Referral for substance abuse treatment and depression improvement among patients with co-occurring disorders seeking behavioral health services in primary care

This study examined the relationship between substance treatment referrals and depression improvement among 2,373 participants with concurrent substance use and depressive disorders enrolled in an integrated behavioral health program. Three groups of substance treatment referral status were identified: accessed treatment (n = 780), declined treatment (n = 315), and no referral for treatment (n = 1278). The primary outcome is improvement in depressive symptoms (PHQ-9 < 10 or ≥ 50% reduction). Using propensity score adjustments, patients accessing substance treatment were significantly more likely to achieve depression improvement than those who declined receiving treatment services (hazard ratio (HR) = 1.82, 95% confidence interval (CI): 1.50–2.20, p < 0.001) and those without a referral for treatment (HR = 1.13, 95% CI: 1.03–1.25, p = 0.014). Each 1 week delay in initiating a referral was associated with a decreased likelihood of depression improvement (HR = 0.97, 95% CI: 0.96–0.98, p < 0.001). Study findings highlight the need of enhancing early treatment contact for co-occurring substance use disorders in primary care.     

Hepatitis B virus and hepatitis C virus services offered by substance abuse treatment programs in the United States

Although substance abuse treatment programs are important contact points for providing health services for hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, availability of services in these programs has not been well characterized. This study evaluated the spectrum of HBV and HCV services offered by substance abuse treatment programs within the National Drug Abuse Treatment Clinical Trials Network. Our survey of substance abuse treatment program administrators covered availability of testing for HBV and HCV; hepatitis A virus (HAV) and HBV immunization; and HCV medical and nonmedical services. There were also questions covering clarity of guidelines for HBV and HCV testing and HAV and HBV immunization. Differences between methadone and nonmethadone programs were examined. Despite the importance of substance abuse in sustaining the hepatitis epidemics, few programs offer comprehensive HBV and HCV testing or HCV health care services. Interventions to improve access to hepatitis services for substance-abusing patients are needed.