Sample records for abuse treatment services

  1. 28 CFR 550.52 - Non-residential drug abuse treatment services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Non-residential drug abuse treatment... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.52 Non-residential drug abuse treatment services. All institutions must have non-residential drug abuse treatment services, provided...

  2. 28 CFR 550.52 - Non-residential drug abuse treatment services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Non-residential drug abuse treatment... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.52 Non-residential drug abuse treatment services. All institutions must have non-residential drug abuse treatment services, provided...

  3. 28 CFR 550.52 - Non-residential drug abuse treatment services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Non-residential drug abuse treatment... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.52 Non-residential drug abuse treatment services. All institutions must have non-residential drug abuse treatment services, provided...

  4. 28 CFR 550.52 - Non-residential drug abuse treatment services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Non-residential drug abuse treatment... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.52 Non-residential drug abuse treatment services. All institutions must have non-residential drug abuse treatment services, provided...

  5. 28 CFR 550.52 - Non-residential drug abuse treatment services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Non-residential drug abuse treatment... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.52 Non-residential drug abuse treatment services. All institutions must have non-residential drug abuse treatment services, provided...

  6. Women and Drug Abuse Treatment: Needs and Services. Services Research Monograph Series.

    ERIC Educational Resources Information Center

    Beschner, George; Thompson, Peggy

    During the 1970s, several activities were initiated in response to concern about the quality of treatment services available to drug-abusing women. A comparison of services needed by women with services actually available to women found that special treatment services for drug-abusing women were needed in the areas of medical treatment,…

  7. HIV/AIDS Services in Private Substance Abuse Treatment Programs

    PubMed Central

    Abraham, Amanda J.; O’Brien, Lauren A.; Bride, Brian E.; Roman, Paul M.

    2010-01-01

    Background HIV infection among substance abusers is a growing concern in the United States. Little research, however, has examined the provision of HIV/AIDS services in substance abuse treatment programs. Methods This study examines the provision of onsite HIV/AIDS services in a nationally representative sample of 345 privately funded substance abuse treatment programs. Data were collected via face-to-face interviews with administrators and clinical directors of treatment programs in 2007–2008. Results Results show that larger programs and programs with a higher percentage of both African American and injection drug using (IDU) patients were more likely to offer onsite HIV/AIDS support groups and a dedicated HIV/AIDS treatment track. Multinomial logistic regression reveals that the odds of offering onsite HIV testing services were higher for hospital based programs, programs providing medical services onsite, and programs with higher percentages of African American patients, relative to the odds of offering no HIV testing or referring patients to an external provider for HIV testing services. The odds of providing onsite testing were lower for outpatient-only treatment programs, relative to the odds of offering no HIV testing or referring patients to an external provider for HIV testing services. Conclusions Our findings highlight critical barriers to the adoption of onsite HIV/AIDS services and suggest treatment programs are missing the opportunity to significantly impact HIV-related health outcomes. PMID:21145179

  8. 45 CFR 96.46 - Substance abuse prevention and treatment services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Substance abuse prevention and treatment services... BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.46 Substance abuse prevention... organizations under the substance abuse prevention and treatment Block Grant. (b) For the purpose of determining...

  9. 45 CFR 96.46 - Substance abuse prevention and treatment services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Substance abuse prevention and treatment services... BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.46 Substance abuse prevention... organizations under the substance abuse prevention and treatment Block Grant. (b) For the purpose of determining...

  10. 45 CFR 96.46 - Substance abuse prevention and treatment services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Substance abuse prevention and treatment services... BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.46 Substance abuse prevention... organizations under the substance abuse prevention and treatment Block Grant. (b) For the purpose of determining...

  11. 45 CFR 96.46 - Substance abuse prevention and treatment services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Substance abuse prevention and treatment services... BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.46 Substance abuse prevention... organizations under the substance abuse prevention and treatment Block Grant. (b) For the purpose of determining...

  12. 45 CFR 96.46 - Substance abuse prevention and treatment services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Substance abuse prevention and treatment services... BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.46 Substance abuse prevention... organizations under the substance abuse prevention and treatment Block Grant. (b) For the purpose of determining...

  13. Provision of Mental Health Services in South African Substance Abuse Treatment Facilities

    ERIC Educational Resources Information Center

    Myers, Bronwyn; Fakier, Nuraan

    2009-01-01

    To date, South African research has not examined mental health service provision in substance abuse treatment facilities, even though these services improve client retention and treatment outcomes. To describe the extent to which substance abuse treatment facilities in Gauteng and KwaZulu-Natal provinces provide clients with mental health services…

  14. Characteristics of substance abuse treatment programs providing services for HIV/AIDS, hepatitis C virus infection, and sexually transmitted infections: the National Drug Abuse Treatment Clinical Trials Network.

    PubMed

    Brown, Lawrence S; Kritz, Steven Allan; Goldsmith, R Jeffrey; Bini, Edmund J; Rotrosen, John; Baker, Sherryl; Robinson, Jim; McAuliffe, Patrick

    2006-06-01

    Illicit drug users sustain the epidemics of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), hepatitis C (HCV), and sexually transmitted infections (STIs). Substance abuse treatment programs present a major intervention point in stemming these epidemics. As a part of the "Infections and Substance Abuse" study, established by the National Drug Abuse Treatment Clinical Trials Network, sponsored by National Institute on Drug Abuse, three surveys were developed; for treatment program administrators, for clinicians, and for state and District of Columbia health and substance abuse department administrators, capturing service availability, government mandates, funding, and other key elements related to the three infection groups. Treatment programs varied in corporate structure, source of revenue, patient census, and medical and non-medical staffing; medical services, counseling services, and staff education targeted HIV/AIDS more often than HCV or STIs. The results from this study have the potential to generate hypotheses for further health services research to inform public policy.

  15. Availability of HIV-related health services in adolescent substance abuse treatment programs.

    PubMed

    Knudsen, H K; Oser, C B

    2009-10-01

    Given that alcohol and drug abuse heightens the risk of adolescents acquiring HIV, substance abuse treatment programs for youths may represent an important site of HIV prevention. In this research, we explored the adoption of three HIV-related health services: risk assessment during intake, HIV prevention programing, and HIV testing. Data were collection through telephone interviews with 149 managers of adolescent-only substance abuse treatment programs in the USA. About half of these programs had adopted HIV risk assessment and HIV prevention. On-site HIV testing was less widely adopted, with only one in four programs offering this service. At the bivariate level, the availability of on-site primary medical care and the availability of an overnight level of care were positively associated with these three types of services. The association for the measure of an overnight level of care was no longer significant once medical services were controlled. However, in a separate analysis, it was found that programs offering an overnight level of care were much more likely to offer on-site medical care than outpatient-only facilities. There was also evidence that publicly funded treatment programs were more likely to offer HIV prevention and on-site HIV testing, after controlling for other organizational characteristics. Much more research about the adoption of HIV-related services in adolescent substance abuse treatment is needed, particularly to offer greater insight into why certain types of organizations are more likely to adopt these health services.

  16. Drug Treatment Service Utilization and Outcomes for Hispanic and White Methamphetamine Abusers

    PubMed Central

    Niv, Noosha; Hser, Yih-Ing

    2006-01-01

    Objective To examine differences in drug treatment service needs, utilization, satisfaction, and outcomes between Hispanic and white methamphetamine (meth) abusers. Data Sources Intake assessments and follow-up interviews of 128 Hispanic and 371 non-Hispanic white meth abusers admitted during 2000–2001 to 43 drug treatment programs in 13 counties across California. Study Design A prospective longitudinal study comparing ethnic differences in problem severity during pre- and posttreatment periods, as well as in services received during treatment. Data Collection/Extraction Methods The Addiction Severity Index (ASI) was administered at both intake and the 9-month follow-up to assess clients' problem severity in a number of domains. Service utilization and satisfaction were assessed 3 months following treatment admission. Principal Findings Hispanics were less educated and reported more employment difficulties than whites. Whites were more likely to be treated in residential programs than Hispanics despite similar severity in drug and alcohol use, legal, medical and family/social problems, and psychiatric status. Significantly more whites than Hispanics received psychiatric services, likely because more of them were treated in residential programs. Whites also reported receiving greater numbers of total services and services addressing alcohol and psychiatric problems. While no ethnic differences were found in treatment satisfaction and several other outcomes, Hispanics demonstrated better family and social outcomes than whites. Conclusions Both Hispanic and white meth abusers improved after treatment, although benefits from treatment can be further enhanced if services underscore different facets of their psychosocial problems. PMID:16899005

