Ali Mir M, Ghertner Robin
Office of the Assistant Secretary for Planning & Evaluation, US Department of Health & Human Services, 200 Independence Avenue SW, Washington, DC 20202, United States of America.
Office of the Assistant Secretary for Planning & Evaluation, US Department of Health & Human Services, 200 Independence Avenue SW, Washington, DC 20202, United States of America.
J Subst Abuse Treat. 2022 Aug;139:108780. doi: 10.1016/j.jsat.2022.108780. Epub 2022 Apr 11.
Buprenorphine utilization is an effective treatment for opioid use disorder (OUD). Given the recent increase in child maltreatment reports related to parental substance use, research should explore the correlation between buprenorphine treatment and child maltreatment-related outcomes.
The study team drew the data for the study from 2016 to 2018 administrative records on buprenorphine waivered providers and child welfare caseloads in 25 states. Multivariable linear regression models with county and year fixed effects were estimated to examine the correlation between changes in buprenorphine treatment capacity (defined as the total patient limit of all providers with a buprenorphine waiver in a county) and the total number of children reported for maltreatment in a county, and the case determinations of those children.
An increase in buprenorphine treatment capacity did not have a significant impact on the total number of children reported to child welfare agencies for maltreatment but was associated with a reduction in the number of substantiated cases. Specifically, an increase in capacity of 1 patient per 100 residents was associated with a -0.9% decrease in the probability that a report will be substantiated following an investigation.
Increased buprenorphine treatment capacity was correlated with lower rates of substantiated cases of maltreatment, suggesting that OUD treatment is effective in reducing immediate risk to children. Increased treatment for OUD has a positive externality in the child welfare context. Increases in buprenorphine treatment are likely to provide parents not only with the needed treatment for their OUD but also act as a support mechanism to fulfill their parental roles.
丁丙诺啡的使用是治疗阿片类物质使用障碍（OUD）的有效方法。鉴于近期与父母物质使用相关的儿童虐待报告有所增加，研究应探讨丁丙诺啡治疗与儿童虐待相关结果之间的相关性。
研究团队从2016年至2018年25个州关于获得丁丙诺啡豁免的提供者和儿童福利案件量的行政记录中提取研究数据。估计具有县和年份固定效应的多变量线性回归模型，以检验丁丙诺啡治疗能力的变化（定义为一个县中所有获得丁丙诺啡豁免的提供者的总患者限额）与一个县报告的受虐待儿童总数以及这些儿童的案件判定之间的相关性。
丁丙诺啡治疗能力的增加对向儿童福利机构报告受虐待的儿童总数没有显著影响，但与经证实的案件数量减少有关。具体而言，每100名居民中治疗能力增加1名患者，与调查后报告得到证实的概率降低0.9%相关。
丁丙诺啡治疗能力的增加与经证实的虐待案件发生率降低相关，这表明阿片类物质使用障碍治疗在降低儿童面临的直接风险方面是有效的。在儿童福利背景下，增加对阿片类物质使用障碍的治疗具有积极的外部效应。丁丙诺啡治疗的增加可能不仅为父母提供所需的阿片类物质使用障碍治疗，还作为一种支持机制，帮助他们履行父母的职责。
