not available. Fourth, we based our analyses in DSM-IV categories.…”

Section: Discussionmentioning

confidence: 99%

Probability and predictors of treatment-seeking for substance use disorders in the U.S

Blanco

Iza

Rodríguez-Fernández

et al. 2015

Drug and Alcohol Dependence

118

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show abstract

“…These findings are consistent with previous research on disparities in access to mental health services. 29,33,44 When comparing rural and urban communities, neighborhood-level insurance status is only significantly associated with access to behavioral health professionals in urban settings. Therefore, primary care physicians located in urban communities with high percentages of minority and uninsured populations experience the greatest unmet need for geographically-proximate behavioral health professionals.…”

Section: Discussionmentioning

confidence: 99%

Not Near Enough: Racial and Ethnic Disparities in Access to Nearby Behavioral Health Care and Primary Care

Wielen¹,

Gilchrist²,

Nowels³

et al. 2015

hpu

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“…However, provider capacity in areas with higher demand could be strained, which would limit access. 41 …”

mentioning

confidence: 99%

An ACA Provision Increased Treatment For Young Adults With Possible Mental Illnesses Relative To Comparison Group

Saloner

Cook

2014

Health Affairs

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The Affordable Care Act (ACA) required that insurers allow people ages 19-25 to remain as dependents on their parents' health insurance beginning in 2010. Using data from the 2008-12 National Survey of Drug Use and Health, we examined the impact of the ACA dependent coverage provision on people ages 18-25 with possible mental health or substance use disorders. We found that after implementation of the ACA provision, among people ages 18-25 with possible mental health disorders, mental health treatment increased by 5.3 percentage points relative to a comparison group of similar people ages 26-35. Smaller, but consistent, effects were found among all young adults, not only those with possible illnesses. For people using mental health treatment, uninsured visits declined by 12.4 percentage points, and visits paid by private insurance increased by 12.9 percentage points. We observed no changes in mental health treatment setting. Outcomes related to substance abuse treatment did not change during the study period. The dependent coverage provision can contribute to a broader strategy for improving behavioral health treatment for young adults.

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Race/Ethnicity and Geographic Access to Medicaid Substance Use Disorder Treatment Facilities in the United States

Cited by 163 publications

References 26 publications

Probability and predictors of treatment-seeking for substance use disorders in the U.S

Probability and predictors of treatment-seeking for substance use disorders in the U.S

Not Near Enough: Racial and Ethnic Disparities in Access to Nearby Behavioral Health Care and Primary Care

An ACA Provision Increased Treatment For Young Adults With Possible Mental Illnesses Relative To Comparison Group

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