  17. Differences between U.S. substance abuse treatment facilities that do and do not offer domestic violence services.

    PubMed

    Cohn, Amy; Najavits, Lisa M

    2014-04-01

    Victimization by and perpetration of domestic violence are associated with co-occurring mental and substance use disorders. This study used data from the National Survey of Substance Abuse Treatment Services to examine differences in organizational factors, treatment approaches offered, and client-level factors among 13,342 substance abuse treatment facilities by whether or not they offered domestic violence services. Only 36% of the facilities offered domestic violence services. Those that offered such services were more likely than those that did not to treat clients with co-occurring disorders. Principal-components analysis reduced eight treatment approaches to two factors: psychosocial services and traditional substance abuse services. Regression models indicated that the frequency with which psychosocial services were offered depended on the percentage of clients with co-occurring disorders who were being treated in the facility and whether or not that facility offered domestic violence services. Specifically, facilities that did not offer domestic violence services and that had a high percentage of clients with co-occurring disorders were more likely to offer psychosocial services than facilities that offered domestic violence services. A larger proportion of facilities offering domestic violence services offered traditional substance abuse treatment services, compared with facilities not offering domestic violence services, but this relationship was not contingent on the percentage of clients with co-occurring disorders at each facility. Improved efforts should be made to tailor treatments to accommodate the links between domestic violence, mental disorders, and substance abuse.

  18. Characteristics of U.S. Substance Abuse Treatment Facilities Offering HIV Services: Results From a National Survey.

    PubMed

    Cohn, Amy; Stanton, Cassandra; Elmasry, Hoda; Ehlke, Sarah; Niaura, Ray

    2016-06-01

    Substance use disorders are common among persons with HIV/AIDS. This study examined the prevalence and correlates of the provision of four HIV services in a national sample of substance abuse treatment facilities. Data were from the 2011 National Survey of Substance Abuse Treatment Services. Prevalence estimates indicated that 28% of facilities offered HIV testing, 26% early intervention, 58% HIV/AIDS education, and 8% special programs for HIV/AIDS. Facilities offering inpatient substance abuse care were more than six times as likely to offer HIV testing but not more likely to offer any other type of HIV service. Facilities offering methadone treatment were 2.5 times more likely to offer HIV services. Given the high rates of substance use among persons with HIV, the prevalence of facilities offering HIV services was low in most domains, with different barriers identified in multivariable models. Integrating comprehensive HIV prevention, testing, and support services into programs that address substance abuse is needed.

  19. Promoting successful collaborations between domestic violence and substance abuse treatment service sectors: a review of the literature.

    PubMed

    Macy, Rebecca J; Goodbourn, Melissa

    2012-10-01

    Women who experience intimate partner violence (IPV) victimization are more likely to struggle with substance abuse problems than are women who do not experience IPV. Given the connection between IPV victimization and substance abuse, recommended practices urge collaboration between domestic violence service agencies and substance abuse treatment agencies to provide comprehensive services for women with these co-occurring problems. However, domestic violence and substance abuse services have unique histories of development that have led to distinct ways of service delivery. To promote successful collaborations, service providers and researchers are developing strategies to foster relationships across the two service sectors. The authors conducted a review of this emerging body of knowledge with the aim of assembling recommendations for strategies to foster collaboration between domestic violence and substance abuse services. The authors identified 15 documents for review inclusion and our analysis established 5 categories of documents. Findings yield key collaboration strategies and recommended service models. In addition, the review determined the existence of considerable challenges to promoting collaborative relationships between domestic violence and substance abuse treatment service sectors.

  20. Identifying perceived barriers to monitoring service quality among substance abuse treatment providers in South Africa

    PubMed Central

    2014-01-01

    Background A performance measurement system is planned for South African substance abuse treatment services. Provider-level barriers to implementing these systems have been identified in the United States, but little is known about the nature of these barriers in South Africa. This study explored the willingness of South African substance abuse treatment providers’ to adopt a performance measurement system and perceived barriers to monitoring service quality that would need to be addressed during system development. Methods Three focus group discussions were held with treatment providers from two of the nine provinces in South Africa. These providers represented the diverse spread of substance abuse treatment services available in the country. The final sample comprised 21 representatives from 12 treatment facilities: eight treatment centres in the Western Cape and four in KwaZulu-Natal. Content analysis was used to extract core themes from these discussions. Results Participants identified barriers to the monitoring of service quality that included outdated modes of collecting data, personnel who were already burdened by paperwork, lack of time to collect data, and limited skills to analyse and interpret data. Participants recommended that developers engage with service providers in a participatory manner to ensure that service providers are invested in the proposed performance measurement system. Conclusion Findings show that substance abuse treatment providers are willing to adopt a performance measurement system and highlight several barriers that need to be addressed during system development in order to enhance the likelihood that this system will be successfully implemented. PMID:24499037

  1. Substance abuse treatment management information systems: balancing federal, state, and service provider needs.

    PubMed

    Camp, J M; Krakow, M; McCarty, D; Argeriou, M

    1992-01-01

    There is increased interest in documenting the characteristics and treatment outcomes of clients served with Alcohol, Drug Abuse, and Mental Health Block Grant funds. The evolution of federal client-based management systems for substance abuse treatment services demonstrates that data collection systems are important but require continued support. A review of the Massachusetts substance abuse management information system illustrates the utility of a client-based data set. The development and implementation of a comprehensive information system require overcoming organizational barriers and project delays, fostering collaborative efforts among staff from diverse agencies, and employing considerable resources. In addition, the need to develop mechanisms for increasing the reliability of the data and ongoing training for the users is presented. Finally, three applications of the management information system's role in shaping policy are reviewed: developing services for special populations (communities of color, women, and pregnant substance abusers, and injection drug users), utilizing MIS data for evaluation purposes, and determining funding allocations.

  2. Characterizing smoking, cessation services, and quit interest across outpatient substance abuse treatment modalities

    PubMed Central

    McClure, Erin A.; Acquavita, Shauna P.; Dunn, Kelly E.; Stoller, Kenneth B.; Stitzer, Maxine L.

    2013-01-01

    The majority of individuals seeking treatment for substance use disorders are cigarette smokers, yet smoking cessation is rarely addressed during treatment. Conducting a detailed smoking-related characterization of substance abuse treatment patients across treatment modalities may facilitate the development of tailored treatment strategies. This study administered a battery of self-report instruments to compare tobacco use, quit attempts, smoking knowledge and attitudes, program services, and interest in quitting among smoking patients enrolled in opioid replacement therapy (ORT) vs. non-opioid replacement (non-ORT). ORT compared with non-ORT participants smoked more heavily, had greater tobacco dependence, and endorsed greater exposure to smoking cessation services at their treatment programs. Favorable attitudes towards cessation during treatment were found within both groups. These data identify several potential clinical targets, most notably including confidence in abstaining and attitudes toward cessation pharmacotherapies that may be addressed by substance abuse treatment clinics. PMID:23988192

  3. Facility-level, state, and financial factors associated with changes in the provision of smoking cessation services in US substance abuse treatment facilities: Results from the National Survey of Substance Abuse Treatment Services 2006 to 2012.

    PubMed

    Cohn, Amy; Elmasry, Hoda; Niaura, Ray

    2017-06-01

    Cigarette smoking is common among patients in substance abuse treatment. Tobacco control programs have advocated for integrated tobacco dependence treatment into behavioral healthcare, including within substance abuse treatment facilities (SATFs) to reduce the public health burden of tobacco use. This study used data from seven waves (2006 to 2012) of the National Survey of Substance Abuse Treatment Services (n=94,145) to examine state and annual changes in the provision of smoking cessation services within US SATFs and whether changes over time could be explained by facility-level (private vs public ownership, receipt of earmarks, facility admissions, acceptance of government insurance) and state-level factors (cigarette tax per pack, smoke free policies, and percent of CDC recommended tobacco prevention spending). Results showed that the prevalence of SATFs offering smoking cessation services increased over time, from 13% to 65%. The amount of tax per cigarette pack, accepting government insurance, government (vs private) ownership, facility admissions, and CDC recommended tobacco prevention spending (per state) were the strongest correlates of the provision of smoking cessation programs in SATFs. Facilities that received earmarks were less likely to provide cessation services. Adult smoking prevalence and state-level smoke free policies were not significant correlates of the provision of smoking cessation services over time. Policies aimed at increasing the distribution of tax revenues to cessation services in SATFs may offset tobacco-related burden among those with substance abuse problems. Copyright © 2017. Published by Elsevier Inc.

