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.

项目摘要/摘要 药物使用障碍（SUD）不成比例地影响多个脆弱人群， 包括患有心理健康问题的人。尽管长期以来一直认为SUD 自闭症谱系障碍，最近出版物的个体中的风险不会升高 包括JAMA中的那些，以相比之下，强调了对SUD的脆弱性不成比例的脆弱性 在自闭症谱系障碍（ASD）的青年和成人中，正如独立报道的 几项国际研究。例如，在一项研究台湾SUD的人的研究中 显示ASD的存在是三重死亡率，增加了SUD症状的严重程度和 升级他们的发展。在美国，关于SUD的脆弱性较高 在ASD的青年和成人中，有可能造成“隐藏”的脆弱人群 当前的物质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，即 美国国家医疗补助数据，以（1）比较有各种泡沫的可能性 有和没有ASD的人，年龄在11岁及以上； （2）分析SUD的差异 在有或没有ASD的使用物质的个体中，治疗用法和肿瘤的严重程度。 要确定上述关系的可延展主持人，我们将首次合并 医疗补助患者拥有患者健康社会决定者的数据（例如，社会隔离和 经济不稳定）来自Transunion，这是一个个人社会经济的国家存储库 数据（仅适用于成人）。我们还将测试国家政策对 报销特定的SUD和ASD干预措施。 更具体地说，拟议的研究将检查SUD患病率，严重程度，模式是否 与SU相关的不良事件会因ASD状态加剧。它还将检查 健康的社会决定者，人口因素和州级治疗政策 缓冲或放大ASD对药物使用相关结果的影响。