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Abstract #147586

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Steven Kritz, MD¹, Lawrence S. Brown, MD, MPH, FASAM¹, R. Jeffrey Goldsmith, MD², Edmund J. Bini, MD, MPH³, Jim Robinson, MEd⁴, Don Alderson, MS⁵, and John Rotrosen, MD⁶. (1) Division of Medical Services, Research and Information Technology, Addiction Research and Treatment Corporation, 22 Chapel Street, Brooklyn, NY 11201, 718 260-2955, skritz@artcny.org, (2) Department of Psychiatry, Cincinnati VA Medical Center, University of Cincinnati, 3200 Vine Street, Cincinnati, OH 45220, (3) Division of Gastroenterology, VA NY Harbor Healthcare System and NYU School of Medicine, 423 East 23rd Street, New York, NY 10010, (4) Nathan Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY 10962, (5) NYS Psychiatric Institute, New York Presbyterian Hospital, 1051 Riverside Drive, New York, NY 10032, (6) Department of Psychiatry, NYU School of Medicine and VA New York Harbor Healthcare System, 423 East 23rd Street, New York, NY 10010

Background: This survey study emphasized the perspective of state substance abuse and health departments in relationship to the treatment programs within their jurisdiction for three infection groups: HIV/AIDS, hepatitis C virus and sexually transmitted infections. Methods: State substance abuse and health departments were compared regarding priorities, written guidelines and availability of funding for 8 selected services for the 3 infections (24 comparisons). In addition, clarity of guidelines and availability of funding for the 8 services, as reported by administrators and clinicians at treatment programs offering these services were compared with guidelines and funding as reported by the states. Results: Surveys were received from 48 states and DC (96%) representing 46 substance abuse and 42 health departments. The response rate from treatment program administrators and clinicians was 269 (84%) and 1723 (78%), respectively. There was general agreement between states and the 2 departments within the states regarding priorities and availability of funding (19 of 24 comparisons). While most states had guidelines for infection-related services, clarity of guidelines as expressed by treatment program administrators and clinicians was less than optimal. For funding, treatment program administrators indicated less availability than the states for all 24 comparisons, 19 of which were statistically significant. Conclusions: While states appear generally to have their priorities, guidelines and funding in place, the mosaic that constitutes the healthcare delivery system may be too complex for the treatment programs to access most efficiently.

Learning Objectives:

• To examine associations between state substance abuse and health department priorities, guidelines and funding, and the availability of services at substance abuse treatment programs for HIV/AIDS, hepatitis C and sexually transmitted diseases

Keywords: Substance Abuse Treatment, Infectious Diseases

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

• Slides (pdf) or Handout
• Handout (free access)