Substance use trends and service needs among child welfare involved caregivers Orion Mowbray, PhD University of Georgia Brian Perron, PhD Joseph Ryan, PhD Co-Directors, University of Michigan Child and Adolescent Datalab
Opioid use in the U.S. Number of opioid prescriptions: 1991: 76 Million 2013: 207 Million CDC, 2015 Prescription opioid misuse associated with accidental overdose and increased risk for illicit other drug and alcohol use (Bohnert, Valenstein, Bair, et al, 2011) Heroin use rates show a 50% increase between 2002 and 2015. A 400% increase in rates of overdose for same time period (SAMHSA, 2015)
Opioid use in child welfare Caregivers have higher risk for substance use, and differ on multiple key demographic factors (Young et al. 2007) Opioid use among caregivers associated with lower reunification rate (Choi & Ryan, 2001) Effective treatment, including medication assisted treatment show improved reunification rate (Hall et al., 2016) Do national trends generalize? Are opioid using clients getting services?
Sample Families screened for Title IV-E AODA Waiver (Cook County, IL) 2000 – 2015 Measures examined: primary substance used and substance use service needs and utilization Total sample =11,722 caregivers Program description: Illinois received waiver authority to redirect IV-E dollars to fund Recovery Coaches to assist birth parents with obtaining needed AODA treatment services and in negotiating departmental and judicial requirements associated with drug recovery and concurrent permanency planning.
Trends in substances used Of the 11,722, 3,183 substance use behavior. These were evenly split across all four groups – percentages range from 20-28% About 60% of opioid users in the sample described injection as the primary route
Frequency of opioid use
AODA service needs of daily and non-daily opioid users
Methadone use among daily and non-daily opioid users No significant main effect, no interaction.
Discussion Consistent opioid use patterns over time Large recent increase in daily users Implications for intensity of service needs and duration of treatment Similarity in AODA service needs among daily and non-daily users Differing trends in methadone use between daily and non-daily users Alternatives to methadone? Decreases in screening and referral for methadone services?
Thank you Contacts: Orion Mowbray: omowbray@uga.edu UM Datalab: ssw-datalab@umich.edu https://ssw-datalab.org