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APHA Scientific Session and Event Listing

Elspeth M. Slayter, PhD, MSW, School of Social Work, Salem State College, 352 Lafayette Street, Academic Building, Salem, MA 01970, 617-686-6594, eslayter@brandeis.edu

Since de-institutionalization, people with mental retardation (MR) have experienced increasing levels of participation in community life, including access to alcohol and other drugs. Several decades into this social experiment, little is known about the prevalence of substance abuse (SA) across the lifespan. Using a cross-sectional design, research questions about SA treatment processes (access, initiation, dropout, engagement) were examined by analyzing administrative claims for Medicaid beneficiaries aged 12-21,21-64 and 65+, with and without MR. Using performance measures initially developed by the Washington Circle and further adapted by the National Committee on Quality Assurance for inclusion in HEDIS, 599,658 people with SA claims were identified. Among those with MR, 24.5% initiated treatment and 52.6% engaged in treatment, both of which were statistically lower rates than for the population without MR. Youth were most likely to access SA treatment, followed by adults and elders, in that order. Predictors of access, initiation dropout and engagement derived from multivariate logistic regression analysis are presented for each age group. Medicaid, a major source of health coverage for people with MR across the lifespan, also pays for up to 20% of SA specialty treatment nationwide. Increased levels of initiation and engagement are predictive of treatment retention, which is in turn linked to better recovery outcomes, indicating an areas for improvement with service provision to both adults and elders with MR. Implications relate to how existing systems provide AOD-related care to this population and areas in which improvements in access to and quality of AOD treatment are needed.

Learning Objectives:

• To assess the prevalence of substance abuse among Medicaid beneficiaries with mental retardation across the lifespan
• To apply a set of substance abuse performance measures to people with mental retardation through their application to administrative claims data
• To identify predictors of substance abuse treatment access, dropout, initiation and engagement among Medicaid beneficiaries with mental retardation across the lifespan

Presenting author's disclosure statement:

Any relevant financial relationships? No