Publications · 2024
Adolescent Residential Addiction Treatment in the US: Uneven Access, Waitlists, and High Costs
Health Affairs , 43(1):64-71 , 2024 · doi:10.1377/hlthaff.2023.00777
Overview
Posing as the aunt or uncle of a 16-year-old recovering from a non-fatal overdose, we called 160 US residential addiction facilities serving adolescents. Just over half had immediate beds; among the rest, the average waitlist was 28 days. Average daily cost was $878, with for-profit facilities charging roughly three times the nonprofit average. Half of facilities required up-front payment averaging $28,731. Ten states and DC had no identifiable adolescent residential treatment options at all.
Abstract
Drug overdose deaths among adolescents are increasing in the United States. Residential treatment facilities are one treatment option for adolescents with substance use disorders, yet little is known about their accessibility or cost. Using the Substance Abuse and Mental Health Services Administration's treatment locator and search engine advertising data, we identified 160 residential addiction treatment facilities that treated adolescents with opioid use disorder as of December 2022. We called facilities while role-playing as the aunt or uncle of a sixteen-year-old child with a recent nonfatal overdose, to inquire about policies and costs. Eighty-seven facilities (54.4 percent) had a bed immediately available. Among sites with a waitlist, the mean wait time for a bed was 28.4 days. Of facilities providing cost information, the mean cost of treatment per day was $878. Daily costs among for-profit facilities were triple those of nonprofit facilities. Half of facilities required up-front payment by self-pay patients. The mean up-front cost was $28,731. We were unable to identify any facilities for adolescents in ten states or Washington, D.C. Access to adolescent residential addiction treatment centers in the United States is limited and costly.
Recognition & impact
Awards2
- Top Ten Health Affairs Articles of 2024Health Affairs Forefront
- Highest Impact Publications (2023-2024)American Society of Addiction Medicine
Cited in policy & guidance1
- Closing Gaps in the Care Continuum: Opportunities to Improve Substance Use Disorder Care in the Federal Health ProgramsExpert Testimony, US Senate Finance Subcommittee on Health Care
Media7
- The cancer moonshot goes to spacePolitico
- A look at substance use and mental health treatment facilities across the U.S.Kaiser Family Foundation
- Families hit with high costs, waitlists for youth rehab in Oregon and nationwideOregon Public Broadcasting
- Addiction treatment for teens in crisis is often hard to findUS News and World Report
- Residential addiction treatment for adolescents is scarce and expensiveNIH News Release
- Uneven access and high costs: The state of residential addiction treatment for adolescentsBoston Medical Center HealthCity
- Residential addiction treatment for U.S. teens is scarce and expensive, OHSU-led study findsOregon Capital Chronicle
Commentary & response2
Topics
- adolescent addiction treatment
- residential treatment
- waitlists
- treatment cost
- audit study
- for-profit care
- health equity
- behavioral health
How to cite
King C, Beetham T, Smith N, Englander H, Button D, Brown PCM, Hadland SE, Bagley SM, Wright OR, PT Korthuis, Cook R. Adolescent Residential Addiction Treatment in the US: Uneven Access, Waitlists, and High Costs. Health Affairs, 43(1):64-71; 2024. doi:10.1377/hlthaff.2023.00777
Show BibTeX
@article{king2024adolescentresidential,
title = {{Adolescent Residential Addiction Treatment in the US: Uneven Access, Waitlists, and High Costs}},
author = {King, C. and Beetham, T. and Smith, N. and Englander, H. and Button, D. and Brown, P. C. M. and Hadland, S. E. and Bagley, S. M. and Wright, O. R. and PT Korthuis and Cook, R.},
journal = {Health Affairs},
year = {2024},
volume = {43},
number = {1},
pages = {64--71},
doi = {10.1377/hlthaff.2023.00777},
url = {https://doi.org/10.1377/hlthaff.2023.00777},
abstract = {Drug overdose deaths among adolescents are increasing in the United States. Residential treatment facilities are one treatment option for adolescents with substance use disorders, yet little is known about their accessibility or cost. Using the Substance Abuse and Mental Health Services Administration's treatment locator and search engine advertising data, we identified 160 residential addiction treatment facilities that treated adolescents with opioid use disorder as of December 2022. We called facilities while role-playing as the aunt or uncle of a sixteen-year-old child with a recent nonfatal overdose, to inquire about policies and costs. Eighty-seven facilities (54.4 percent) had a bed immediately available. Among sites with a waitlist, the mean wait time for a bed was 28.4 days. Of facilities providing cost information, the mean cost of treatment per day was $878. Daily costs among for-profit facilities were triple those of nonprofit facilities. Half of facilities required up-front payment by self-pay patients. The mean up-front cost was $28,731. We were unable to identify any facilities for adolescents in ten states or Washington, D.C. Access to adolescent residential addiction treatment centers in the United States is limited and costly.},
keywords = {adolescent addiction treatment; residential treatment; waitlists; treatment cost; audit study; for-profit care; health equity; behavioral health},
note = {Awards: Top Ten Health Affairs Articles of 2024, Health Affairs Forefront; Highest Impact Publications (2023-2024), American Society of Addiction Medicine. Media coverage: Politico, Kaiser Family Foundation, Oregon Public Broadcasting, US News and World Report}
}