  4. Organizational-level correlates of the provision of detoxification services and medication-based treatments for substance abuse in correctional institutions.

    PubMed

    Oser, Carrie B; Knudsen, Hannah K; Staton-Tindall, Michele; Taxman, Faye; Leukefeld, Carl

    2009-08-01

    In recent years, there has been an increased examination of organizational-level innovation adoption in substance abuse treatment organizations. However, the majority of these studies have focused on community-based treatment centers. One understudied area of the substance abuse treatment system is correctional institutions. This study uses the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) cooperative's National Criminal Justice Treatment Practices (NCJTP) survey to examine the adoption of detoxification services and pharmacotherapies for the treatment of substance abuse across a nationally representative sample of correctional institutions (n=198). There were significant differences between jails and prisons in the percentage of organizations offering detoxification services and medications. Specifically, detoxification services were offered by 5% of prisons and 34% of jails; and, medications were offered by 6% of prisons and 32% of jails. Binary logistic regression models were used to examine the associations between these services and organizational characteristics, including context, resources, previously introduced practices, culture, and systems integration. Variables measuring organizational context and previously introduced practices were significant correlates of the provision of both detoxification services and medications. Multivariate results indicated that the differences between jails and prisons remained significant after controlling for other organizational factors. Although the adoption of detoxification services and pharmacotherapies may be a controversial topic for correctional institutions, these services have the potential to improve offender well-being and reduce public health risks associated with substance abuse.

  5. Organizational-Level Correlates of the Provision of Detoxification Services and Medication-Based Treatments for Substance Abuse in Correctional Institutions

    PubMed Central

    Knudsen, Hannah K.; Staton-Tindall, Michele; Taxman, Faye; Leukefeld, Carl

    2009-01-01

    In recent years, there has been an increased examination of organizational-level innovation adoption in substance abuse treatment organizations. However, the majority of these studies have focused on community-based treatment centers. One understudied area of the substance abuse treatment system is correctional institutions. This study uses the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) cooperative’s National Criminal Justice Treatment Practices survey (NCJTP) to examine the adoption of detoxification services and pharmacotherapies for the treatment of substance abuse across a nationally representative sample of correctional institutions (n=198). There were significant differences between jails and prisons in the percentage of organizations offering detoxification services and medications. Specifically, detoxification services were offered by 5% of prisons and 34% of jails; and, medications were offered by 6% of prisons and 32% of jails. Binary logistic regression models were used to examine the associations between these services and organizational characteristics, including context, resources, previously introduced practices, culture, and systems integration. Variables measuring organizational context and previously introduced practices were significant correlates of the provision of both detoxification services and medications. Multivariate results indicated that the differences between jails and prisons remained significant after controlling for other organizational factors. Although the adoption of detoxification services and pharmacotherapies may be a controversial topic for correctional institutions, these services have the potential to improve offender well-being and reduce public health risks associated with substance abuse. PMID:19108957

  6. Social service offices as a point of entry into substance abuse treatment for poor South Africans

    PubMed Central

    2012-01-01

    Background In South Africa, district social service offices are often the first point of entry into the substance abuse treatment system. Despite this, little is known about the profile of people presenting with substance-related problems at these service points. This has a negative impact on treatment service planning. This paper begins to redress this gap through describing patterns of substance use and service needs among people using general social services in the Western Cape and comparing findings against the profile of persons attending specialist substance abuse treatment facilities in the region. Methods As part of a standard client information system, an electronic questionnaire was completed for each person seeking social assistance. Data on socio-demographic characteristics, the range of presenting problems, patterns of substance use, perceived consequences of substance use, as well as types of services provided were analysed for the 691 social welfare clients who reported substance use between 2007 and 2009. These data were compared against clients attending substance abuse treatment centres during the same time period. Results Findings indicate that social services offices are used as a way of accessing specialist services but are also used as a service point, especially by groups under-represented in the specialist treatment sector. Women, people from rural communities and people with alcohol-related problems are more likely to seek assistance at social service offices providing low threshold intervention services than from the specialist treatment sector. Conclusions The study provides evidence that social services are a point of entry and intervention for people from underserved communities in the Western Cape. If these low-threshold services can be supported to provide good quality services, they may be an effective and efficient way of improving access to treatment in a context of limited service availability. PMID:22642796

  7. How Outpatient Substance Abuse Treatment Unit Director Activities May Affect Provision of Community Outreach Services

    ERIC Educational Resources Information Center

    Chuang, Emmeline; Wells, Rebecca; Alexander, Jeffrey; Green, Sherri

    2013-01-01

    Aims: Community outreach services play an important role in infectious disease prevention and engaging drug users not currently in treatment. However, fewer than half of US substance abuse treatment units provide these services and many have little financial incentive to do so. Unit directors generally have latitude about scope of services,…

  8. Insights from a national survey into why substance abuse treatment units add prevention and outreach services

    PubMed Central

    Wells, Rebecca; Lemak, Christy Harris; D'Aunno, Thomas A

    2006-01-01

    Background Previous studies have found that even limited prevention-related interventions can affect health behaviors such as substance use and risky sex. Substance abuse treatment providers are ideal candidates to provide these services, but typically have little or no financial incentive to do so. The purpose of this study was therefore to explore why some substance abuse treatment units have added new prevention and outreach services. Based on an ecological framework of organizational strategy, three categories of predictors were tested: (1) environmental, (2) unit-level, and (3) unit leadership. Results A lagged cross-sectional logistic model of 450 outpatient substance abuse treatment units revealed that local per capita income, mental health center affiliation, and clinical supervisors' graduate degrees were positively associated with likelihood of adding prevention-related education and outreach services. Managed care contracts and methadone treatment were negatively associated with addition of these services. No hospital-affiliated agencies added prevention and outreach services during the study period. Conclusion Findings supported the study's ecological perspective on organizational strategy, with factors at environmental, unit, and unit leadership levels associated with additions of prevention and outreach services. Among the significant predictors, ties to managed care payers and unit leadership graduate education emerge as potential leverage points for public policy. In the current sample, units with managed care contracts were less likely to add prevention and outreach services. This is not surprising, given managed care's emphasis on cost control. However, the association with this payment source suggests that public managed care programs might affects prevention and outreach differently through revised incentives. Specifically, government payers could explicitly compensate substance abuse treatment units in managed care contracts for prevention and

  9. Insights from a national survey into why substance abuse treatment units add prevention and outreach services.

    PubMed

    Wells, Rebecca; Lemak, Christy Harris; D'Aunno, Thomas A

    2006-08-03

    Previous studies have found that even limited prevention-related interventions can affect health behaviors such as substance use and risky sex. Substance abuse treatment providers are ideal candidates to provide these services, but typically have little or no financial incentive to do so. The purpose of this study was therefore to explore why some substance abuse treatment units have added new prevention and outreach services. Based on an ecological framework of organizational strategy, three categories of predictors were tested: (1) environmental, (2) unit-level, and (3) unit leadership. A lagged cross-sectional logistic model of 450 outpatient substance abuse treatment units revealed that local per capita income, mental health center affiliation, and clinical supervisors' graduate degrees were positively associated with likelihood of adding prevention-related education and outreach services. Managed care contracts and methadone treatment were negatively associated with addition of these services. No hospital-affiliated agencies added prevention and outreach services during the study period. Findings supported the study's ecological perspective on organizational strategy, with factors at environmental, unit, and unit leadership levels associated with additions of prevention and outreach services. Among the significant predictors, ties to managed care payers and unit leadership graduate education emerge as potential leverage points for public policy. In the current sample, units with managed care contracts were less likely to add prevention and outreach services. This is not surprising, given managed care's emphasis on cost control. However, the association with this payment source suggests that public managed care programs might affects prevention and outreach differently through revised incentives. Specifically, government payers could explicitly compensate substance abuse treatment units in managed care contracts for prevention and outreach. The effects of

  10. Mothers in Substance Abuse Treatment: Differences in Characteristics Based on Involvement with Child Welfare Services

    ERIC Educational Resources Information Center

    Grella, Christine E.; Hser, Yih-Ing; Huang; Yu-Chuang

    2006-01-01

    Problem: Greater awareness of the role of parental substance abuse in child maltreatment makes it imperative that the substance abuse treatment and child welfare systems coordinate services for these parents. Yet little is known about the characteristics of child-welfare involved parents (primarily mothers) who enter into substance abuse…

  11. Implementing drug abuse treatment services in criminal justice settings: Introduction to the CJ-DATS study protocol series.

