Exploring the Determinants of Treatment Completion Among Youth Who Received Medication-Assisted Treatment in the United States
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Source
2.2. Measures
2.2.1. Dependent Variable: Treatment Completion and Dropout
2.2.2. Covariates
Predisposing Factors
Enabling Factors
Need Factors
Environmental Factor
2.3. Statistical Analysis
3. Results
3.1. Population Characteristics and Bivariate Associations
3.2. Factors Associated with Treatment Completion and Dropout
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
MAT | Medication-Assisted Treatment |
OUD | Opioid Use Disorder |
SUD | Substance use disorder |
SUT | Substance use treatment |
TEDS-D | Treatment Episode Data Set—Discharges |
US | United States |
ARR | Adjusted risk ratios |
CHIP | Children Health Insurance Program |
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Variable | Treatment Completion and Dropout | |||
---|---|---|---|---|
Total n (%) | Completed Treatment n = 2533 (51.5%) | Dropped Out n = 2384 (48.5%) | p-Value | |
Predisposing Factors | ||||
Age | ||||
12–17 years | 60 (1.2) | 39 (65.0) | 21 (35.0) | 0.0355 |
18–24 years | 4857 (98.8) | 2494 (51.4) | 2363 (48.6) | |
Sex | ||||
Male | 2735 (55.6) | 1477 (54.0) | 1258 (46.0) | <0.0001 |
Female | 2182 (44.4) | 1056 (48.4) | 1126 (51.6) | |
Race | ||||
Black or African American | 275 (5.6) | 112 (40.7) | 163 (59.3) | 0.0010 |
White | 4204 (85.5) | 2198 (52.3) | 2006 (47.7) | |
Other races | 438 (8.9) | 223 (50.9) | 215 (49.1) | |
Educational level | ||||
≤High school | 4367 (88.8) | 2239 (51.3) | 2128 (48.7) | 0.0165 |
Some college/vocational school | 497 (10.1) | 275 (55.3) | 222 (44.7) | |
College graduate/postgraduate school/more | 53 (1.1) | 19 (35.9) | 34 (64.1) | |
Enabling Factors | ||||
Health insurance | ||||
Yes | 3420 (69.5) | 1776 (51.9) | 1644 (48.1) | 0.3792 |
No | 1497 (30.5) | 757 (50.6) | 740 (49.4) | |
Past month self-help group participation | ||||
No | 3633 (73.9) | 1820 (50.1) | 1813 (49.9) | 0.0035 |
1–7 times | 668 (13.6) | 368 (55.1) | 300 (44.9) | |
8–30 times | 616 (12.5) | 345 (56.0) | 271 (44.0) | |
Previous substance use treatment episodes | ||||
Yes | 3865 (78.6) | 2023 (52.3) | 1842 (47.7) | 0.0263 |
No | 1052 (21.4) | 510 (48.5) | 542 (51.5) | |
Days waiting to enter substance abuse treatment facility | ||||
≤30 days | 4819 (98.0) | 2478 (51.4) | 2341 (48.6) | 0.3566 |
>30 days | 98 (2.0) | 55 (56.1) | 43 (43.9) | |
Type of treatment or service setting at admission | ||||
24 h detoxification | 1906 (38.8) | 1184 (62.1) | 722 (37.9) | <0.0001 |
Residential and rehabilitation | 1107 (22.5) | 613 (55.4) | 494 (44.6) | |
Ambulatory | 1904 (38.7) | 736 (38.7) | 1168 (61.3) | |
Need Factors | ||||
Use of MAT | ||||
Yes | 1062 (21.6) | 466 (43.9) | 596 (56.1) | <0.0001 |
No | 3855 (78.4) | 2067 (53.6) | 1788 (46.4) | |
Co-occurring mental and substance use disorders | ||||
Yes | 2284 (46.5) | 1214 (53.1) | 1070 (46.9) | 0.0324 |
No | 2633 (53.5) | 1319 (50.1) | 1314 (49.9) | |
Environment | ||||
Census region | ||||
Northeast | 2343 (47.7) | 1293 (55.2) | 1050 (44.8) | <0.0001 |
Midwest and West | 1901 (38.6) | 1022 (53.8) | 879 (46.2) | |
South | 673 (13.7) | 218 (32.4) | 455 (67.6) |
Variable | Adjusted Model | ||
---|---|---|---|
ARR | 95% CI | p-Value | |
Predisposing Factors | |||
Age (12–17 years vs. 18–24 years) | † | ||
Sex (male vs. female) | 1.23 | 1.088–1.381 | 0.0008 |
Race (ref = White) | |||
Black or African American | 0.84 | 0.646–1.096 | 0.2004 |
Other races | 0.75 | 0.609–0.916 | 0.0051 |
Educational level (ref = college graduate or more) | |||
≤High school | † | ||
Some college degree | † | ||
Enabling Factors | |||
Health insurance | ◊ | ||
Past month self-help group participation (ref = no) | |||
1–7 times | 1.33 | 1.115–1.585 | 0.0015 |
8–30 times | 1.50 | 1.246–1.803 | <0.0001 |
Previous substance use treatment episodes (yes vs. no) | † | ||
Days waiting to enter substance abuse treatment facility | ◊ | ||
Type of treatment or service setting at admission (ref = ambulatory) | |||
24 h detoxification | 2.80 | 2.408–3.255 | <0.0001 |
Residential and rehabilitation | 2.05 | 1.749–2.400 | <0.0001 |
Need Factors | |||
Use of MAT (yes vs. no) | 0.81 | 0.694–0.946 | 0.0077 |
Co-occurring mental and substance use disorders (yes vs. no) | 1.28 | 1.133–1.448 | <0.0001 |
Environment Factor | |||
Census region (ref = Northeast) | |||
Midwest and West | 1.18 | 1.030–1.358 | 0.0173 |
South | 0.45 | 0.369–0.549 | <0.0001 |
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Adeniran, E.A.; Quinn, M.; Liu, Y.; Brooks, B.; Pack, R.P. Exploring the Determinants of Treatment Completion Among Youth Who Received Medication-Assisted Treatment in the United States. Healthcare 2025, 13, 798. https://doi.org/10.3390/healthcare13070798
Adeniran EA, Quinn M, Liu Y, Brooks B, Pack RP. Exploring the Determinants of Treatment Completion Among Youth Who Received Medication-Assisted Treatment in the United States. Healthcare. 2025; 13(7):798. https://doi.org/10.3390/healthcare13070798
Chicago/Turabian StyleAdeniran, Esther A., Megan Quinn, Ying Liu, Billy Brooks, and Robert P. Pack. 2025. "Exploring the Determinants of Treatment Completion Among Youth Who Received Medication-Assisted Treatment in the United States" Healthcare 13, no. 7: 798. https://doi.org/10.3390/healthcare13070798
APA StyleAdeniran, E. A., Quinn, M., Liu, Y., Brooks, B., & Pack, R. P. (2025). Exploring the Determinants of Treatment Completion Among Youth Who Received Medication-Assisted Treatment in the United States. Healthcare, 13(7), 798. https://doi.org/10.3390/healthcare13070798