Use of Drug Treatment Services Among Adults With Opioid Use Disorder: Rates, Patterns, and Correlates
Abstract
Objectives:
Methods:
Results:
Conclusions:
Methods
Data Source and Study Sample
Measures
Drug-related health services use.
Sociodemographic characteristics.
Behavioral comorbidities.
Data Analysis
Results
Rates and Patterns of Drug-Related Health Services Use
Sociodemographic Characteristics and Service Use
Used drug-related health services | ||||
---|---|---|---|---|
Yes | No | Total | Bivariate | |
Characteristic | (N=148) | (N=1,330) | (N=1,478) | OR |
Age | ||||
18–44 (reference) | 70.8 | 75.1 | 74.7 | |
45–64 | 28.3 | 21.2 | 21.9 | 1.41 |
≥65 | 1.0 | 3.7 | 3.4 | .29 |
Gender | ||||
Male (reference) | 56.9 | 61.0 | 60.6 | |
Female | 43.1 | 39.0 | 39.4 | 1.19 |
Race-ethnicity | ||||
Non-Hispanic white (reference) | 67.6 | 61.9 | 62.5 | |
Non-Hispanic black | 17.4 | 18.0 | 18.0 | .88 |
Hispanic | 12.0 | 15.0 | 14.7 | .73 |
Other racial-ethnic group | 3.1 | 5.1 | 4.9 | .55 |
Marital status | ||||
Married (reference) | 12.4 | 21.7 | 20.8 | |
Never married | 44.0 | 48.7 | 48.2 | 1.59 |
Otherb | 43.7 | 29.6 | 31.0 | 2.59** |
Family income | ||||
<$20,000 (reference) | 54.3 | 41.5 | 42.7 | |
$20,000–$39,999 | 22.4 | 25.7 | 25.4 | .66 |
≥$40,000 | 23.3 | 32.8 | 31.9 | .54 |
Employed (reference: no) | 62.9 | 73.9 | 72.8 | .60* |
Education | ||||
Less than high school (reference) | 21.0 | 16.4 | 16.9 | |
High school or equivalent | 38.5 | 30.1 | 30.9 | 1.00 |
Some college | 34.9 | 39.3 | 38.9 | .69 |
Bachelor's degree or higher | 5.6 | 14.2 | 13.4 | .31* |
Insurance coveragec | ||||
Private | 32.2 | 42.9 | 41.9 | .63 |
Medicare | 22.4 | 14.9 | 15.6 | 1.65 |
Medicaid | 32.9 | 18.6 | 20.0 | 2.14** |
Otherd | 28.0 | 34.9 | 34.2 | .73 |
Uninsured | 29.7 | 25.6 | 26.0 | 1.23 |
Disability income support (reference: no) | 24.2 | 13.0 | 14.1 | 2.13*** |
Region | ||||
Northeast (reference) | 25.1 | 17.7 | 18.4 | |
Midwest | 22.3 | 19.7 | 20.0 | .80 |
South | 32.5 | 34.4 | 34.2 | .67 |
West | 20.1 | 28.2 | 27.5 | .50* |
Residence | ||||
Rural (reference) | 22.0 | 16.0 | 16.6 | |
Urban | 78.0 | 84.0 | 84.4 | .68 |
Behavioral Comorbidities and Service Use
Used drug-related health services | ||||
---|---|---|---|---|
Yes | No | Total | Bivariate | |
Variable | (N=148) | (N=1,330) | (N=1,478) | OR |
Past-year opioid use disorder | 41.3 | 21.1 | 23.1 | 2.64*** |
Pain | ||||
Never or a little (reference) | 68.1 | 68.1 | 68.1 | |
Moderately, quite a bit, or extremely | 31.9 | 31.9 | 31.9 | 1.00 |
Health-related quality of life mental component summary (M±SD score) | 40.7±12.4 | 44.0±12.0 | 43.7±12.1 | .98* |
Past-year psychiatric disorder | ||||
Any | 63.3 | 47.6 | 49.1 | 1.90** |
Major depressive disorder | 30.1 | 26.8 | 27.1 | 1.17 |
Dysthymia | 10.0 | 10.3 | 10.2 | .97 |
Bipolar 1 disorder | 21.4 | 7.4 | 8.7 | 3.40*** |
Generalized anxiety disorder | 19.2 | 14.4 | 14.9 | 1.41 |
Posttraumatic stress disorder | 26.5 | 16.9 | 17.8 | 1.77* |
Panic disorder | 16.3 | 9.6 | 10.2 | 1.85* |
Past-year substance use disorder | ||||
Alcohol | 55.2 | 53.8 | 53.9 | 1.06 |
Any illicit drug | 86.1 | 85.8 | 85.8 | 1.02 |
Cannabis | 44.2 | 68.2 | 65.9 | .37*** |
Sedative | 20.8 | 8.5 | 9.7 | 2.83** |
Cocaine | 22.0 | 7.7 | 9.0 | 3.40*** |
Stimulant | 22.5 | 6.8 | 8.3 | 3.98*** |
Heroin | 23.7 | 1.2 | 3.4 | 25.11*** |
Hallucinogen | 4.5 | .9 | 1.3 | 5.08** |
Inhalant-solvent | .7 | 1.1 | 1.1 | .62 |
Club drug | 6.3 | 2.7 | 3.1 | 2.39 |
Tobacco | 77.7 | 60.0 | 61.7 | 2.33** |
