Dataset Information

Health insurance coverage and the receipt of specialty treatment for substance use disorders among U.S. adults.

ABSTRACT: The study examined the association between private health insurance and the receipt of specialty substance use disorder treatment.Weighted logistic regressions were estimated to examine the association between health insurance and the receipt of any specialty substance use disorder treatment in national samples of nonelderly adults with alcohol abuse or dependence (N=22,778), alcohol dependence (N=10,104), drug abuse or dependence (N=9,427), and drug dependence (N=6,736). Receipt of any specialty substance abuse treatment was compared among the uninsured and privately insured persons who reported known coverage, no coverage, or unknown coverage for alcohol and drug abuse treatment. Regressions adjusted for sociodemographic characteristics, treatment need, criminal justice involvement, and year of survey.Compared with being uninsured, private insurance was associated with greater use of any specialty substance use disorder treatment only among those with alcohol dependence with known coverage for alcohol treatment (p<.05).Private insurance was associated with increased use of specialty treatment among persons with severe alcohol use disorders who knew they had coverage for alcohol abuse treatment.

SUBMITTER: Cummings JR

PROVIDER: S-EPMC4189808 | biostudies-literature | 2014 Aug

REPOSITORIES: biostudies-literature

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Health insurance coverage and the receipt of specialty treatment for substance use disorders among U.S. adults.

Cummings Janet R JR Wen Hefei H Ritvo Alexis A Druss Benjamin G BG

Psychiatric services (Washington, D.C.) 20140801 8

<h4>Objective</h4>The study examined the association between private health insurance and the receipt of specialty substance use disorder treatment.<h4>Methods</h4>Weighted logistic regressions were estimated to examine the association between health insurance and the receipt of any specialty substance use disorder treatment in national samples of nonelderly adults with alcohol abuse or dependence (N=22,778), alcohol dependence (N=10,104), drug abuse or dependence (N=9,427), and drug dependence ...[more]

PMID: 25082606

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Project description:AimsTo estimate recent trends in cigarette use and health insurance coverage for United States adults with and without mental health and substance use disorders (MH/SUD).DesignEvent study analysis of smoking and insurance coverage trends among US adults with and without MH/SUD using 2008-19 public use data from the National Survey on Drug Use and Health, an annual, cross-sectional survey.SettingUSA.ParticipantsA nationally representative sample of non-institutionalized respondents aged 18-64 years (n = 448 762).MeasurementsOutcome variables were three measures of recent cigarette use and one measure of past-year health insurance coverage. We compared outcomes between people with and without MH/SUD (MH disorder: past-year mental illness, predicted from Kessler-6 and the World Health Organization-Disability Assessment Schedule impairment scale; SUD: met survey-based DSM-IV criteria for past-year alcohol, cannabis, cocaine or heroin use disorder) and over time.FindingsComparing pooled data from 2008 to 2009 and from 2018 to 2019, current smoking rates of adults with MH/SUD decreased from 37.9 to 27.9% while current smoking rates of adults without MH/SUD decreased from 21.4 to 16.3%, a significant difference in decrease of 4.9 percentage points (pts) [95% confidence interval (CI) = 3.3-6.6 pts]. Daily smoking followed similar patterns (difference in decrease of 3.9 pts (95% CI = 2.3-5.4 pts). Recent smoking abstinence rates for adults with MH/SUD increased from 7.4 to 10.9%, while recent smoking abstinence rates for adults without MH/SUD increased from 9.6 to 12.0%, a difference in increase of 1.0 pts (95% CI = -3.0 to 0.9 pts). In 2018-19, 11% of net reductions in current smoking, 12% of net reductions in daily smoking and 12% of net increases in recent smoking abstinence coincided with greater gains in insurance coverage for adults with MH/SUD compared to those without MH/SUD.ConclusionsImprovements in smoking and abstinence outcomes for US adults with mental health and substance use disorders appear to be associated with increases in health insurance coverage.

Project description:ObjectiveThe authors qualitatively examined how lesbian, gay, bisexual, transgender, and queer (LGBTQ) young adults with probable substance use disorders conceptualized their substance use vis-à-vis their LGBTQ identities.MethodsIndividual, in-depth, semistructured interviews were conducted with 59 LGBTQ young adults (ages 21-34) who were participants in a larger longitudinal cohort study and who met criteria for a probable substance use disorder. Data were analyzed via iterative, thematic analytic processes.ResultsParticipants' narratives highlighted processes related to minority stress that shape substance use, including proximal LGBTQ stressors (e.g., self-stigma and expectations of rejection) and distal LGBTQ stressors (e.g., interpersonal and structural discrimination) and associated coping. Participants also described sociocultural influences, including the ubiquitous availability of substances within LGBTQ social settings, as salient contributors to their substance use and development of substance use disorders. Participants who considered themselves transgender or other gender minorities, all of whom identified as sexual minorities, described unique stressors and coping at the intersection of their minority identities (e.g., coping with two identity development and disclosure periods), which shaped their substance use over time.ConclusionsMultilevel minority stressors and associated coping via substance use in adolescence and young adulthood, coupled with LGBTQ-specific sociocultural influences, contribute to the development of substance use disorders among some LGBTQ young adults. Treatment providers should address clients' substance use vis-à-vis their LGBTQ identities and experiences with related stressors and sociocultural contexts and adopt culturally humble and LGBTQ-affirming treatment approaches. Efforts to support LGBTQ youths and young adults should focus on identifying ways of socializing outside of substance-saturated environments.

Dataset Information

Health insurance coverage and the receipt of specialty treatment for substance use disorders among U.S. adults.

Publications

Health insurance coverage and the receipt of specialty treatment for substance use disorders among U.S. adults.

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