TY - JOUR
T1 - Adolescent-Serving Addiction Treatment Facilities in the United States and the Availability of Medications for Opioid Use Disorder
AU - Alinsky, Rachel H.
AU - Hadland, Scott E.
AU - Matson, Pamela A.
AU - Cerda, Magdalena
AU - Saloner, Brendan
N1 - Funding Information:
Conflict of interest: Dr. Alinsky was supported by T32HD052459 ( NIH / NICHD ). Dr. Hadland was supported by K23DA045085 ( NIH / NIDA ), L40DA042434 ( NIH / NIDA ), the Thrasher Research Fund Early Career Award, and the Academic Pediatric Association Young Investigator Award. Dr. Matson was supported by K01DA035387 ( NIH / NIDA ). Dr. Cerda was supported by 1R01DA045872-01A1 ( NIH / NIDA ). Dr. Saloner was supported by K01DA042139-01A1 ( NIH / NIDA ).
Funding Information:
Conflict of interest: Dr. Alinsky was supported by T32HD052459 (NIH/NICHD). Dr. Hadland was supported by K23DA045085 (NIH/NIDA), L40DA042434 (NIH/NIDA), the Thrasher Research Fund Early Career Award, and the Academic Pediatric Association Young Investigator Award. Dr. Matson was supported by K01DA035387 (NIH/NIDA). Dr. Cerda was supported by 1R01DA045872-01A1 (NIH/NIDA). Dr. Saloner was supported by K01DA042139-01A1 (NIH/NIDA).
Publisher Copyright:
© 2020 Society for Adolescent Health and Medicine
PY - 2020/10
Y1 - 2020/10
N2 - Purpose: Adolescents with opioid use disorder are less likely than adults to receive medications for opioid use disorder (MOUD), yet we know little about facilities that provide addiction treatment for adolescents. We sought to describe adolescent-serving addiction treatment facilities in the U.S. and examine associations between facility characteristics and offering MOUD, leading to informed recommendations to improve treatment access. Methods: This cross-sectional study used the 2017 National Survey of Substance Abuse Treatment Services. Facilities were classified by whether they offered a specialized adolescent program. Covariates included facility ownership, hospital affiliation, insurance/payments, government grants, accreditation/licensure, location, levels of care, and provision of MOUD. Descriptive statistics and logistic regression compared adolescent-serving versus adult-focused facilities and identified characteristics associated with offering maintenance MOUD. Results: Among 13,585 addiction treatment facilities in the U.S., 3,537 (26.0%) offered adolescent programs. Adolescent-serving facilities were half as likely to offer maintenance MOUD as adult-focused facilities (odds ratio, .53; 95% confidence interval, .49–.58), which was offered at 23.1% (816) of adolescent-serving versus 35.9% (3,612) of adult-focused facilities. Among adolescent-serving facilities, characteristics associated with increased unadjusted odds of offering maintenance MOUD were nonprofit status, hospital affiliation, accepting insurance (particularly, private insurance), accreditation, Northeastern location, or offering inpatient services. Conclusions: The one-quarter of U.S. addiction treatment facilities that serve adolescents are half as likely to provide MOUD as adult-focused facilities, which may explain why adolescents are less likely than adults to receive MOUD. Strategies to increase adolescent access to MOUD may consider insurance reforms/incentives, facility accreditation, and geographically targeted funding.
AB - Purpose: Adolescents with opioid use disorder are less likely than adults to receive medications for opioid use disorder (MOUD), yet we know little about facilities that provide addiction treatment for adolescents. We sought to describe adolescent-serving addiction treatment facilities in the U.S. and examine associations between facility characteristics and offering MOUD, leading to informed recommendations to improve treatment access. Methods: This cross-sectional study used the 2017 National Survey of Substance Abuse Treatment Services. Facilities were classified by whether they offered a specialized adolescent program. Covariates included facility ownership, hospital affiliation, insurance/payments, government grants, accreditation/licensure, location, levels of care, and provision of MOUD. Descriptive statistics and logistic regression compared adolescent-serving versus adult-focused facilities and identified characteristics associated with offering maintenance MOUD. Results: Among 13,585 addiction treatment facilities in the U.S., 3,537 (26.0%) offered adolescent programs. Adolescent-serving facilities were half as likely to offer maintenance MOUD as adult-focused facilities (odds ratio, .53; 95% confidence interval, .49–.58), which was offered at 23.1% (816) of adolescent-serving versus 35.9% (3,612) of adult-focused facilities. Among adolescent-serving facilities, characteristics associated with increased unadjusted odds of offering maintenance MOUD were nonprofit status, hospital affiliation, accepting insurance (particularly, private insurance), accreditation, Northeastern location, or offering inpatient services. Conclusions: The one-quarter of U.S. addiction treatment facilities that serve adolescents are half as likely to provide MOUD as adult-focused facilities, which may explain why adolescents are less likely than adults to receive MOUD. Strategies to increase adolescent access to MOUD may consider insurance reforms/incentives, facility accreditation, and geographically targeted funding.
KW - Adolescent
KW - Adolescent health services
KW - Medication for addiction treatment
KW - Medication for opioid use disorder
KW - Medication-assisted treatment
KW - Opioid use disorder
KW - Substance abuse treatment centers
KW - Treatment facilities
UR - http://www.scopus.com/inward/record.url?scp=85083593102&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85083593102&partnerID=8YFLogxK
U2 - 10.1016/j.jadohealth.2020.03.005
DO - 10.1016/j.jadohealth.2020.03.005
M3 - Article
C2 - 32336560
AN - SCOPUS:85083593102
SN - 1054-139X
VL - 67
SP - 542
EP - 549
JO - Journal of Adolescent Health
JF - Journal of Adolescent Health
IS - 4
ER -