Looking for the uninsured in Massachusetts? Check opioid dependent persons seeking detoxification.
BACKGROUND
We examined the rate of uninsurance among persons seeking detoxification at a large drug treatment program in Massachusetts in 2013, five years after insurance mandates.


METHODS
We interviewed three hundred and forty opioid dependent persons admitted for inpatient detoxification in Fall River, Massachusetts. Potential predictors of self-reported insurance status included age, gender, ethnicity, employment, homelessness, years of education, current legal status, and self-perceived health status.


RESULTS
Participants mean age was 32 years, 71% were male, and 87% were non-Hispanic Caucasian. Twenty-three percent were uninsured. In the multivariate model, the odds of being uninsured was positively associated with years of education (OR=1.22, 95% CI=1.03; 1.46, p<.05), higher among males than females (OR=2.63, 95% CI=1.33; 5.20, p<.01), and inversely associated with age (OR=0.94, 95% CI=0.90; 0.98, p<.01).


CONCLUSIONS
Opioid dependent persons recruited from a detoxification program in Massachusetts are uninsured at rates far above the state average. With the arrival of the Affordable Care Act, drug treatment programs in Massachusetts and nationally will be important sites to target to expand health coverage.
General Medicine Research Unit, Butler Hospital, Providence, RI 02906, United States; Warren Alpert Medical School of Brown University, Providence, RI 02912, United States. Electronic address: Michael_Stein@brown.edu.
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MD
Stein
Warren Alpert Medical School of Brown University, Providence, RI 02912, United States; Stanley Street Treatment and Resources, Inc., Fall River, MA 02720, United States.
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GL
Bailey
General Medicine Research Unit, Butler Hospital, Providence, RI 02906, United States.
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P
Thurmond
Stanley Street Treatment and Resources, Inc., Fall River, MA 02720, United States.
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N
Paull
D000328:Adult; D000367:Age Factors; D004522:Educational Status; D005006:Ethnicity; D005260:Female; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D058991:Patient Protection and Affordable Care Act; D012737:Sex Factors; D012959:Socioeconomic Factors; D016896:Treatment Outcome
Affordable Care Act; Detoxification; Insurance; Opioid