Erika G Martin1, Karen H Wang. 1. *Rockefeller College of Public Affairs & Policy and †Nelson A. Rockefeller Institute of Government, University at Albany-State University of New York, Albany, NY ‡Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT.
Abstract
BACKGROUND: Untreated substance use disorders (SUD) among HIV patients contribute to worse HIV care outcomes and increased HIV transmission. Although there are clinical and policy recommendations for integrated SUD and HIV treatment, payment issues including complex funding streams are a barrier. OBJECTIVES: We assessed the availability of guideline-concordant medication-assisted therapies to treat alcohol, tobacco, and opioid dependence on state-administered AIDS Drug Assistance Programs (ADAPs), an important source of drug coverage for low-income HIV patients. We examined which medication-assisted therapies are most likely to be included on formularies and variation of these therapies across states. RESEARCH DESIGN: We reviewed state-specific ADAP formularies from 1997 to 2009 for the presence of guideline-concordant medication-assisted therapies to treat alcohol, tobacco, and opioid dependence. RESULTS: The most frequently included medication-assisted therapies were those to treat tobacco dependence, followed by opioid dependence. Few states covered alcohol dependence medications. In each year, <10% of states covered all recommended medications and <50% covered a partial formulary for at least 1 SUD. CONCLUSIONS: ADAPs could provide access to medication-assisted therapies for SUD for a significant number of HIV patients, but these medications have not been widely covered throughout the program's history. Increased availability of medication-assisted therapies through ADAP could facilitate integrated HIV and SUD care.
BACKGROUND: Untreated substance use disorders (SUD) among HIVpatients contribute to worse HIV care outcomes and increased HIV transmission. Although there are clinical and policy recommendations for integrated SUD and HIV treatment, payment issues including complex funding streams are a barrier. OBJECTIVES: We assessed the availability of guideline-concordant medication-assisted therapies to treat alcohol, tobacco, and opioid dependence on state-administered AIDS Drug Assistance Programs (ADAPs), an important source of drug coverage for low-income HIVpatients. We examined which medication-assisted therapies are most likely to be included on formularies and variation of these therapies across states. RESEARCH DESIGN: We reviewed state-specific ADAP formularies from 1997 to 2009 for the presence of guideline-concordant medication-assisted therapies to treat alcohol, tobacco, and opioid dependence. RESULTS: The most frequently included medication-assisted therapies were those to treat tobacco dependence, followed by opioid dependence. Few states covered alcohol dependence medications. In each year, <10% of states covered all recommended medications and <50% covered a partial formulary for at least 1 SUD. CONCLUSIONS:ADAPs could provide access to medication-assisted therapies for SUD for a significant number of HIVpatients, but these medications have not been widely covered throughout the program's history. Increased availability of medication-assisted therapies through ADAP could facilitate integrated HIV and SUD care.
Authors: Nancy F Crum; Robert H Riffenburgh; Scott Wegner; Brian K Agan; Sybil A Tasker; Katherine M Spooner; Adam W Armstrong; Susan Fraser; Mark R Wallace Journal: J Acquir Immune Defic Syndr Date: 2006-02-01 Impact factor: 3.731
Authors: Jack E Burkhalter; Carolyn M Springer; Rosy Chhabra; Jamie S Ostroff; Bruce D Rapkin Journal: Nicotine Tob Res Date: 2005-08 Impact factor: 4.244
Authors: Joseph Conigliaro; Adam J Gordon; Kathleen A McGinnis; Linda Rabeneck; Amy C Justice Journal: J Acquir Immune Defic Syndr Date: 2003-08-01 Impact factor: 3.731
Authors: Jeffrey H Samet; Debbie M Cheng; Howard Libman; David P Nunes; Julie K Alperen; Richard Saitz Journal: J Acquir Immune Defic Syndr Date: 2007-10-01 Impact factor: 3.731
Authors: Jacques Baillargeon; Thomas P Giordano; Josiah D Rich; Z Helen Wu; Katherine Wells; Brad H Pollock; David P Paar Journal: JAMA Date: 2009-02-25 Impact factor: 56.272
Authors: Anne Zinski; Andrew O Westfall; Lytt I Gardner; Thomas P Giordano; Tracey E Wilson; Mari-Lynn Drainoni; Jeanne C Keruly; Allan E Rodriguez; Faye Malitz; D Scott Batey; Michael J Mugavero Journal: Am J Public Health Date: 2015-08-13 Impact factor: 9.308
Authors: Brian T Montague; Christopher W Kahler; Suzanne M Colby; R Kathryn McHugh; Daniel Squires; Brianne Fitzgerald; Don Operario; Donna Gallagher; Peter M Monti; Kenneth H Mayer Journal: Addict Disord Their Treat Date: 2015-03
Authors: Robert L Cook; Christa L Cook; Manju Karki; Kathleen M Weber; Kathleen A Thoma; Chelsea M Loy; Lakshmi Goparaju; Bridgett Rahim-Williams Journal: BMC Public Health Date: 2016-03-15 Impact factor: 3.295
Authors: Bryan R Garner; Heather J Gotham; Hannah K Knudsen; Brittany A Zulkiewicz; Stephen J Tueller; Marcus Berzofsky; Tom Donohoe; Erika G Martin; L Lauren Brown; Theodore Gordon Journal: AIDS Behav Date: 2021-09-29