    PubMed

    Ducharme, Lori J; Chandler, Redonna K; Wiley, Tisha R A

    2013-12-01

    Despite a growing pipeline of effective clinical treatments, there remains a persistent research-to-practice gap in drug abuse services. Delivery of effective treatment services is especially lacking in the U.S. criminal justice system, where half of all incarcerated persons meet the need for drug abuse or dependence, yet few receive needed care. Structural, financial, philosophical and other barriers slow the pace of adoption of available evidence-based practices. These challenges led to the development of a multi-site cooperative research endeavor known as the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS), funded by the National Institute on Drug Abuse (NIDA). CJ-DATS engages university-based research teams, criminal justice agencies, and community-based treatment providers in implementation research studies to test strategies for enhancing treatment service delivery to offender populations. This Introduction reviews the mission of NIDA, the structure and goals of the CJ-DATS cooperative, and the implementation studies being conducted by the participating organizations. The component Study Protocols in this article collection are then described. CJ-DATS applies implementation science perspectives and methods to address a vexing problem - the need to link offender populations with effective treatment for drug abuse, HIV, and other related conditions for which they are at high risk. Applying these principles to the U.S. criminal justice system is an innovative extension of lessons that have been learned in mainstream healthcare settings. This collection is offered as both an introduction to NIDA's work in this area, as well as a window onto the challenges of conducting health services research in settings in which improving public health is not the organization's core mission.

  12. Alcohol Detoxification Completion, Acceptance of Referral to Substance Abuse Treatment, and Entry into Substance Abuse Treatment Among Alaska Native People

    PubMed Central

    Bear, Ursula Running; Beals, Janette; Novins, Douglas K.; Manson, Spero M.

    2016-01-01

    Background Little is known about factors associated with detoxification treatment completion and the transition to substance abuse treatment following detoxification among Alaska Native people. This study examined 3 critical points on the substance abuse continuum of care (alcohol detoxification completion, acceptance of referral to substance abuse treatment, entry into substance abuse treatment following detoxification). Methods The retrospective cohort included 383 adult Alaska Native patients admitted to a tribally owned and managed inpatient detoxification unit. Three multiple logistic regression models estimated the adjusted associations of each outcome separately with demographic/psychosocial characteristics, clinical characteristics, use related behaviors, and health care utilization. Results Seventy-five percent completed detoxification treatment. Higher global assessment functioning scores, longer lengths of stay, and older ages of first alcohol use were associated with completing detoxification. A secondary drug diagnosis was associated with not completing detoxification. Thirty-six percent accepted a referral to substance abuse treatment following detoxification. Men, those with legal problems, and those with a longer length of stay were more likely to accept a referral to substance abuse treatment. Fifty-eight percent had a confirmed entry into a substance abuse treatment program at discharge. Length of stay was the only variable associated with substance abuse treatment entry. Conclusions Services like motivational interviewing, counseling, development of therapeutic alliance, monetary incentives, and contingency management are effective in linking patients to services after detoxification. These should be considered, along with the factors associated with each point on the continuum of care when linking patients to follow-up services. PMID:27705843

  13. Determinants of hospital-based substance abuse treatment programs.

    PubMed

    Bell, R

    1994-01-01

    Experts agree that treatment is the best solution to substance abuse problems. As the societywide problem of drug and alcohol dependence increases, so does the need for treatment programs. Research has shown that many hospitals have entered into the substance abuse treatment program business because a need for quality programs exists and because an alcohol and a substance abuse treatment product line has the potential for increasing sagging revenues. This article addresses the question of what types of hospitals are likely to engage in providing inpatient and/or outpatient treatment programs. The results indicate that organizational size (measured by the number of beds) is the best predictor of treatment service provision for both inpatient and outpatient settings, with larger hospitals being more likely to provide substance abuse programs. A need for additional chemical dependency treatment programs does not appear to be the primary motivating factor for hospitals developing this service. Rather, it seems hospitals provide these programs for other reasons--as part of providing a full array of services, as an average toward achieving organizational goals, as a means of sustaining a competitive advantage, or as a strategy for maintaining the same level of service as the competition.

  14. Effect of insurance parity on substance abuse treatment.

    PubMed

    Azzone, Vanessa; Frank, Richard G; Normand, Sharon-Lise T; Burnam, M Audrey

    2011-02-01

    This study examined the impact of insurance parity on the use, cost, and quality of substance abuse treatment. The authors compared substance abuse treatment spending and utilization from 1999 to 2002 for continuously enrolled beneficiaries covered by Federal Employees Health Benefit (FEHB) plans, which require parity coverage of mental health and substance use disorders, with spending and utilization among beneficiaries in a matched set of health plans without parity coverage. Logistic regression models estimated the probability of any substance abuse service use. Conditional on use, linear models estimated total and out-of-pocket spending. Logistic regression models for three quality indicators for substance abuse treatment were also estimated: identification of adult enrollees with a new substance abuse diagnosis, treatment initiation, and treatment engagement. Difference-in-difference estimates were computed as (postparity - preparity) differences in outcomes in plans without parity subtracted from those in FEHB plans. There were no significant differences between FEHB and non-FEHB plans in rates of change in average utilization of substance abuse services. Conditional on service utilization, the rate of substance abuse treatment out-of-pocket spending declined significantly in the FEHB plans compared with the non-FEHB plans (mean difference=-$101.09, 95% confidence interval [CI]=-$198.06 to -$4.12), whereas changes in total plan spending per user did not differ significantly. With parity, more patients had new diagnoses of a substance use disorder (difference-in-difference risk=.10%, CI=.02% to .19%). No statistically significant differences were found for rates of initiation and engagement in substance abuse treatment. Findings suggest that for continuously enrolled populations, providing parity of substance abuse treatment coverage improved insurance protection but had little impact on utilization, costs for plans, or quality of care.

  15. Childhood sexual abuse and substance abuse treatment utilization among substance-dependent incarcerated women.

    PubMed

    Peltan, Jessica R; Cellucci, Tony

    2011-10-01

    Incarcerated women have high rates of substance abuse problems and trauma. A variety of variables may influence whether these women seek help or are referred for substance abuse problems. This study reports an exploratory project on service utilization among incarcerated substance-dependent women (N = 40) in southeastern Idaho. Using self-report and interview tools, most participants reported some substance abuse treatment history, although extent and types of treatment varied. Most of the women also reported some type of childhood abuse. Age, income, and consequences of alcohol and other drug use related positively to substance abuse treatment. However, severity of childhood sexual abuse and current trauma symptoms were negatively correlated with substance abuse treatment episodes. These women may use substances to cope with childhood trauma or may not perceive the substance abuse system as responsive to their co-occurring trauma symptoms. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Reforming Dutch substance abuse treatment services.

    PubMed

    Schippers, Gerard M; Schramade, Mark; Walburg, Jan A

    2002-01-01

    The Dutch substance abuse treatment system is in the middle of a major reorganization. The goal is to improve outcomes by redesigning all major primary treatment processes and by implementing a system of regular monitoring and feedback of clinical outcome data. The new program includes implementing standardized psychosocial behavior-oriented treatment modalities and a stepped-care patient placement algorithm in a core-shell organizational model. This article outlines the new program and presents its objectives, developmental stages, and current status.

  17. Treatment Needs and Services for Mothers with a Dual Diagnosis: Substance Abuse and Mental Illness.

    ERIC Educational Resources Information Center

    Morris, Sylvia K.; Schinke, Steven P.

    1990-01-01

    Reviews treatment needs of dual diagnosed, substance abusing and mentally ill mothers. Suggests treatment strategies and programmatic options for serving and meeting needs of these mothers and their children. Devotes particular attention to residential and continuing care services and skills-based interventions for target clients. Concludes with…

  18. The adoption of wraparound services among substance abuse treatment organizations serving criminal offenders: The role of a women-specific program.

