PMID- 34102461
OWN - NLM
STAT- MEDLINE
DCOM- 20220321
LR  - 20221207
IS  - 1873-6483 (Electronic)
IS  - 0740-5472 (Linking)
VI  - 132
DP  - 2022 Jan
TI  - National trends in substance use treatment admissions for opioid use disorder 
      among adults experiencing homelessness.
PG  - 108504
LID - S0740-5472(21)00230-0 [pii]
LID - 10.1016/j.jsat.2021.108504 [doi]
AB  - OBJECTIVE: People experiencing homelessness (PEH) have high rates of substance 
      use, and homelessness may be an important driver of health disparities in the 
      opioid overdose epidemic. However, few studies focus on homelessness among the 
      opioid use disorder (OUD) treatment population. We examine national-level trends 
      in substance use treatment admissions among PEH with OUD. METHODS: This study 
      used data from first-time treatment admissions in the United States from the 
      Treatment Episode Data Set: Admissions (TEDS-A) to examine characteristics and 
      trends of adults experiencing homelessness who entered state-licensed substance 
      use treatment programs for OUD from 2013 to 2017. We used chi-squared analyses to 
      examine changes in characteristics of this population over time and logistic 
      regression to assess characteristics associated with receipt of medications for 
      opioid use disorder (MOUD) among PEH. RESULTS: Among all adults with OUD entering 
      specialty treatment from 2013 to 2017, 12.5% reported experiencing homelessness. 
      Compared to individuals not experiencing homelessness, PEH were more likely to be 
      male, inject opioids, use cocaine or methamphetamine, and enter into residential 
      detoxification treatment. PEH were less likely to enter outpatient treatment or 
      receive MOUD. From 2013 to 2017, significant increases occurred in the proportion 
      of PEH who had co-occurring psychiatric problems and used methamphetamines. Over 
      time, treatment type shifted significantly from residential detoxification to 
      outpatient treatment. Receipt of MOUD increased among PEH over time (13.7% to 
      25.2%), but lagged behind increases among individuals not experiencing 
      homelessness. Among PEH, being older was associated with receiving MOUD, while 
      concurrent methamphetamine use [adjusted odds ratio (AOR) 0.63; 95% CI 0.58, 
      0.69] and living in the southern United States (AOR 0.27; 95% CI 0.25, 0.30) were 
      associated with not receiving MOUD. DISCUSSION: The proportion of PEH with OUD 
      who receive medications as part of treatment increased over time, but three 
      quarters of PEH entering treatment still do not receive this highest standard in 
      evidence-based care. The sharp increase observed in concomitant methamphetamine 
      use in this population is concerning and has implications for treatment.
CI  - Copyright (c) 2021 Elsevier Inc. All rights reserved.
FAU - Han, Benjamin H
AU  - Han BH
AD  - Division of Geriatrics, Gerontology, and Palliative Care, University of 
      California, San Diego School of Medicine, 9500 Gilman Dr, San Diego, CA 92161, 
      United States of America. Electronic address: b2han@health.ucsd.edu.
FAU - Doran, Kelly M
AU  - Doran KM
AD  - Department of Emergency Medicine, NYU School of Medicine, 550 First Avenue, New 
      York, NY 10016, United States of America; Department of Population Health, NYU 
      School of Medicine, 550 First Avenue, New York, NY 10016, United States of 
      America.
FAU - Krawczyk, Noa
AU  - Krawczyk N
AD  - Department of Population Health, NYU School of Medicine, 550 First Avenue, New 
      York, NY 10016, United States of America.
LA  - eng
GR  - K23 DA039179/DA/NIDA NIH HHS/United States
GR  - K23 DA043651/DA/NIDA NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20210529
PL  - United States
TA  - J Subst Abuse Treat
JT  - Journal of substance abuse treatment
JID - 8500909
RN  - 0 (Analgesics, Opioid)
SB  - IM
MH  - Adult
MH  - Ambulatory Care
MH  - Analgesics, Opioid/therapeutic use
MH  - Female
MH  - *Ill-Housed Persons
MH  - Humans
MH  - Male
MH  - *Opioid-Related Disorders/drug therapy/therapy
MH  - Residential Treatment
MH  - United States/epidemiology
OTO - NOTNLM
OT  - Homelessness
OT  - Opioids
OT  - Substance use treatment
EDAT- 2021/06/09 06:00
MHDA- 2022/03/22 06:00
CRDT- 2021/06/08 20:47
PHST- 2020/10/19 00:00 [received]
PHST- 2021/04/05 00:00 [revised]
PHST- 2021/05/21 00:00 [accepted]
PHST- 2021/06/09 06:00 [pubmed]
PHST- 2022/03/22 06:00 [medline]
PHST- 2021/06/08 20:47 [entrez]
AID - S0740-5472(21)00230-0 [pii]
AID - 10.1016/j.jsat.2021.108504 [doi]
PST - ppublish
SO  - J Subst Abuse Treat. 2022 Jan;132:108504. doi: 10.1016/j.jsat.2021.108504. Epub 
      2021 May 29.