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      National trends and characteristics of inpatient detoxification for drug use disorders in the United States

      , 1 , , 1 , 2 , 3 , 4

      BMC Public Health

      BioMed Central

      Drug use disorder, Opioid use disorder, Detoxification, Rehabilitation, Inpatient

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          Prior studies indicate that the opportunity from detoxification to engage in subsequent drug use disorder (DUD) treatment may be missed. This study examined national trends and characteristics of inpatient detoxification for DUDs and explored factors associated with receiving DUD treatment (i.e., inpatient drug detoxification plus rehabilitation) and discharges against medical advice (DAMA).


          We analyzed inpatient hospitalization data involving the drug detoxification procedure for patients aged≥12 years ( n = 271,403) in the 2003–2011 Nationwide Inpatient Samples. We compared the estimated rate and characteristics of inpatient drug-detoxification hospitalizations between 2003 and 2011 and determined demographic and clinical correlates of inpatient drug detoxification plus rehabilitation (versus detoxification-only) and DAMA (versus transfer to further treatment).


          There was no significant yearly change in the population rate of inpatient drug-detoxification hospitalizations during 2003–2011. The majority of inpatient drug detoxification were patients aged 35–64 years, males, and those on Medicaid. Among inpatient drug-detoxification hospitalizations, only 13% received detoxification plus rehabilitation during inpatient care, and up to 14% were DAMA; the most commonly identified diagnoses were opioid use disorder (OUD; 75%) and non-addiction mental health disorders (48%). Being on Medicaid (vs. having private insurance) and having OUD (vs. no OUD) were associated with decreased odds of receiving detoxification plus rehabilitation, as well as increased odds of DAMA.


          These findings suggest the presence of a potentially large detoxification-treatment gap for inpatient detoxification patients. They highlight the need for implementing DUD services to improve engagement in receiving further DUD treatment in order to improve recovery and health outcomes.

          Electronic supplementary material

          The online version of this article (10.1186/s12889-018-5982-8) contains supplementary material, which is available to authorized users.

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          Most cited references 39

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          Treatment of Opioid-Use Disorders.

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              New Data on Opioid Use and Prescribing in the United States


                Author and article information

                (919)6840015 ,
                (919)6686067 ,
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                29 August 2018
                29 August 2018
                : 18
                [1 ]ISNI 0000000100241216, GRID grid.189509.c, Department of Psychiatry and Behavioral Sciences, School of Medicine, , Duke University Medical Center, ; BOX 3903, Durham, NC 27710 USA
                [2 ]ISNI 0000000100241216, GRID grid.189509.c, Department of Medicine, Division of General Internal Medicine, , Duke University Medical Center, ; Durham, NC USA
                [3 ]ISNI 0000000100241216, GRID grid.189509.c, Duke Clinical Research Institute, , Duke University Medical Center, ; Durham, NC USA
                [4 ]ISNI 0000 0004 1936 7961, GRID grid.26009.3d, Center for Child and Family Policy, Sanford School of Public Policy, , Duke University, ; Durham, NC USA
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

                Funded by: FundRef, National Institutes of Health;
                Award ID: UG1DA040317
                Award ID: R01MD007658
                Award Recipient :
                Research Article
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                © The Author(s) 2018

                Public health

                drug use disorder, inpatient, rehabilitation, detoxification, opioid use disorder


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