Social determinants of substance use disorder treatment outcomes in a vulnerable population

弱势群体物质使用障碍治疗结果的社会决定因素

• 批准号: 10352689
• 负责人: Victor Lushin
• 金额: $ 21.29万
• 依托单位: LONG ISLAND UNIVERSITY BROOKLYN CAMPUS
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10352689
• 关键词: Accounting; Address; Adolescent; Adopted; Adult; Adverse event; Affect; American Medical Association; Attention deficit hyperactivity disorder; Buffers; Characteristics; Cognitive Therapy; Communication; Consequentialism; Country; Data; Data Set; Demographic Factors; Economics; Effectiveness; Enrollment; Epidemiology; Epilepsy; General Population; Goals; Health; Health Personnel; Health Policy; Healthcare; Hospitalization; Individual; Intellectual functioning disability; International; Intervention; Journals; Knowledge; Learning; Literature; Mediating; Mediation; Medicaid; Mental Depression; Mental Health; Motivation; Outcome; Overdose; Patients; Pattern; Policies; Population; Prevalence; Process; Publications; Reciprocal Social Interaction; Reporting; Role; Schizophrenia; Services; Severities; Social Interaction; Social isolation; Socioeconomic Factors; Substance Use Disorder; Symptoms; System; Taiwan; Testing; Time; Treatment outcome; Underserved Population; Vulnerable Populations; Youth; adult with autism spectrum disorder; aged; associated symptom; autism spectrum disorder; barrier to care; base; comorbidity; data repository; disorder risk; dosage; health data; high dimensionality; housing instability; individuals with autism spectrum disorder; insight; mortality; neuropsychiatry; opioid epidemic; polysubstance use; preference; prevent; repository; social; social determinants; social health determinants; socioeconomics; substance use; substance use treatment; uptake

Project Summary/Abstract Substance use disorders (SUD) disproportionately affect multiple vulnerable populations, including individuals with mental health problems. Although it had been long assumed that SUD risks are not elevated among individuals with autism spectrum disorders, recent publications, including those in JAMA, highlighted, on the contrary, a disproportionate vulnerability to SUD among youth and adults with autism spectrum disorder (ASD), as independently reported in several international studies. For example, in a study of individuals with SUD in Taiwan, the presence of ASD was shown to triple mortality rates, increase severity of SUD symptoms and escalate their progression. In the US, very little is known about the elevated vulnerability to SUD among youth and adults with ASD, potentially creating a “hidden” vulnerable population underserved by the current substance use treatment systems. The overall goal of the proposed study is to analyze the world’s largest healthcare data set, the US national Medicaid data, to (1) compare the likelihood of having various SUDs among individuals with and without ASD, aged 11 and older; and (2) analyze differences in SUD treatment usage and SUD severity among substance-using individuals with and without ASD. To identify malleable moderators of the above relationships, we will for the first time merge Medicaid patient with data on patients’ social determinants of health (e.g. social isolation and economic instability) from TransUnion, a national repository of individual-level socio-economic data (available only for adults). We will also test moderating effects of state policies regarding reimbursement of specific SUD and ASD interventions. More specifically, the proposed study will examine whether SUD prevalence, severity, patterns and SU- related adverse events are exacerbated by ASD status. It will also examine the role of social determinants of health, demographic factors, and state-level treatment policies in buffering or amplifying the effects of ASD on substance use related outcomes.

项目概要/摘要 物质使用障碍 (SUD) 对多个弱势群体造成不成比例的影响， 包括有心理健康问题的人。尽管长期以来人们一直认为 SUD 最近的出版物显示，自闭症谱系障碍患者的风险并未升高， 相反，包括《JAMA》中的那些人，强调了 SUD 的不成比例的脆弱性 据独立报道，患有自闭症谱系障碍 (ASD) 的青少年和成人 多项国际研究。例如，在一项针对台湾 SUD 患者的研究中， 研究表明，自闭症谱系障碍 (ASD) 的存在会使死亡率增加三倍，增加自闭症谱系障碍 (SUD) 症状的严重程度， 升级他们的进步。在美国，人们对 SUD 的脆弱性知之甚少 在患有自闭症谱系障碍的青少年和成年人中，可能会形成一个“隐藏”的弱势群体 当前的药物使用治疗系统服务不足。 拟议研究的总体目标是分析世界上最大的医疗保健数据集 美国国家医疗补助数据， (1) 比较不同人群拥有不同 SUD 的可能性 患有或不患有自闭症谱系障碍 (ASD) 的个人，年龄 11 岁及以上； (2)分析SUD的差异 患有和不患有 ASD 的物质使用者的治疗使用情况和 SUD 严重程度。 为了确定上述关系的可塑性调节者，我们将首次合并 医疗补助患者提供有关患者健康的社会决定因素的数据（例如社会隔离和 经济不稳定）来自 TransUnion，这是个人层面社会经济的国家存储库 数据（仅适用于成人）。我们还将检验国家政策的调节作用 报销特定 SUD 和 ASD 干预措施。 更具体地说，拟议的研究将检查 SUD 的患病率、严重程度、模式是否 ASD 状态会加剧 SU 相关不良事件。它还将审查 健康的社会决定因素、人口因素和国家一级的治疗政策 缓冲或放大 ASD 对药物使用相关结果的影响。