When it comes to individuals struggling with substance use disorder, many people seek out treatment options. A study by Indiana University researchers reveals that a referral to treatment does not always happen when indicated, presenting a missed opportunity to link people with risky substance use to treatment. In addition, there is an uneven distribution of existing treatment programs and workforce across the State, creating challenges to access to treatment for the State’s most vulnerable people.
IU study finds important gaps in treatment services for people with substance use disorder
"Our study revealed important gaps in treatment services for people with substance use disorder," said Robin Newhouse, lead investigator of the study and lead investigator for IU’s Responding to the Addictions Crisis Grand Challenge. "We found that referral to treatment is rarely used for people discharged from medical surgical units; and patients seeking treatment experience delays in intake. The availability of medication-assisted treatment in Indiana counties is inconsistent and highly dependent on the distribution of qualified clinicians who have obtained state waivers. Essentially, we fall short in meeting the needs of Hoosiers seeking treatment."
The study, a collaboration with IU Health and part of IU’s Responding to the Addictions Crisis Grand Challenge, aimed to increase the number of people in recovery for alcohol and drug use; assess the available workforce and treatment capacity; and develop and test a web-based resource for local referral networks
Additionally, the study found differences in treatment center characteristics exist that could affect access to care, and over 40% of treatment centers have a wait list for intake for substance use disorder treatment for new patients, with 65% reporting a wait time greater than two weeks. Less than half (49%) of treatment centers have at least one provider who can prescribe medications.
To address this issue, the team developed and tested a web-based referral-to-treatment tool to facilitate the identification of treatment centers for outpatient referrals. The tool can be customized for a variety of healthcare settings and patient needs, and researchers are working to create an updated version of the tool, incorporating the findings from usability testing.
Another solution to reduce barriers to treatment is that more advanced practice nurses could prescribe buprenorphine increasing access if they complete Medication Assisted Treatment Waiver Training.
"This study shows the barriers to availability of addiction treatment services in Indiana, the need for accurate publicly available data and reinforces the importance of quality metrics to inform credentialing of treatment centers," Newhouse said. "If we truly want to reduce substance use disorder in our state, we have to create a network that helps those in need receive treatment to begin their path to recovery."
Co-investigators and collaborators of the study are Michelle Janney, Ukamaka Oruche, Hannah Maxey, Sharon Crowder, Robert Skipworth Comer, Eric Afuseh, Sierra Vaughn and PhD students Kelli Thoele and Alyson Keen.
Responding to the Addictions Crisis
The Responding to the Addictions Crisis Grand Challenge initiative engages a broad array of IU's world-class faculty, as well as IU's business, nonprofit and government partners. Working together, the groups are contributing to an initiative to implement a comprehensive plan to reduce deaths from addiction, ease the burden of drug addiction on Hoosier communities and improve health and economic outcomes. This initiative is one of the nation's largest and most comprehensive state-based responses to the opioid addiction crisis -- and the largest led by a university.