School of Social Work, University of Connecticut, Hartford, CT, United States.
School of Social Work, Virginia Commonwealth University, United States.
Drug Alcohol Depend. 2024 Nov 1;264:112456. doi: 10.1016/j.drugalcdep.2024.112456. Epub 2024 Sep 26.
The purpose of this study is to investigate the use of buprenorphine within non-hospital residential programs. We hypothesize that programs offering long-term treatment will be less likely to accept or prescribe buprenorphine, but those that accept public insurance will demonstrate relative increased likelihood of buprenorphine availability.
This study analyzed data from the 2021 National Substance Use and Mental Health Services Survey. The analytic sample (n=3654) included a subset of facilities that reported providing only substance use treatment, including three non-mutually exclusive service types: detox, short-term, and long-term. A logistic regression examined the association between buprenorphine availability and residential service type, holding constant characteristics associated with the outcome of interest. We then tested an interaction between public insurance and long-term service type on the outcome of interest.
While long-term service type was associated with reduced odds of buprenorphine availability (OR=.288, p <.05), programs that both offered long-term residential programs and accepted public health insurance had 3.5 higher odds of accepting or prescribing buprenorphine (OR=4.586, p<.01) compared to long-term programs without public insurance.
Patients who require treatment of longer duration may face barriers to buprenorphine availability; however, public insurance acceptance may increase odds of availability of buprenorphine among long-term programs.
本研究旨在调查丁丙诺啡在非住院住宅项目中的使用情况。我们假设，提供长期治疗的项目不太可能接受或开处丁丙诺啡，但那些接受公共保险的项目将表现出相对更高的丁丙诺啡可及性的可能性。
本研究分析了 2021 年全国物质使用和心理健康服务调查的数据。分析样本（n=3654）包括报告仅提供物质使用治疗的设施的一个子集，包括三种非互斥的服务类型：戒毒、短期和长期。逻辑回归检验了丁丙诺啡可用性与住宅服务类型之间的关联，同时控制与感兴趣结果相关的特征。然后，我们测试了公共保险和长期服务类型对感兴趣结果的交互作用。
虽然长期服务类型与丁丙诺啡可及性的几率降低有关（OR=.288，p<.05），但同时提供长期住宅项目和接受公共医疗保险的项目接受或开处丁丙诺啡的几率比没有公共保险的长期项目高 3.5 倍（OR=4.586，p<.01）。
需要治疗时间较长的患者可能面临丁丙诺啡可及性的障碍；然而，公共保险的接受可能会增加长期项目中丁丙诺啡可及性的几率。
