Quality of Opioid Treatment Programs: Findings from the Evaluation of Opioid Treatment Programs Accreditation Study
Kasten, J. J., & Wechsberg, W. M. (2005, December). Quality of Opioid Treatment Programs: Findings from the Evaluation of Opioid Treatment Programs Accreditation Study. Presented at American Public Health Association Annual Meeting, Philadelphia, PA.
Funded by the Center for Substance Abuse Treatment (CSAT), RTI International conducted the Evaluation of Opioid Programs Accreditation Study (Evaluation Study). This project was a large-scale evaluation taking place between 1998 and 2003, with the objective of evaluating impact data on current practices in opioid treatment programs (OTPs) prior to and after undergoing accreditation. As part of the Evaluation Study, RTI International staff had the opportunity to survey OTP Directors and key staff from a nationally representative sample of 172 OTPs. The OTPs in the Evaluation study reported experiencing a fair amount of organizational change in the 6 months preceding the Evaluation site visit. Approximately 40% had undergone a major change, such as new ownership, a new site director, or new approaches to treatment. Just over 18% reported extensive staff turnover in the 6 months before data collection. Only 17 sites of the 172 (10%) in the sample reported having a full-time physician/ psychiatrist on staff. The average time spent by physicians at the OTP was 0.23 FTE (based on a 40 hour FTE) per 100 patients. Only 29 % of all OTP counselors reported having advanced degrees, and only 38% reported more than 5 years experience in a methadone treatment setting. Approximately 44% of counselors reported having a substance abuse certification; however, just over 35% of these certifications were State Certifications. These results support reported findings by McLellan, Carise, and Kleber (2003) and call into questions the ability of OTPs to meet the complex demands of opioid maintenance treatment.