Recorded presentation

Paul M. Roman, PhD, Lori J. Ducharme, PhD, and Meredith Huey, MA. Institute for Behavioral Research, University of Georgia, 101 Barrow Hall, D. W. Brooks Drive, Athens, GA 30602, 7065426090, proman@uga.edu

There has been longstanding attention to the “two-tiered” system of addiction treatment in the U.S. Research has shown significant differences between public- and private-sector treatment programs in their organization, management, service delivery patterns, and stability. Assertions have been made that these between-sector differences translate into significant disparities in the scope and quality of services available to patients accessing treatment in the public and private sectors. Using data from a nationally representative sample of 800 public and private treatment programs, this presentation first examines an alternative method of classifying treatment programs, using revenue sources rather than ownership. The result is a “four-tiered” system, including private for-profits, privately funded non-profits, publicly funded non-profits, and government-owned programs. A rationale for this classification scheme and its analytic utility are discussed. Using this classification system, we examine differences in the patient populations accessing each type of program finding significant differences by race/ethnicity, primary diagnosis, and special populations (HIV/AIDS, pregnant women, etc.). Finally, we assess whether systematic disparities exist in the services offered across each of the four program types, with a particular focus on the use of evidence-based treatment techniques. Again results show significant differences in tracks for special populations as well as the use of pharmacological and behavioral innovations. Implications for treatment providers and patients are discussed. (Supported by grant numbers R01-DA13110 and R01-DA14482 from the National Institute on Drug Abuse)

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