title: Service delivery and pharmacotherapy for alcohol use disorder in the era of health reform: Data from a national sample of treatment organizations.
abstract: BACKGROUND
  Although there is a growing literature examining organizational characteristics and medication adoption, little is known about service delivery differences between specialty treatment organizations that have and have not adopted pharmacotherapy for alcohol use disorder (AUD). This study compares adopters and nonadopters across a range of treatment services, including levels of care, availability of tailored services for specific populations, treatment philosophy and counseling orientations, and adoption of comprehensive wraparound services.
  
  
  METHODS
  In-person interviews were conducted with program leaders from a national sample of 372 organizations that deliver AUD treatment services in the United States.
  
  
  RESULTS
  About 23.6% of organizations had adopted at least 1 AUD medication. Organizations offering pharmacotherapy were similar to nonadopters across many measures of levels of care, tailored services, treatment philosophy, and social services. The primary area of difference between the 2 groups was for services related to health problems other than AUD. Pharmacotherapy adopters were more likely to offer primary medical care, medications for smoking cessation, and services to address co-occurring psychiatric conditions.
  
  
  CONCLUSIONS
  Service delivery differences were modest between adopters and nonadopters of AUD pharmacotherapy, with the exception of health-related services. However, the greater adoption of health-related services by organizations offering AUD pharmacotherapy represents greater medicalization of treatment, which may mean these programs are more strongly positioned to respond to opportunities for integration under health reform.
authors.affiliation: a Department of Behavioral Science and Center on Drug and Alcohol Research , University of Kentucky , Lexington , Kentucky , USA.
authors.forename: Hannah K
authors.initials: HK
authors.lastname: Knudsen
authors.affiliation: b Owens Institute for Behavioral Research and Department of Sociology , University of Georgia , Athens , Georgia , USA.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Roman
mesh_terms: D019973:Alcohol-Related Disorders / Q000188:drug therapy*; D003695:Delivery of Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D018166:Health Care Reform; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D007407:Interviews as Topic; D014481:United States
keywords: Alcohol pharmacotherapy; organization of treatment services; specialty treatment for alcohol use disorder