Helena De Azeredo Miranda
Florida Atlantic University
Co-Authors: Jhon Ostanin1, Simon Shugar2, Alan Kunz Lomelin2, Panagiota Kitsanta2
1Florida International University, 2Florida Atlantic University
Background: Limited research exists on treatment admission delays among adolescents with cannabis use disorder (CUD). Examining delays is essential, as they can adversely affect treatment outcomes, especially among young individuals.
Objectives: This study explored patterns of admission delays to publicly funded treatment facilities and assessed factors contributing to delays in treatment for CUD among U.S. adolescents.
Methods: The study used data from the 2012-2022 Treatment Episode Data Set-Admissions (TEDS-A), which included 124,501 adolescents (ages 12-17) diagnosed with CUD. Descriptive statistics, Chi-square tests, and multivariable logistic regression were employed to assess admission delays and factors associated with delayed treatment initiation. An admission delay was defined as waiting more than one day to receive care.
Results: Delays in receiving treatment for CUD were highest between 2012 (37.5%) and 2013 (38.1%) but decreased significantly from 2015 (24.7%) to 2018 (26.1%). However, delays began to rise again from 2019 onward, reaching 33.8% in 2022. Among those experiencing delays, longer delays (over a week) became more pronounced in 2021 and 2022, with 5.4% of adolescents waiting at least 30 days for treatment in 2022. Overall, delays in treatment were higher for children aged 12 to 14 years from 2018 to 2022 compared to those aged 15 to 17.
Males (OR=1.11, 95% CI 1.08-1.14) and White non-Hispanic adolescents (OR=1.29, 95% CI 1.25-1.34) had higher odds of experiencing delays compared to females and Hispanics, respectively. Homeless adolescents (0.50, 95% CI 0.35-0.73) and those with independent living arrangements (0.82, 95% CI 0.79-0.86) were less likely to experience delays compared to those with dependent living arrangements. Receiving a referral from a healthcare provider was associated with an increased likelihood of delay (OR=1.43, 95% CI 1.35-1.51) compared to individual/self-referrals. Significant delays were also observed if the treatment service/setting was rehabilitation/residential, short-term/long-term (13.9, 95% CI 12.1-15.9), or ambulatory, intensive/non-intensive outpatient (11.5, 95% CI 10.1-13.2) compared to detox treatment services.
Conclusions: Delays in receiving treatment for CUD among adolescents have varied over time, with a noticeable increase starting in 2019. These trends underscore the urgent need for focused interventions to reduce treatment delays, especially for vulnerable groups like younger adolescents, White non-Hispanic adolescents, those in independent living situations, individuals receiving services outside of detox facilities, and those referred by healthcare providers. Addressing these delays could improve treatment outcomes and more effectively address the growing prevalence of CUD among adolescents in the U.S.