    PubMed

    Oser, Carrie; Knudsen, Hannah; Staton-Tindall, Michele; Leukefeld, Carl

    2009-08-01

    Women's substance abuse treatment outcomes are improved when women-specific needs are addressed through wraparound services, such as the provision of child care, employment assistance, or mental health counseling. Despite a higher prevalence of pre-incarceration drug use, women in prison report receiving fewer services than their male counterparts, suggesting they likely have greater service needs upon release. It is unknown whether community-based treatment organizations with a women-specific program offer more wraparound services than programs without a focus on women. This study uses data from the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) research cooperative's National Criminal Justice Treatment Practices Survey (NCJTPS), a nationally representative sample of community-based treatment programs serving predominantly criminal offenders (n=217). First, bivariate analyses identified differences between organizations with and without a women-specific program on the number of wraparound services adopted as well as organizational-level characteristics (i.e., organizational structure, personnel characteristics, culture, sources of information, and systems integration) related to their adoption. Second, Poisson regression was used to identify the organizational characteristics associated with the number of adopted wraparound services, with having a women-specific program being the primary covariate of interest. Results indicate larger organizations that utilized a greater number of treatment approaches and believed that treatment could reduce crime were more likely to offer a greater assortment of wraparound services. In an effort to improve behavioral treatment outcomes, it is imperative to examine organizational-level contextual factors that shape the availability of wraparound services for female offenders in community-based substance abuse treatment settings.

  19. The Adoption of Wraparound Services among Substance Abuse Treatment Organizations Serving Criminal Offenders: The Role of a Women-Specific Program

    PubMed Central

    Knudsen, Hannah; Staton-Tindall, Michele; Leukefeld, Carl

    2009-01-01

    Women’s substance abuse treatment outcomes are improved when women-specific needs are addressed through wraparound services, such as the provision of child care, employment assistance, or mental health counseling. Despite a higher prevalence of pre-incarceration drug use, women in prison report receiving fewer services than their male counterparts, suggesting they likely have greater service needs upon release. It is unknown whether community-based treatment organizations with a women-specific program offer more wraparound services than programs without a focus on women. This study uses data from the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) research cooperative’s National Criminal Justice Treatment Practices Survey (NCJTPS), a nationally representative sample of community-based treatment programs serving predominantly criminal offenders (n = 217). First, bivariate analyses identified differences between organizations with and without a women-specific program on the number of wraparound services adopted as well as organizational-level characteristics (i.e., organizational structure, personnel characteristics, culture, sources of information, and systems integration) related to their adoption. Second, Poisson regression was used to identify the organizational characteristics associated with the number of adopted wraparound services, with having a women-specific program being the primary covariate of interest. Results indicate larger organizations that utilized a greater number of treatment approaches and believed that treatment could reduce crime were more likely to offer a greater assortment of wraparound services. In an effort to improve behavioral treatment outcomes, it is imperative to examine organizational-level contextual factors that shape the availability of wraparound services for female offenders in community-based substance abuse treatment settings. PMID:19181457

  20. The economics of public health: financing drug abuse treatment services.

    PubMed

    Cartwright, William S; Solano, Paul L

    2003-12-01

    Drug abuse treatment financing exhibits a heterogeneous set of sources from federal, state, and local governments, as well as private sources from insurance, patient out-of-pocket, and charity. A public health model of drug abuse treatment is presented for a market that can be characterized by excess demand in many communities and an implied policy of rationing. According to best estimates, as many as 6.7 million individuals may need treatment, but only an estimated 1.5 million individuals actually participated in treatment episodes. Since, as demonstrated empirically, drug abuse treatment has a robust and positive social net benefit to society, it is perplexing that treatment financing stops with a rationing outcome that inhibits social welfare. The justification for public financing is centered on the external costs of drug addiction, but subsidization is grounded in the reality that a large number of addicted individuals do not have sufficient resources to pay for treatment out-of-pocket, nor do they have private insurance coverage. Social welfare losses are generated by financial arrangements that are inconsistent with rational budgeting theory and as such would lead to non-optimal organization and management of the drug abuse treatment system.

  1. Treatment Programs in the National Drug Abuse Treatment Clinical Trials Network

    PubMed Central

    McCarty, Dennis; Fuller, Bret; Kaskutas, Lee Ann; Wendt, William W.; Nunes, Edward V.; Miller, Michael; Forman, Robert; Magruder, Kathryn M.; Arfken, Cynthia; Copersino, Marc; Floyd, Anthony; Sindelar, Jody; Edmundson, Eldon

    2008-01-01

    Drug abuse treatment programs and university-based research centers collaborate to test emerging therapies for alcohol and drug disorders in the National Drug Abuse Treatment Clinical Trials Network (CTN). Programs participating in the CTN completed organizational (n = 106 of 112; 95% response rate) and treatment unit surveys (n = 348 of 384; 91% response rate) to describe the levels of care, ancillary services, patient demographics, patient drug use and co-occurring conditions. Analyses describe the corporations participating in the CTN and provide an exploratory assessment of variation in treatment philosophies. A diversity of treatment centers participate in the CTN; not for profit organizations with a primary mission of treating alcohol and drug disorders dominate. Compared to N-SSATS (National Survey of Substance Abuse Treatment Services), programs located in medical settings are over-represented and centers that are mental health clinics are under-represented. Outpatient, methadone, long-term residential and inpatient treatment units differed on patients served and services proved. Larger programs with higher counselor caseloads in residential settings reported more social model characteristics. Programs with higher social model scores were more likely to offer self-help meetings, vocational services and specialized services for women. Conversely, programs with accreditation had less social model influence. The CTN is an ambitious effort to engage community-based treatment organizations into research and more fully integrate research and practice. PMID:17875368

  2. Competing values among criminal justice administrators: The importance of substance abuse treatment.

    PubMed

    Henderson, Craig E; Taxman, Faye S

    2009-08-01

    This study applied latent class analysis (LCA) to examine heterogeneity in criminal justice administrators' attitudes toward the importance of substance abuse treatment relative to other programs and services commonly offered in criminal justice settings. The study used data collected from wardens, probation and/or parole administrators, and other justice administrators as part of the National Criminal Justice Treatment Practices survey (NCJTP), and includes both adult criminal and juvenile justice samples. Results of the LCA suggested that administrators fell into four different latent classes: (1) those who place a high importance on substance abuse treatment relative to other programs and services, (2) those who place equal importance on substance abuse treatment and other programs and services, (3) those who value other programs and services moderately more than substance abuse treatment, and (4) those who value other programs and services much more than substance abuse treatment. Latent class membership was in turn associated with the extent to which evidence-based substance abuse treatment practices were being used in the facilities, the region of the country in which the administrator worked, and attitudes toward rehabilitating drug-using offenders. The findings have implications for future research focused on the impact that administrators' attitudes have on service provision as well as the effectiveness of knowledge dissemination and diffusion models.

  3. Group treatment for men with intellectual disability and sexually abusive behaviour: service user views.

    PubMed

    Hays, Sarah-Jane; Murphy, Glynis H; Langdon, Peter E; Rose, David; Reed, Tracy

    2007-06-01

    Men with intellectual disability (ID) and sexually abusive behaviour are a disempowered and marginalised group. Nevertheless, as service users, they can be consulted and involved in a variety of different ways, including ascertaining their views of the services they receive. A group of 16 men with ID and sexually abusive behaviour were interviewed to ascertain their views approximately 2 months after completing a 1-year group cognitive behavioural treatment (CBT) for sexual offending. Two raters independently reviewed interview transcripts and participant responses were summarised. The most salient components of treatment recalled by participants were: sex education; legal and illegal behaviours and their consequences; and discussions about specific sexual assaults. Only 3 of the 16 participants stated that they had problems with sexual offending, and only 1 identified that he had learnt about victim empathy, although this is an important component of treatment. Having support, the knowledge that they had the same problems as other group members, and talking through problems, were appreciated as some of the "best things" about the group, while the "worst things" were generally person-specific. Participants had mixed views on talking about their own offences during group sessions and, overall, viewed the experience as difficult but helpful. Valuable insights into the aspects of treatment that group members found useful were explored. Such insights are often not captured by studies that assess the efficacy of treatment models using treatment-specific measures only, and these are important in defining the quality of services provided.

  4. Addressing the service linkage problem. Increasing substance abuse treatment engagement using personalized feedback interventions in heavy-using female domestic violence shelter residents.

