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From the mid-1980s to the early 2000s, most substance abuse treatment in the U.S. was provided by specialty centers. These centers offered two main types of care:
• Outpatient care, where patients receive treatment during scheduled visits and do not stay overnight
• Inpatient care, where patients stay at the facility during treatment
In the early to mid-1990s, inpatient programs were seen as too expensive and less cost-effective than outpatient alternatives. As a result, there was a general shift toward outpatient care. Private insurers, in particular, began covering fewer inpatient treatments and focused more on outpatient programs.
During this period, spending on prescription medications for substance abuse remained a small portion of total treatment costs. Few FDA-approved drugs (the U.S. Food and Drug Administration is the agency that authorizes medications for use in the United States) were available: disulfiram and naltrexone were already in use for alcohol addiction, and acamprosate was added in 2004. Buprenorphine was FDA-approved in 2002 for opioid addiction. Methadone, another FDA-approved medication for opioid treatment, is not sold through regular pharmacies. Instead, it is administered at treatment centers, and its cost is counted as part of spending on those centers.
• Outpatient care, where patients receive treatment during scheduled visits and do not stay overnight
• Inpatient care, where patients stay at the facility during treatment
In the early to mid-1990s, inpatient programs were seen as too expensive and less cost-effective than outpatient alternatives. As a result, there was a general shift toward outpatient care. Private insurers, in particular, began covering fewer inpatient treatments and focused more on outpatient programs.
During this period, spending on prescription medications for substance abuse remained a small portion of total treatment costs. Few FDA-approved drugs (the U.S. Food and Drug Administration is the agency that authorizes medications for use in the United States) were available: disulfiram and naltrexone were already in use for alcohol addiction, and acamprosate was added in 2004. Buprenorphine was FDA-approved in 2002 for opioid addiction. Methadone, another FDA-approved medication for opioid treatment, is not sold through regular pharmacies. Instead, it is administered at treatment centers, and its cost is counted as part of spending on those centers.
Overall spending on substance abuse treatment more than doubled from 1986 to 2003.: Yes
State and local government programs (Public Other State and Local) accounted for approximately $18 billion in substance abuse spending in 2003.: No
Medicare spending on substance abuse treatment remained unchanged between 1986 and 2003.: No
Be sure to select an answer first to save it in the Error Log before revealing the correct answer (OA)!
Difficulty:
55%
(hard)
Question Stats:
64% (03:46) correct
36%
(03:44)
wrong
based on 341
sessions
History
Date
Time
Result
Not Attempted Yet
Private spending on substance abuse treatment—across all three private payer categories—grew only from $4.6 billion in 1986 to $4.7 billion in 2003. Based on this and the information in the tabs, for each of the following statements, select Yes if the statement is accurate. Otherwise, select No.
| Yes | No | |
| Overall spending on substance abuse treatment more than doubled from 1986 to 2003. | ||
| State and local government programs (Public Other State and Local) accounted for approximately $18 billion in substance abuse spending in 2003. | ||
| Medicare spending on substance abuse treatment remained unchanged between 1986 and 2003. |
ShowHide Answer
Official Answer
Overall spending on substance abuse treatment more than doubled from 1986 to 2003.: Yes
State and local government programs (Public Other State and Local) accounted for approximately $18 billion in substance abuse spending in 2003.: No
Medicare spending on substance abuse treatment remained unchanged between 1986 and 2003.: No
Only a small number of FDA-approved medications were available
Be sure to select an answer first to save it in the Error Log before revealing the correct answer (OA)!
Difficulty:
15%
(low)
Question Stats:
87% (01:30) correct
13%
(01:37)
wrong
based on 383
sessions
History
Date
Time
Result
Not Attempted Yet
Which of the following best describes the role of medications in substance use treatment through 2004, based on the information provided?
| A wide range of medications was routinely used in treatment | |
| Most approved medications were for opioid addiction | |
| Prescription drugs accounted for the majority of treatment spending | |
| Medications largely replaced outpatient and inpatient care | |
| Only a small number of FDA-approved medications were available |
ShowHide Answer
Official Answer
Only a small number of FDA-approved medications were available
Alcohol-induced or drug-induced psychoses: Yes
Opioid dependence requiring methadone administration: Yes
Pervasive developmental disorders: No
Be sure to select an answer first to save it in the Error Log before revealing the correct answer (OA)!
