Health insurance coverage is associated with access to substance use treatment among individuals with injection drug use: Evidence from a 12-year prospective study

Abstract

Objective: Understand how insurance impacts access to services among people who have injected drugs.

Methods: 1748 adults who have injected drugs were assessed at twice-annual study visits between 2006 and 2017 (18,869 visits). Use of specialty substance use treatment, receipt of buprenorphine, and having a regular source of medical care were assessed for association with concurrent insurance coverage. Random intercept logistic regression was used to adjust for potential confounders.

Results: When participants acquired insurance, they were more likely to report specialty substance use treatment (aOR 2.0, 95% CI 1.6 to 2.5), a buprenorphine prescription (aOR 3.3, 95% CI 2.0 to 5.5), and a regular source of medical care (aOR 6.3, 95% CI 5.1 to 7.8).

Conclusion: Insurance is associated with increased use of three important services for individuals who inject drugs.

Implications: Expanding insurance may facilitate access to substance use treatment and other needed health services.

Keywords: Cohort study; Injection drug use; Insurance; Substance use treatment.