    PubMed

    Ogle, Richard L; Baer, John S

    2003-11-01

    Two personalized substance abuse assessment and feedback interventions were tested for effectiveness in engaging female domestic violence shelter residents in substance abuse treatment. One hundred forty-seven residents were assessed for quantity andfrequency of substance use, negative consequences due to use, motivation to change substance use behavior, and psychopathological symptoms related to substance abuse. Assessment identified (33) 22% of participants as heavy substance users. Twenty of the 33 heavy-using residents received one of two personalized substance use feedback interventions:face-to-face feedback or writtenfeedbackplaced in shelter mailboxes. Treatment engagement was defined as attending at least one substance abuse treatment session within 30 days after the intervention. Results showed a significant difference in treatment engagement rates in favor of the face-to-face feedback group (60% vs. 0%). The results provide preliminary data suggesting that substance abuse assessment can be effectively accomplished in the shelter environment and that the face-to-face feedback procedure may be an effective intervention to bridge the service linkage problem between domestic violence services and substance abuse treatment.

  5. 75 FR 47819 - Center for Substance Abuse Treatment; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-09

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment; Notice of Meeting Pursuant to Public Law 92-463, notice is hereby given that the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance...

  6. 75 FR 38112 - Center for Substance Abuse Treatment; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment; Notice of Meeting Pursuant to Public Law 92-463, notice is hereby given that the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance...

  7. 78 FR 37560 - Center for Substance Abuse Treatment; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment; Notice of Meeting Pursuant to Public Law 92-463, notice is hereby given that the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance...

  8. 75 FR 16488 - Center for Substance Abuse Treatment; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment; Notice of Meeting Pursuant to Public Law 92-463, notice is hereby given of the meeting of the Substance Abuse and Mental Health Services Administration's Center for...

  9. 75 FR 16487 - Center for Substance Abuse Treatment; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-01

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment; Notice of Meeting Pursuant to Public Law 92-463, notice is hereby given of the meeting of the Substance Abuse and Mental Health Services Administration's Center for...

  10. Substance Abuse Treatment for Persons with Co-Occurring Disorders. Treatment Improvement Protocol (TIP) Series 42

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration, 2005

    2005-01-01

    Treatment Improvement Protocols (TIPs), developed by the Center for Substance Abuse Treatment (CSAT), part of the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services (DHHS), are best-practice guidelines for the treatment of substance use disorders. CSAT draws on the experience…

  11. What Oregon's parity law can tell us about the federal Mental Health Parity and Addiction Equity Act and spending on substance abuse treatment services.

    PubMed

    McConnell, K John; Ridgely, M Susan; McCarty, Dennis

    2012-08-01

    The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) requires commercial group health plans offering coverage for mental health and substance abuse services to offer those services at a level that is no more restrictive than for medical-surgical services. The MHPAEA is notable in restricting the extent to which health plans can use managed care tools on the behavioral health benefit. The only precedent for this approach is Oregon's 2007 state parity law. This study aims to provide evidence on the effect of comprehensive parity on utilization and expenditures for substance abuse treatment services. A difference-in-difference analysis compared individuals in five Oregon commercial plans (n=103,820) from 2005 to 2008 to comparison groups exempt from parity in Oregon (n=19,633) and Washington (n=39,447). The primary outcome measures were annual use and total expenditures. Spending for alcohol treatment services demonstrated statistically significant increase in comparison to the Oregon and Washington comparison groups. Spending on other drug abuse treatment services was not associated with statistically significant spending increases, and the effect of parity on overall spending (alcohol plus other drug abuse treatment services) was positive but not statistically significant from zero. Oregon's experience suggests that behavioral health insurance parity that places restrictions on how plans manage the benefit may lead to increases in expenditures for alcohol treatment services but is unlikely to lead to increases in spending for other drug abuse treatment services. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  12. Utilization of emergency and hospital services among individuals in substance abuse treatment

    PubMed Central

    2014-01-01

    Background To examine risk factors for use of hospital services among racial and ethnic minority clients in publicly funded substance abuse treatment in Los Angeles County, California. We explored cross-sectional annual data (2006 to 2009) from the Los Angeles County Participant Reporting System for adult participants (n = 73,251) who received services from treatment programs (n = 231). Methods This retrospective analysis of county admission data relied on hierarchical linear negative binomial regression models to explore number of hospital visits, accounting for clients nested in programs. Client data were collected during personal interviews at admission. Findings Our findings support previous work that noted increased use of emergency rooms among individuals suffering from mental health- and substance use-related issues and extend the knowledge base by highlighting other important features such as treatment need, i.e., residential compared to outpatient treatment. Conclusions These findings have implications for health care policy in terms of the need to increase prevention services and reduce costly hospitalization for a population at significant risk of co-occurring mental and physical disorders. PMID:24708866

  13. Substance abuse treatment services for pregnant women: psychosocial and behavioral approaches.

    PubMed

    Haug, Nancy A; Duffy, Megan; McCaul, Mary E

    2014-06-01

    Women who use tobacco, alcohol and drugs during pregnancy are at increased risk of maternal and fetal morbidity. Universal screening using empirically validated approaches can improve identification of substance-using pregnant women and facilitate comprehensive assessment of treatment needs. There is strong evidence for effectiveness of psychosocial and behavioral substance abuse treatments across a range of intensities and levels of care. In addition to addressing substance use, services for co-occurring psychiatric disorders, trauma exposure, and prenatal care are important components of coordinated systems of care. More research on and greater access to evidence-based interventions is needed for this underserved population. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Competing Values Among Criminal Justice Administrators: The Importance of Substance Abuse Treatment*

    PubMed Central

    Henderson, Craig E.; Taxman, Faye S.

    2009-01-01

    This study applied latent class analysis (LCA) to examine heterogeneity in criminal justice administrators’ attitudes toward the importance of substance abuse treatment relative to other programs and services commonly offered in criminal justice settings. The study used data collected from wardens, probation and/or parole administrators, and other justice administrators as part of the National Criminal Justice Treatment Practices survey (NCJTP), and includes both adult criminal and juvenile justice samples. Results of the LCA suggested that administrators fell into four different latent classes: (1) those who place a high importance on substance abuse treatment relative to other programs and services, (2) those who place equal importance on substance abuse treatment and other programs and services, (3) those who value other programs and services moderately more than substance abuse treatment, and (4) those who value other programs and services much more than substance abuse treatment. Latent class membership was in turn associated with the extent to which evidence-based substance abuse treatment practices were being used in the facilities, the region of the country in which the administrator worked, and attitudes toward rehabilitating drug-using offenders. The findings have implications for future research focused on the impact that administrators’ attitudes have on service provision as well as the effectiveness of knowledge dissemination and diffusion models. PMID:19054632

  15. 29 CFR 825.119 - Leave for treatment of substance abuse.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 3 2014-07-01 2014-07-01 false Leave for treatment of substance abuse. 825.119 Section 825... Leave for treatment of substance abuse. (a) Substance abuse may be a serious health condition if the... substance abuse by a health care provider or by a provider of health care services on referral by a health...

  16. 29 CFR 825.119 - Leave for treatment of substance abuse.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 3 2013-07-01 2013-07-01 false Leave for treatment of substance abuse. 825.119 Section 825... Leave for treatment of substance abuse. (a) Substance abuse may be a serious health condition if the... substance abuse by a health care provider or by a provider of health care services on referral by a health...

  17. 29 CFR 825.119 - Leave for treatment of substance abuse.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Leave for treatment of substance abuse. 825.119 Section 825... Leave for treatment of substance abuse. (a) Substance abuse may be a serious health condition if the... substance abuse by a health care provider or by a provider of health care services on referral by a health...

  18. 29 CFR 825.119 - Leave for treatment of substance abuse.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 3 2012-07-01 2012-07-01 false Leave for treatment of substance abuse. 825.119 Section 825... Leave for treatment of substance abuse. (a) Substance abuse may be a serious health condition if the... substance abuse by a health care provider or by a provider of health care services on referral by a health...

  19. 29 CFR 825.119 - Leave for treatment of substance abuse.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 3 2011-07-01 2011-07-01 false Leave for treatment of substance abuse. 825.119 Section 825... Leave for treatment of substance abuse. (a) Substance abuse may be a serious health condition if the... substance abuse by a health care provider or by a provider of health care services on referral by a health...

  20. Rural Child Sexual Abuse Prevention and Treatment.

    ERIC Educational Resources Information Center

    Ray, JoAnn; Murty, Susan A.

