Study Looks At Barriers To Getting Treatment For Substance Use Disorders
Four Themes Affecting Obstacles to Treatment for Substance Use Disorders The ongoing opioid crisis has drawn attention to the widening gap between the high need and limited access to substance use treatment in the United States. A recent Substance Abuse and Mental Health Services Administration report found that of 21.7 million Americans in need of substance use disorder treatment, only 2.35 million received treatment at a specialty facility. Yet there is little information on the organizational-level barriers to treatment for substance use disorders. To address this issue, Dr. Blevins and colleagues performed a series of interviews with 59 stakeholders in the treatment referral process. The study gathered input from those who make referrals for substance use treatment, including emergency medicine physicians, addiction specialists, and other medical providers; as well as those who receive referrals, including substance use treatment facility staff and administrators. Analysis of the interviews identified four broad themes:
- Patient Eligibility. Healthcare providers face difficulties in determining whether patients meet criteria for admission to a particular treatment center, including the application of treatment eligibility criteria. "Eligibility requirements may prevent a patient from entering a treatment center," the researchers write.
- Treatment Capacity. Even if a patient is eligible, providers have trouble finding out whether space is available. "Despite the need for services, treatment centers may not run at capacity, because of frustrations encountered and time wasted on the referral and admission process."
- Knowledge of Treatment Options. Providers may not understand the levels of available care for substance use treatment, and how to select the best treatment for their patient. "After determining appropriate level of care, a provider must then find a program that meets the patient's needs, which becomes more difficult with the differences in terminology and program guidelines."
- Communication. Difficulties in communication between referring providers and treatment facilities can contribute to delays to starting treatment. The need for direct referral – "from the emergency department to a bed" – is particularly high for patients with opioid use disorders.