title: The adoption of medications in substance abuse treatment: associations with organizational characteristics and technology clusters.
abstract: Despite growing interest in closing the "research to practice gap", there are few data on the availability of medications in American substance abuse treatment settings. Recent research suggests that organizational characteristics may be associated with medication availability. It is unclear if the availability of medications can be conceptualized in terms of "technology clusters", where the availability of a medication is positively associated with the likelihood that other medications are also offered. Using data from 403 privately funded and 363 publicly funded specialty substance abuse treatment centers in the US, this research models the availability of agonist medications, naltrexone, disulfiram, and SSRIs. Bivariate logistic regression models indicated considerable variation in adoption across publicly funded non-profit, government-owned, privately funded non-profit, and for-profit treatment centers. Some of these differences were attenuated by organizational characteristics, such as accreditation, the presence of staff physicians, and the availability of detoxification services. There was some evidence that naltrexone, disulfiram, and SSRIs represent a group of less intensely regulated medications that is distinct from more intensely regulated medications. These types of medications were associated with somewhat different correlates. Future research should continue to investigate the similarities and differences in the predictors of medication availability across national contexts.
authors.affiliation: Center for Research on Behavioral Health and Human Services Delivery, The University of Georgia, 101 Barrow Hall, Athens, GA 30602-2401, USA. hknudsen@uga.edu
authors.forename: Hannah K
authors.initials: HK
authors.lastname: Knudsen
authors.forename: Lori J
authors.initials: LJ
authors.lastname: Ducharme
authors.forename: Paul M
authors.initials: PM
authors.lastname: Roman
mesh_terms: D003155:Community Mental Health Centers / Q000706:statistics & numerical data; D004221:Disulfiram / Q000627:therapeutic use; D006801:Humans; D015999:Multivariate Analysis; D009271:Naltrexone / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use; D009316:National Institutes of Health (U.S.); D012044:Regression Analysis; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000188:drug therapy* / Q000534:rehabilitation; D016896:Treatment Outcome; D014481:United States
chemical_list: D009292:Narcotic Antagonists; D009271:Naltrexone; D004221:Disulfiram