2019 Public Health in the Rockies

Research Objective: To describe changes over time among patients admitted to substance use treatment facilities for opioid use disorder (OUD) treatment at Denver Health’s (DH) Outpatient Behavioral Health Services (OBHS) facility, Denver Core-Based Statistical Area (CBSA), Colorado, and the United States, overall and by demographic characteristics.
Population Studied: We analyzed patient reported opioid misuse at the time of admission, or those recommended to receive methadone or buprenorphine as a part of treatment during 2006-2015. Data for Denver CBSA, Colorado, and the U.S. were abstracted from the Treatment Episodes Dataset. Data for DH OBHS were from the Drug/Alcohol Coordinated Data System.
Study Design: We calculated annual percentage distributions for each study year (2006-2015) and geographic aggregation (DH OBHS, Denver CBSA, Colorado, and the U.S.) for the following variables: age group, sex, pregnancy status, racial ethnic group, and homelessness status.
Principal Findings: In general, admissions to substance use treatment facilities increased over time across all geographic aggregations. Admissions for patients >35 years, declined during 2006-2015 in almost all geographic aggregations. The largest decline across all geographic aggregations was among patients aged 45-54 years (16 percentage points at DH OBHS, 17 percentage points in Denver CBSA, 15 percentage points in Colorado, and 5 percentage points nationally). The largest increase in admissions for OUD treatment was among patients aged 25-34 (16 percentage points at DH OBHS, 14 percentage points in Denver CBSA, 10 percentage points in Colorado, and 12 percentage points nationally). Proportion of females at the time of admission slightly increased in all geographic aggregations. Admissions for OUD treatment among pregnant women increased by 17.8 percentage points at DH OBHS, 4.2 percentage points in Denver CBSA, 2 percentage points in Colorado, and by 0.3 percentage points nationally over 2006-2015. The composition of race and ethnicity varied across geographic aggregations over time.
Conclusions: Admissions for OUD among young adults have steadily increased; targeted prevention efforts are necessary among this group. Increased admission for OUD treatment among pregnant women may result in better outcomes associated with neonatal abstinence syndrome. To address the opioid crisis, policymakers might consider targeting policies toward a younger population and pregnant women.