Journal
JOURNAL OF SUBSTANCE ABUSE TREATMENT
Volume 41, Issue 4, Pages 431-439Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.jsat.2011.06.005
Keywords
Methadone; Treatment access; Admission delays; Waiting lists; Disparities; Program capacity
Categories
Funding
- NIDA NIH HHS [R01 DA013636-06, 1 R01 DA 026003, 2 R01 DA 13636, R01 DA026003-01, R01 DA026003, R01 DA013636] Funding Source: Medline
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Waiting lists for methadone treatment have existed in many U.S. communities, but little is known nationally about what patient and service system factors are related to admission delays that stem from program capacity shortfalls. Using a combination of national data sources, this study examined patterns in capacity-related admission delays to outpatient methadone treatment in 40 U.S. metropolitan areas (N = 28,920). Patient characteristics associated with admission delays included racial/ethnic minority status, lower education, criminal justice referral, prior treatment experience, secondary cocaine or alcohol use, and co-occurring psychiatric problems. Injection drug users experienced fewer delays, as did self-pay patients and referrals from health care and addiction treatment providers. Higher community-level utilization of methadone treatment was associated with delay, whereas delays were less common in communities with higher utilization of alternative modalities. These findings highlight potential disparities in timely admission to outpatient methadone treatment. Implications for improving treatment access and service system monitoring are discussed. (C) 2011 Elsevier Inc. All rights reserved.
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