Treatment utilization among persons with opioid use disorder in the United States

Drug Alcohol Depend. 2016 Dec 1;169:117-127. doi: 10.1016/j.drugalcdep.2016.10.015. Epub 2016 Oct 19.

Abstract

Background: The United States is experiencing an opioid overdose epidemic. Treatment use data from diverse racial/ethnic groups with opioid use disorder (OUD) are needed to inform treatment expansion efforts.

Methods: We examined demographic characteristics and behavioral health of persons aged ≥12 years that met criteria for past-year OUD (n=6,125) in the 2005-2013 National Surveys on Drug Use and Health (N=503,101). We determined the prevalence and correlates of past-year use of alcohol/drug use treatment and opioid-specific treatment to inform efforts for improving OUD treatment.

Results: Among persons with OUD, 81.93% had prescription (Rx) OUD only, 9.75% had heroin use disorder (HUD) only, and 8.32% had Rx OUD+HUD. Persons with Rx OUD+HUD tended to be white, adults aged 18-49, males, or uninsured. The majority (80.09%) of persons with OUD had another substance use disorder (SUD), and major depressive episode (MDE) was common (28.74%). Of persons with OUD, 26.19% used any alcohol or drug use treatment, and 19.44% used opioid-specific treatment. Adolescents, the uninsured, blacks, native-Hawaiians/Pacific-Islanders/Asian-Americans, persons with Rx OUD only, and persons without MDE or SUD particularly underutilized opioid-specific treatment. Among alcohol/drug use treatment users, self-help group and outpatient rehabilitation treatment were commonly used services.

Conclusions: Most people with OUD report no use of OUD treatment. Multifaceted interventions, including efforts to access insurance coverage, are required to change attitudes and knowledge towards addiction treatment in order to develop a supportive culture and infrastructure to enable treatment-seeking. Outreach efforts could target adolescents, minority groups, and the uninsured to improve access to treatment.

Keywords: Heroin use disorder; Medication-assisted treatment; Opioid use disorder; Prescription opioid misuse; Substance use treatment.

MeSH terms

  • Adolescent
  • Adult
  • Analgesics, Opioid / adverse effects*
  • Child
  • Continental Population Groups / psychology
  • Drug Overdose / epidemiology
  • Drug Overdose / therapy
  • Ethnic Groups / psychology
  • Female
  • Health Behavior*
  • Humans
  • Male
  • Middle Aged
  • Opioid-Related Disorders / epidemiology*
  • Opioid-Related Disorders / therapy*
  • Patient Acceptance of Health Care* / psychology
  • Self Report / standards
  • Self-Help Groups / statistics & numerical data
  • Socioeconomic Factors
  • United States / epidemiology
  • Young Adult

Substances

  • Analgesics, Opioid