Roberto A Trevino, Alan J Richard
Most nonprofit drug treatment providers (DTPs) in the US rely on discretionary government funding (DGF) allocations in order to provide drug treatment services to uninsured clients. However, little is known about the factors associated with DGF funding of DTPs. Of particular interest is whether the use of evidence-based treatment practices (EBP) helps explain whether a DTP has DGF or not. EBP are treatment protocols that randomized, controlled research has indicated are more effective in reducing substance abuse disorders than standard treatment protocols. Although EBP are more effective than standard substance abuse treatment practices, many DTPs do not use EBP. This paper begins to fill this gap in research by examining whether DTPs that have DGF use EBP more often than DTPs without DGF. Using linear and hierarchical linear models, we analyze cross-sectional data on 6,062 private non-profit DTPs in 362 metropolitan areas participating in the 2009 National Survey on Substance Abuse Treatment Services (NSSATS). The results indicate that EBP use is positively and significantly associated with DGF in standard regression models, but the association is weakened and no significant when hierarchical linear models (HLM) are used. These results suggest that EBP are less solidly associated with DGF than may be optimal for the reinforcement of EBP adoption. Furthermore, the results suggest that other considerations compete with EBP in DGF allocations, weakening an already-fragile supply of EBP.
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