Differences in treatment for substance use disorders by insurance status: Self-help only versus outpatient medical treatment

Background: The role of insurance on substance use disorders (SUD) treatment utilization generally is poorly understood and still less is known on how insurance status relates to the use of evidence-based treatment (i.e., medicalization approach) compared to other treatments, like single self-help groups, where the research on effectiveness is less supportive. This study examines associations between health insurance and any SUD treatment utilization as well as use of single self- help versus medicalization approach. Methods: A cross-sectional study design was used. Data were from the 2015-2017, public use National Surveys on Drug Use and Health (NSDUH). Adjusted logistic regressions were used to examine the associations controlling for socio-demographics, recent major depressive episode, and survey year. All analyses used survey weights to be representative of the US population and account for the NSDUH’s complex survey design. Results: After adjustment for covariates, those with publicly insured remained more likely to use any SUD treatment in the past year (odd ratio [OR] 1.82; 95% CI: 1.36-2.43), compared to those without insurance. Further, compared with uninsured, those with public insurance reported lower odds of using only self-help treatment (OR 0.42; 95% CI: 0.23-0.74) versus medicalization approach utilization. Conclusions: Publicly insured persons with SUD are more likely to use SUD treatment in the past year than the uninsured. Uninsured people with SUD are more likely to use single self-help as a substitute for medicalization approach.https://scholarscompass.vcu.edu/gradposters/1098/thumbnail.jp