    1990-01-01

    Reviews literature on rural child sexual abuse and treatment. Surveys providers in rural Washington treatment programs. Responses describe agency characteristics, services, delivery problems, and suggested solutions. Reports providers' perceptions of service quality and interagency cooperation. Cites as problems heavy caseloads, lack of staff, and…

  1. Effectiveness of substance abuse treatment programming for women: a review.

    PubMed

    Ashley, Olivia Silber; Marsden, Mary Elen; Brady, Thomas M

    2003-01-01

    Recent research has shown that women and men differ in substance abuse etiology, disease progression, and access to treatment for substance abuse. Substance abuse treatment specifically designed for women has been proposed as one way to meet women's distinctive needs and reduce barriers to their receiving and remaining in treatment. However, relatively few substance abuse treatment programs offer specialized services for women, and effectiveness has not been fully evaluated. This article reviews the literature on the extent and effectiveness of substance abuse treatment programming for women and provides an overview of what is known about the components of successful treatment programs for women. Thirty-eight studies of the effect on treatment outcomes of substance abuse treatment programming for women were reviewed. Seven were randomized, controlled trials, and 31 were nonrandomized studies. In our review, six components of substance abuse treatment programming for women were examined: child care, prenatal care, women-only programs, supplemental services and workshops that address women-focused topics, mental health programming, and comprehensive programming. The studies found positive associations between these six components and treatment completion, length of stay, decreased use of substances, reduced mental health symptoms, improved birth outcomes, employment, self-reported health status, and HIV risk reduction. These findings suggest that to improve the future health and well-being of women and their children, there is a continued need for well-designed studies of substance abuse treatment programming for women.

  2. 78 FR 15961 - Center for Substance Abuse Treatment National Advisory Council; Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-13

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment National Advisory Council; Meeting Pursuant to Public Law 92-463, notice is hereby given of the meeting of the Substance Abuse and Mental Health Services Administration's...

  3. Substance abuse treatment as HIV prevention: more questions than answers.

    PubMed

    Brown, Lawrence S; Kritz, Steven; Bini, Edmund J; Louie, Ben; Robinson, Jim; Alderson, Donald; Rotrosen, John

    2010-12-01

    This report examines associations between the availability of human immunodeficiency virus (HIV)-related health services in substance abuse treatment programs and characteristics of the programs and the patients they serve. In a cross-sectional, descriptive design and via a validated survey, program administrators within the National Drug Abuse Treatment Clinical Trials Network provided information on program characteristics, patient characteristics (rates of risky sexual and drug behaviors and HIV infection), and the availability of 31 different HIV-related health services. Of 319 programs, 84% submitted surveys. Service availability rates ranged from: 10% (pneumococcal vaccination) to 86% (drug testing) for the 6 HIV-related services offered to all patients, 13% (Pap smear for women) to 54% (tuberculin skin testing) for the 6 services offered to new patients, 2% (sterile injection equipment) to 64% (male condoms) for the 4 risk-reduction services, 37% (Pap smear for women) to 61% (tuberculin skin testing) for the 11 biological assessments offered to HIV-positive patients, and 33% (medical treatments) to 52% (counseling) for the 4 other services offered to HIV-positive patients. The availability of these HIV-related services was associated with clinical settings, the types of addiction treatment services, the rates of risky drug and sexual behaviors, and HIV infection rates among patients. Availability of such services was below published guidelines. While the results provide another basis for the infection-related prevention benefits of substance abuse treatment, the variability in the availability of HIV-related health care deserves further study and has health policy implications in determining how to utilize substance abuse treatment in reducing drug-related HIV transmission.

  4. Neighborhood Alcohol Outlet Density and Rates of Child Abuse and Neglect: Moderating Effects of Access to Substance Abuse Services

    PubMed Central

    Morton, Cory M.; Simmel, Cassandra; Peterson, N. Andrew

    2014-01-01

    This study investigates the relationship between concentrations of on- and off-premises alcohol outlets and rates of child abuse and neglect. Additionally, the study seeks to locate protective features of a neighborhood's built environment by investigating the potentially moderating role that access to substance abuse treatment and prevention services plays in the relationship between alcohol outlet density and child maltreatment. Using a cross-sectional design, this ecological study utilized data from 163 census tracts in Bergen County, New Jersey, on reports of child abuse and neglect, alcohol outlets, substance abuse treatment and prevention facilities, and the United States Census to investigate the linkages between socioeconomic structure, alcohol availability, and access to substance abuse service facilities on rates of child abuse and neglect. Findings indicate areas with a greater concentration of on-premises alcohol outlets (i.e., bars) had higher rates of child neglect, and those with easier access to substance abuse services had lower rates of neglect, controlling for neighborhood demographic and socioeconomic structure. Additionally, the relationship between on-premises alcohol outlet density and rates of child neglect was moderated by the presence of substance abuse service facilities. A greater concentration of off-premises outlets (i.e., liquor stores) was associated with lower rates of physical abuse. Findings suggest that the built environment and socioeconomic structure of neighborhoods have important consequences for child well-being. The implications for future research on the structural features of neighborhoods that are associated with child well-being are discussed. PMID:24529493

  5. Culturally competent substance abuse treatment with transgender persons.

    PubMed

    Nuttbrock, Larry A

    2012-01-01

    Transgender individuals are misunderstood and inadequately treated in many conventional substance abuse treatment programs. This article reviews current concepts regarding the definition and diversity of transgenderism and summarizes the existing literature on the prevalence and correlates of substance use in transgendered populations. Examples of culturally competent and gender-sensitive treatment in specialized settings are cited, with a call to extend these initiatives throughout the gamut of service venues that engage transgender individuals. Cultural competence combined with gender sensitivity should improve the effectiveness of substance abuse treatment for transgender individuals and will contribute to the goal of providing effective services in an increasingly diverse society.

  6. Neighborhood alcohol outlet density and rates of child abuse and neglect: moderating effects of access to substance abuse services.

    PubMed

    Morton, Cory M; Simmel, Cassandra; Peterson, N Andrew

    2014-05-01

    This study investigates the relationship between concentrations of on- and off-premises alcohol outlets and rates of child abuse and neglect. Additionally, the study seeks to locate protective features of a neighborhood's built environment by investigating the potentially moderating role that access to substance abuse treatment and prevention services plays in the relationship between alcohol outlet density and child maltreatment. Using a cross-sectional design, this ecological study utilized data from 163 census tracts in Bergen County, New Jersey, on reports of child abuse and neglect, alcohol outlets, substance abuse treatment and prevention facilities, and the United States Census to investigate the linkages between socioeconomic structure, alcohol availability, and access to substance abuse service facilities on rates of child abuse and neglect. Findings indicate areas with a greater concentration of on-premises alcohol outlets (i.e., bars) had higher rates of child neglect, and those with easier access to substance abuse services had lower rates of neglect, controlling for neighborhood demographic and socioeconomic structure. Additionally, the relationship between on-premises alcohol outlet density and rates of child neglect was moderated by the presence of substance abuse service facilities. A greater concentration of off-premises outlets (i.e., liquor stores) was associated with lower rates of physical abuse. Findings suggest that the built environment and socioeconomic structure of neighborhoods have important consequences for child well-being. The implications for future research on the structural features of neighborhoods that are associated with child well-being are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Measurement of gender-sensitive treatment for women in mixed-gender substance abuse treatment programs.

    PubMed

    Tang, Zhiqun; Claus, Ronald E; Orwin, Robert G; Kissin, Wendy B; Arieira, Carlos

    2012-06-01

    Gender-sensitive (GS) substance abuse treatment services have emerged in response to the multidimensional profile of problems that women display upon admission to substance abuse treatment. The present study examines the extent to which treatment programs vary in GS programming for women in real-world mixed-gender treatment settings, where most women are treated. Data were collected through site visits using semi-structured interviews with program directors, clinical directors, and counselors in 13 mixed-gender treatment programs from Washington State. Rasch modeling techniques were used to analyze the data. Naturally occurring variation was revealed within and across the treatment programs, and demonstrated that reliable measures of three GS domains (Grella, 2008) can be constructed despite a small number of programs. This is the first study to quantify GS treatment for substance abusing women. The identified treatment services and practices and the way they clustered together to form scales have practical implications for researchers, service providers, clinicians, and policy makers. The scales can be used to study treatment outcomes and to evaluate the effectiveness, cost-effectiveness, and cost-benefit of GS programming for women. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  8. Characteristics of lesbian, gay, bisexual, and transgender individuals entering substance abuse treatment.

