A peek under the covers: What special studies tell us about trends in substance abuse treatment spending

Over 22 million people in the U.S. have a substance abuse (SA) or dependence disorder, which can include abuse of illicit drugs, prescription medications, alcohol, or a combination of these. Given the immense burden of disability associated with SA, understanding characteristics of the investment in treatment services has important implications for resource planning, health care reform, and practice.

Spending patterns revealed through the SAMHSA Spending Estimates project have prompted special studies to more closely examine issues surrounding SA services, and several studies have focused specifically on how SA treatment is provided in community hospitals. Analyses of data from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases show that the use of specialty units within general hospitals to treat SA conditions varies widely across states. Often, persons with SA conditions are first diagnosed during hospital visits for intoxication or other medical complications related to their SA. Upon stabilization, community hospitals have the potential to link patients to rehabilitation and recovery services to help them move toward improved health outcomes. However, analysis of HCUP Nationwide Inpatient Sample data found that most people treated for SA in community hospitals receive only detoxification without further rehabilitation. Of those with private insurance, analyses of MarketScan claims data show that most people do not receive follow-up care within 30 days after inpatient detoxification. This session will provide a perspective on how SA treatment spending shapes providers and affects clients.