Substance Abuse and Access to Treatment in the Appalachian Region

As required by Section 505 of the Public Health Service Act (42 USC 290aa-4), annual data on the number and characteristics of persons admitted to public and private nonprofit substance abuse treatment programs have been collected. Although reports have been produced on the estimates of the admissions at the national level, detailed examinations in particular rural areas and/or specific sub-regions have been lacking. This study aims to examine the potential disparities between the Appalachian region and other areas in terms of substance abuse prevalence and access to treatment services by using SAMHSA's database recording more than half a million in 2000-2004 to public and private drug treatment facilities licensed by the 13 states in the Appalachian region. Intra-regional comparisons among communities at different economic development levels (as defined by the Appalachian Regional Commission) and sub-regional comparisons (Northern, Central, and Southern Appalachia) are conducted. Source of the referral to treatment; various drug use (methamphetamine, non-medical prescription drug, etc.); DSM diagnosed drug use dependence; injection drug use; service settings; waiting time to be admitted to treatment; and sources of treatment payment are examined. To advance beyond the descriptive epidemiology of disparities, further examinations to untangle the complex interactions of individual, treatment services, and county-level community factors are performed to help elucidate the causes of disparity.