Factors Associated With Drug-Related Health Services Use
Factor | AOR | 95% CI |
---|---|---|
Opioid use disorder diagnosis (reference: other illicit drug use disorder diagnosis) | 2.43** | 1.38–4.28 |
Age | 1.01 | .99–1.03 |
Female (reference: male) | 1.01 | .65–1.57 |
Race-ethnicity (reference: non-Hispanic white) | ||
Non-Hispanic black | .81 | .46–1.43 |
Hispanic | .96 | .50–1.84 |
Other racial-ethnic group | .64 | .24–1.74 |
Marital status (reference: married) | ||
Never married | 1.78 | .75–4.19 |
Otherb | 2.12 | 1.05–4.31 |
Family income (reference: <$20,000) | ||
$20,000–$39,999 | .81 | .47–1.40 |
≥$40,000 | .76 | .41–1.42 |
Employed (reference: no) | .85 | .48–1.52 |
Education (reference: less than high school) | ||
High school or equivalent | 1.17 | .62–2.21 |
Some college | .88 | .47–1.65 |
Bachelor's degree or higher | .51 | .14–1.83 |
Insurance coverage (reference: no) | .83 | .51–1.36 |
Disability income support (reference: no) | 1.64 | .95–2.81 |
Region (reference: Northeast) | ||
Midwest | .75 | .39–1.46 |
South | .62 | .34–1.12 |
West | .54* | .32–.91 |
Urban residence (reference: rural) | .74 | .42–1.30 |
Pain felt moderately, quite a bit, or extremely (reference: never or a little bit) | .47* | .27–.84 |
Health-related quality of life mental component summary | .99 | .97–1.01 |
Any psychiatric disorder (reference: no) | 1.46 | .87–2.44 |
Alcohol use disorder (reference: no) | 1.00 | .59–1.70 |
Tobacco use disorder (reference: no) | 1.65 | .94–2.90 |
Factor | OR | 95% CI | AOR | 95% CI |
---|---|---|---|---|
Age | .96** | .94–.99 | 1.00 | .96–1.04 |
Female (reference: male) | .71 | .36–1.39 | .69 | .30–1.57 |
Race-ethnicity (reference: non-Hispanic white) | ||||
Non-Hispanic black | .20*** | .10–.42 | .22** | .08–.63 |
Hispanic | .73 | .29–1.81 | 1.22 | .35–4.23 |
Other racial-ethnic group | .10* | .01–.80 | .19 | .01–2.43 |
Marital status (reference: married) | ||||
Never married | 4.48** | 1.61–12.45 | 5.02* | 1.31–19.24 |
Otherb | 1.76 | .58–5.31 | 1.24 | .37–4.12 |
Family income (reference: <$20,000) | ||||
$20,000–$39,999 | .49 | .21–1.15 | .88 | .32–2.40 |
≥$40,000 | .78 | .31–1.95 | 1.40 | .53–3.71 |
Employed (reference: no) | 1.63 | .71–3.76 | 1.10 | .42–2.89 |
Education (reference: less than high school) | ||||
High school or equivalent | 1.08 | .49–2.40 | .87 | .31–2.44 |
Some college | 1.14 | .49–2.69 | 1.11 | .33–3.80 |
Bachelor's degree or higher | .07* | .01–.62 | .11 | .01–1.70 |
Insurance coverage (reference: no) | .29*** | .14–.57 | .35* | .14–.86 |
Disability income support (reference: no) | .61 | .29–1.30 | 1.29 | .37–4.49 |
Region (reference: Northeast) | ||||
Midwest | .95 | .26–3.44 | 1.76 | .49–6.30 |
South | 1.19 | .37–3.87 | 1.60 | .47–5.50 |
West | .58 | .17–1.97 | .87 | .26–2.91 |
Urban residence (reference: rural) | .86 | .41–1.83 | .65 | .24–1.72 |
Pain felt moderately, quite a bit, or extremely (reference: never or a little bit) | .48* | .24–.96 | 1.04 | .37–2.98 |
Health-related quality of life mental component summary | 1.00 | .96–1.03 | 1.01 | .97–1.05 |
Any psychiatric disorder (reference: no) | 1.97 | .87–4.43 | 1.79 | .72–4.40 |
Alcohol use disorder (reference: no) | 1.26 | .62–2.56 | .55 | .23–1.30 |
Any additional illicit drug use disorder (reference: no) | 4.07*** | 1.99–8.30 | 2.66* | 1.07–6.63 |
Tobacco use disorder (reference: no) | 3.93** | 1.65–9.38 | 1.87 | .62–5.61 |
Discussion and Conclusions
References
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