Drug treatment admissions fell sharply for people of color during pandemic

Photo: Jeff Lagasse/Healthcare Finance News

Admissions to drug treatment programs declined by nearly one-quarter during the first year of the COVID-19 pandemic, with the cuts steepest among people of color, according to a new RAND Corporation study.

It touts itself as the first national analysis to establish declines in the number of treatment admissions during the COVID-19 pandemic, and provides one possible reason for the recent surge in drug overdose deaths.

Researchers found that the decline in drug treatment admissions was steepest in New Mexico (61%), Hawaii (55%), Washington D.C. (45%), Nevada (42%) and West Virginia (33%). Just three states (Rhode Island, Louisiana and Mississippi) saw increases in treatment admissions, all small.

The study is published in the latest edition of the journal JAMA Network Open.

WHAT'S THE IMPACT?

What makes the numbers especially noteworthy is that, while the number of Americans receiving treatment is declining, substance use disorder and overdose death rates climbed during the same period.

To examine one possible reason for the surge in drug overdose deaths, RAND researchers quantified changes in national substance use disorder treatment admissions both before (2017-2019) and during the COVID-19 pandemic. They analyzed information from the federal Treatment Episode Data Set, which has admission-level data for substance use disorder treatment from state agencies as reported by facilities that receive state funds or block grants.

Admissions were calculated per 10,000 people in participating states, with researchers examining demographic differences as well as overall changes in admission rates. The findings do not include Idaho, Oregon, Maryland, Vermont and Washington, because there was insufficient data.

Prior to 2020, the number of treatment admissions was relatively stable. But in 2020, the number of treatment admissions declined from 66 per 10,000 in 2019 to 50 per 10,000 in 2020, a relative reduction of 24%. The decline was larger for men (88 per 10,000 to 67 per 10,000) as compared to women (45 per 10,000 to 35 per 10,000).

All racial and ethnic groups experienced a decline in treatment admissions, with the largest decline observed for Native Americans (145 per 10,000 to 83 per 10,000), followed by Black people (86 per 10,000 to 63 per 10,000), Hispanic people (55 per 10,000 to 41 per 10,000), white people (54 per 10,000 to 43 per 10,000) and Asian individuals (10 per 10,000 to 7 per 10,000).

Researchers say future work is needed to examine possible reasons for the differences, including the impact that policies such as elective procedure bans and shelter-in-place policies played in the drug treatment admission changes.

THE LARGER TREND

Treatment for substance use disorder has also been an area of focus for the Department of Health and Human Services, which in June invested close to $15 million in 29 organizations in rural communities to address psychostimulant misuse and related overdose deaths.

Drug overdose deaths involving psychostimulants, including methamphetamine, rose from 547 in 1999 to 23,837 in 2020, an increase exacerbated by the COVID-19 pandemic, according to the National Institute on Drug Abuse.

With the investment, HHS has provided a total of more than $400 million for the Rural Communities Opioid Response Program (RCORP) initiative, the HRSA said. This is a multiyear initiative aimed at reducing the morbidity and mortality of substance use, including opioid use, in high-risk rural communities.

Through the Substance Abuse and Mental Health Services Administration (SAMHSA), HHS also recently announced $55 million in funding for its Tribal Opioid Response grant program that addresses the overdose crisis in tribal communities.

Both programs address opioid and stimulant misuse, as reflected in the President's Fiscal Year 2023 proposed budget for HHS on drug-related programs and initiatives that totaled $21.1 billion. The funding helps support the National Drug Control Strategy. 

Last month the White House released the administration's plan to address methamphetamine and its impact on public health and safety.
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com