Costs, Scarcity Remain Problematic for Families Seeking Adolescent Residential Addiction Treatment
Challenges related to limited availability and high costs continue to plague US families seeking residential addiction treatment for adolescents under the age of 18, according to new research from Oregon Health & Science University (OHSU) released by the National Institutes of Health on Monday.
Published in Health Affairs, the study was backed by the National Institute on Drug Abuse and the National Center for Advancing Translational Sciences.
Using the FindTreatment.gov database that is maintained by the Substance Abuse and Mental Health Services Administration, OHSU researchers identified 354 programs across the US that indicated they offer residential treatment for individuals under 18. Between October and December 2022, the researchers contacted each of the identified facilities to inquire about the availability of treatment and services offered for a 16-year-old with a recent non-fatal fentanyl overdose. Of the facilities contacted, 45% confirmed that they provided residential treatment for patients under the age of 18.
Of the 160 programs found to provide such treatment services, the researchers found the following:
- 66 facilities (41%) were for-profit and 94 (59%) were not-for-profit;
- For-profit operators were more likely than their not-for-profit counterparts to have space immediately available (77% vs. 39%), however their services were roughly 3 times as expensive ($1211 per day at for-profit facilities vs. $395 for not-for-profit facilities); and
- 65 programs (40%) provided estimates on the number of days before a bed was expected to become available, with an average wait time of 19 days at for-profit centers vs. 31 days at not-for-profit facilities.
Stark differences were also observed with regards to facilities accepting Medicaid. Overall, 57% of treatment programs contacted said they accept Medicaid, but OHSU researchers noted that just 1 in 5 for-profit operators said they accept Medicaid, while 4 in 5 not-for-profit operators said they do.
Moreover, the researchers did not find any programs that accept Medicaid in 23 states. Facilities that accept Medicaid were more likely to also have waitlists than those that do not (57% vs. 19%).
“When your kid is in a crisis and needs treatment, it can be terrifying to know where to turn. Many parents or family members who look for residential care find the experience profoundly disheartening,” study senior Author Ryan Cook, PhD, research and training scientist for addiction medicine at OHSU, said in a news release. “Systems-level changes are needed to ensure effective, affordable treatment options for adolescents.”
Lastly, OHSU reported that just 7 states have facilities that accept Medicaid, had an open bed, and offered buprenorphine, which is the single medication approved to treat opioid use disorder in adolescents.
“These new results give us an even fuller picture [than our previous work], highlighting that not only is the care in residential treatment facilities often incomplete, but it can also be costly and hard to access,” said lead author Caroline King, MD, PhD, who conducted the study as a medical student at OHSU and now serves as an emergency medicine resident in the Yale School of Medicine.
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