title: Role of state policies in the adoption of naltrexone for substance abuse treatment.
abstract: OBJECTIVE
  To examine state policies associated with adoption of a pharmaceutical agent-naltrexone-by substance abuse treatment facilities to treat alcohol-dependent clients.
  
  
  METHODS
  Facility-level data from the 2003 National Survey of Substance Abuse Treatment Services, and state-level data on policy and environmental factors from publicly available sources.
  
  
  METHODS
  We use facility- and state-level data in a cross-sectional, multilevel model to analyze state-level policies that are associated with treatment facilities' naltrexone adoption.
  
  
  METHODS
  The analysis uses survey data.
  
  
  RESULTS
  State Medicaid policies supporting the use of generic drugs, reducing drug costs, and permitting managed care organizations to establish policies encouraging use of generics were associated with higher odds of naltrexone adoption (by up to 96 percent). State policies limiting access to pharmaceutical technologies through Medicaid preferred drug lists, restricting access to pharmacy networks, and imposing general limitations on use of Medicaid benefits for rehabilitation for substance abuse treatment were associated with reduced odds of naltrexone adoption.
  
  
  CONCLUSIONS
  Policy levers that are available to state governments are associated with the adoption of pharmaceutical technologies such as naltrexone that could help meet widespread need for access to clinically proven and cost-effective treatments for substance abuse.
authors.affiliation: Georgetown Public Policy Institute, Georgetown University, 3520 Prospect Street NW, 4th Floor, Washington, DC 20007, USA.
authors.forename: Carolyn J
authors.initials: CJ
authors.lastname: Heinrich
authors.forename: Carolyn J
authors.initials: CJ
authors.lastname: Hill
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000188:drug therapy*; D003363:Cost Control; D003430:Cross-Sectional Studies; D004059:Diffusion of Innovation; D016527:Drug Costs; D016568:Drugs, Generic; D006801:Humans; D009271:Naltrexone / Q000191:economics / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000191:economics / Q000627:therapeutic use*; D011050:Policy Making; D013219:State Government; D014481:United States
chemical_list: D016568:Drugs, Generic; D009292:Narcotic Antagonists; D009271:Naltrexone