Receiving addiction treatment in the US: Do patient demographics, drug of choice, or substance use disorder severity matter?

Abstract

Background: Understanding addiction treatment needs and utilization is important to health systems and government to develop policies that effectively address substance use disorders (SUDs) at a population level. This study aims to describe differences in treatment receipt by diagnostic category, drug of choice, and demographic characteristics in an effort to identify potential disparities in receipt of care.

Methods: Using data from the 2017 National Survey on Drug Use and Health, we calculated the proportion of various groups that received treatment and conducted binary logistic regression to determine the association between addiction treatment receipt and SUD severity, drug of choice, and patient demographics.

Results: Using DSM-5, 16.7 million Americans (age 12 and older) are estimated to have a mild SUD, 5.2 million a moderate SUD, and 4.6 million a severe SUD. The two greatest predictors of treatment receipt are addiction severity and probation status. People with severe opioid use disorder have the greatest probability of treatment receipt with a 55.6% predicted probability of receiving treatment, while people with a mild alcohol use disorder are the least likely to receive treatment with a predicted probability of 1.8% receiving treatment. People with mild alcohol use disorder make up the largest proportion of people identified as needing but not receiving treatment when assuming all people with a diagnosis need treatment.

Conclusions: Improving use of existing specialty addiction treatment capacity to address the needs of the 8.5 million Americans with moderate or severe SUD and better use of the general health care system to treat mild or stable SUD may be a better focus for health system planners and government than adding new capacity for specialty treatment.