Difficulty:
25%
(medium)
Question Stats:
83% (01:28) correct
17%
(01:34)
wrong
based on 398
sessions
History
Date
Time
Result
Not Attempted Yet
For each of the following, indicate whether it is a condition typically treated at specialty substance abuse centers, based on the information provided in the tabs.
| Yes | No | |
| Alcohol-induced or drug-induced psychoses | ||
| Opioid dependence requiring methadone administration | ||
| Pervasive developmental disorders |
ShowHide Answer
Official Answer
Alcohol-induced or drug-induced psychoses: Yes
Opioid dependence requiring methadone administration: Yes
Pervasive developmental disorders: No
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Official Solution:
Statement 1:
Private spending on substance abuse treatment stayed roughly the same, but its share dropped from about 50% in 1986 to around 22% in 2003. That means total spending must have risen by about 50/22 ≈ 2.3, i.e. more than doubled. So, this statement is accurate.
Statement 2:
If private spending was $4.7 billion and made up 25% of the total, then total spending was around $18.8 billion. State and local programs made up 40% of that, or about $7.5 billion—not $18 billion. So, this statement is not accurate.
Statement 3:
Medicare’s share stayed about the same from 1986 to 2003, but since total spending doubled, Medicare spending in dollars also doubled. So, this statement is not accurate.
Correct answer:
Overall spending on substance abuse approximately doubled from 1986 to 2003.
"Yes"
State and local government programs (Public Other State and Local) accounted for approximately \$18 billion in substance abuse spending in 2003.
"No"
Medicare spending on substance abuse treatment remained unchanged between 1986 and 2003. "No"
Bunuel
Statement 1:
Private spending on substance abuse treatment stayed roughly the same, but its share dropped from about 50% in 1986 to around 22% in 2003. That means total spending must have risen by about 50/22 ≈ 2.3, i.e. more than doubled. So, this statement is accurate.
Statement 2:
If private spending was $4.7 billion and made up 25% of the total, then total spending was around $18.8 billion. State and local programs made up 40% of that, or about $7.5 billion—not $18 billion. So, this statement is not accurate.
Statement 3:
Medicare’s share stayed about the same from 1986 to 2003, but since total spending doubled, Medicare spending in dollars also doubled. So, this statement is not accurate.
Correct answer:
Overall spending on substance abuse approximately doubled from 1986 to 2003.
"Yes"
State and local government programs (Public Other State and Local) accounted for approximately \$18 billion in substance abuse spending in 2003.
"No"
Medicare spending on substance abuse treatment remained unchanged between 1986 and 2003. "No"
15 Apr 2025, 01:15
Kudos
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Official Solution:
• A wide range of medications was routinely used in treatment. The passage makes it clear that this was not the case. Medication use was limited, and prescription drug spending remained a minor part of total treatment costs. Not correct.
• Most approved medications were for opioid addiction. This is inaccurate. Only one medication—buprenorphine—was approved for opioids by 2004, while three were approved for alcohol. Not correct.
• Prescription drugs accounted for the majority of treatment spending. Tab 1 clearly states that prescription drug spending was a small portion of total substance abuse treatment costs. Not correct.
• Medications largely replaced outpatient and inpatient care. The passage does not support this. Medications were used alongside these treatments, not in place of them. Not correct.
• Only a small number of FDA-approved medications were available. Tab 1 confirms that only a few medications were approved through 2004—three for alcohol (disulfiram, naltrexone, acamprosate) and one for opioids (buprenorphine). Methadone was used as well but not counted under prescription drug spending. This accurately reflects the limited role of medications in treatment. Correct.
Correct answer:
Which of the following best describes the role of medications in substance use treatment through 2004, based on the information provided?
"Only a small number of FDA-approved medications were available"
Bunuel
• A wide range of medications was routinely used in treatment. The passage makes it clear that this was not the case. Medication use was limited, and prescription drug spending remained a minor part of total treatment costs. Not correct.
• Most approved medications were for opioid addiction. This is inaccurate. Only one medication—buprenorphine—was approved for opioids by 2004, while three were approved for alcohol. Not correct.
• Prescription drugs accounted for the majority of treatment spending. Tab 1 clearly states that prescription drug spending was a small portion of total substance abuse treatment costs. Not correct.
• Medications largely replaced outpatient and inpatient care. The passage does not support this. Medications were used alongside these treatments, not in place of them. Not correct.
• Only a small number of FDA-approved medications were available. Tab 1 confirms that only a few medications were approved through 2004—three for alcohol (disulfiram, naltrexone, acamprosate) and one for opioids (buprenorphine). Methadone was used as well but not counted under prescription drug spending. This accurately reflects the limited role of medications in treatment. Correct.
Correct answer:
Which of the following best describes the role of medications in substance use treatment through 2004, based on the information provided?
"Only a small number of FDA-approved medications were available"
