Organizational Correlates of Specialized Substance Abuse Treatment Provision to Seropositive Clients

Abstract

Data from the Alcohol and Drug Services Study, 1996–1999 (United States Department of Health and Human Services [USD-HHS], 2002), a nationally representative sample of 2,351 drug treatment programs were examined to identify organizational predictors of specialized substance abuse treatment provision to seropositive clients. The Political Economy Perspective developed by Wamsley and Zald (1976) was used to interpret results. A minority of facilities (22%, 517) provided specialized treatment. Among internal political economy measures, provision of mental health (p < 0.01), basic HIV services (p < 0.05), as well as methadone maintenance treatment (p < 0.05) were significantly and positively associated with specialized treatment provision. Among external political economy measures, managed care funding significantly decreased the likelihood of specialized treatment provision (p < 0.05), while parent organization control (p < 0.01) and number of clients (p < 0.01) significantly increased it. Specialized treatment provision was significantly positively associated with proportion of Blacks, Hispanics, seropositives (p < 0.01 for all), and injection drug users (p < 0.05).

Key Words:

• HIV/AIDS
• substance abuse
• addiction treatment services
• political economy
• organizational theory