    PubMed

    Cochran, Bryan N; Cauce, Ana Mari

    2006-03-01

    Previous research has suggested that lesbian, gay, bisexual, and transgender (LGBT) individuals enter treatment for substance abuse with more severe problems than heterosexual individuals. However, methodological difficulties, particularly the difficulty of obtaining a representative sample, have limited the ability to draw conclusions about LGBT individuals who receive services for substance abuse. This study took advantage of a unique opportunity to examine a representative sample of openly LGBT clients receiving publicly funded substance abuse treatment by using data gathered by treatment providers in Washington State. Baseline differences between openly LGBT and heterosexual clients were compared in a variety of domains. Results demonstrated that openly LGBT clients enter treatment with more severe substance abuse problems, greater psychopathology, and greater medical service utilization when compared with heterosexual clients. When the analyses were stratified based on sex, different patterns of substance use and associated psychosocial characteristics emerged for the LGBT clients. Implications for provision of appropriate services and recommendations to treatment agencies are discussed in this article.

  9. Characteristics of Transgender Individuals Entering Substance Abuse Treatment

    PubMed Central

    Heck, Nicholas C.; Sorensen, James L.

    2014-01-01

    Little is known about the needs or characteristics of transgender individuals in substance abuse treatment settings. Transgender (n=199) and non-transgender (cisgender, n=13440) individuals were compared on psychosocial factors related to treatment, health risk behaviors, medical and mental health status and utilization, and substance use behaviors within a database that documented individuals entering substance abuse treatment in San Francisco, CA from 2007–2009 using logistic and linear regression analyses (run separately by identified gender). Transgender men (assigned birth sex of female) differed from cisgender men across many psychosocial factors, including having more recent employment, less legal system involvement, greater incidence of living with a substance abuser, and greater family conflict, while transgender women (assigned birth sex of male) were less likely to have minor children than cisgender women. Transgender women reported greater needle use and HIV testing rates were greater among transgender women. Transgender men and women reported higher rates of physical health problems, mental health diagnoses, and psychiatric medications but there were no differences in service utilization. There were no differences in substance use behaviors except that transgender women were more likely to endorse primary methamphetamine use. Transgender individuals evidence unique strengths and challenges that could inform targeted services in substance abuse treatment. PMID:24561017

  10. Substance Abuse and Mental Health Services Administration. March/April 2008

    ERIC Educational Resources Information Center

    Goodman, Deborah, Ed.

    2008-01-01

    "SAMHSA News" is the national newsletter of the Substance Abuse and Mental Health Services Administration. Published six times a year (bimonthly) by SAMHSA's Office of Communications, SAMHSA News contains information about the latest substance abuse and mental health treatment and prevention practices, recent statistics on mental health and…

  11. [Treatment program for dual-diagnosis substance abusers].

    PubMed

    Kandel, Isack

    2007-01-01

    Dual-diagnosis mentally ill patients, i.e. those characterized with substance abuse problems combined with mental health problems, are a challenge both for systems treating substance abusers and for mental health services. These patients are not easily integrated in either of these healthcare systems and/or are treated only for one aspect of their problem by each of these systems. For such patients it is necessary to create a separate treatment model, combining care of the problem of substance abuse and attention to the patient's mental pathology, according to his individual personality traits. For purposes of this programme a treatment setting operating on the model of a therapeutic community is proposed. This setting will open an affiliated treatment programme for dual-diagnosed patients in a separate treatment programme that is not part of the therapeutic community but will be affiliated with it and will accept dual-diagnosis patients.

  12. Do adult mental health services identify child abuse and neglect? A systematic review.

    PubMed

    Read, John; Harper, David; Tucker, Ian; Kennedy, Angela

    2018-02-01

    Child abuse and neglect play a causal role in many mental health problems. Knowing whether users of mental health services were abused or neglected as children could be considered essential for developing comprehensive formulations and effective treatment plans. In the present study we report the findings of a systematic review, using independent searches of three databases designed to discover how often mental health staff find out whether their clients were abused or neglected as children. Twenty-one relevant studies were identified. Most people who use mental health services are never asked about child abuse or neglect. The majority of cases of child abuse or neglect are not identified by mental health services. Only 28% of abuse or neglect cases identified by researchers are found in the clients' files: emotional abuse, 44%; physical abuse, 33%; sexual abuse, 30%; emotional neglect, 17%; and physical neglect, 10%. Between 0% and 22% of mental health service users report being asked about child abuse. Men and people diagnosed with psychotic disorders are asked less than other people. Male staff ask less often than female staff. Some improvement over time was found. Policies compelling routine enquiry, training, and trauma-informed services are required. © 2017 Australian College of Mental Health Nurses Inc.

  13. Vocational Rehabilitation in Substance Abuse Treatment Programs

    ERIC Educational Resources Information Center

    Machlan, Bonna; Brostrand, H. L.; Benshoff, John J.

    2004-01-01

    Research indicates that those who undergo treatment for alcohol and other drug abuse largely have poor work histories and low employment rates, regardless of their education. Relapse rates for individuals in recovery increase when unemployment remains a constant in their lives. Consequently, providing vocational services during treatment may be a…

  14. A rationale and model for addressing tobacco dependence in substance abuse treatment.

    PubMed

    Richter, Kimber P; Arnsten, Julia H

    2006-08-14

    Most persons in drug treatment smoke cigarettes. Until drug treatment facilities systematically treat their patients' tobacco use, millions will flow through the drug treatment system, overcome their primary drug of abuse, but die prematurely from tobacco-related illnesses. This paper reviews the literature on the health benefits of quitting smoking for drug treatment patients, whether smoking causes relapse to other drug or alcohol abuse, the treatment of tobacco dependence, and good and bad times for quitting smoking among drug treatment patients. It also presents a conceptual model and recommendations for treating tobacco in substance abuse treatment, and provides references to internet and paper-copy tools and information for treating tobacco dependence. At present, research on tobacco treatment in drug treatment is in its infancy. Although few drug treatment programs currently offer formal services, many more will likely begin to treat nicotine dependence as external forces and patient demand for these services increases. In the absence of clear guidelines and attention to quality of care, drug treatment programs may adopt smoking cessation services based on cost, convenience, or selection criteria other than efficacy. Because research in this field is relatively new, substance abuse treatment professionals should adhere to the standards of care for the general population, but be prepared to update their practices with emerging interventions that have proven to be effective for patients in drug treatment.

  15. Evolution of Women's Trauma-Integrated Services at the Substance Abuse and Mental Health Services Administration

    ERIC Educational Resources Information Center

    Salasin, Susan E.

    2005-01-01

    In this article a historical overview of the evolution of the Women's Trauma Integrated Services model at the Substance Abuse and Mental Health Services Administration (SAMHSA) is presented. Milestones in women's services policy development at SAMHSA (1992-1998) and in trauma treatment development for four different trauma populations (1960-1998)…

  16. Improving Service Utilization for Parents with Substance Abuse Problems: Experimenting with Recovery Coaches in Child Welfare.

    PubMed

    Choi, Sam

    2015-01-01

    Substance abusers often face substantial systematic and personal barriers to receiving required substance abuse treatment services as well as other services; hence, various linkage mechanisms have been proposed for drug abuse treatment programs to overcome such barriers. Although there is a growing interest in the use of case management with a substance abuse background, its effectiveness in child welfare has yet to be explored. In this study the author attempts to investigate the effectiveness of case management in service utilization by systematically evaluating the five-year Alcohol and Other Drug Abuse (AODA) waiver demonstration project with Recovery Coaches in Illinois. A classic experimental design with a control group was used. Random assignment occurs at the agency level. Parents in the experimental group (N = 1562) received recovery coaches in addition to traditional child welfare services while parents in the control group (N = 598) only received traditional child welfare services. Bivariate and multivariate analyses (Ordinary Last Square regressions) were used. Compared to parents in the control group, parents in the experimental group were more likely to utilize substance abuse treatment. The results suggest that gender, education level, employment status, and the number of service needs were significantly associated with service utilization. Controlling other factors, recovery coaches improved overall service utilization. Because the outcome of child welfare often depends on the improvement of risks or resolution, it is important for parents to utilize the needed services. Future studies need to address what aspects of recovery coaches facilitate the services utilization.

  17. Randomized Trial of Drug Abuse Treatment-Linkage Strategies

    ERIC Educational Resources Information Center

    Sorenson, James L.; Masson, Carmen L.; Delucchi, Kevin; Sporer, Karl; Barnett, Paul G.; Mitsuishi, Fumi; Lin, Christine; Song, Yong; Chen, TeChieh; Hall, Sharon M.

    2005-01-01

    A clinical trial contrasted 2 interventions designed to link opioid-dependent hospital patients to drug abuse treatment. The 126 out-of-treatment participants were randomly assigned to (a) case management, (b) voucher for free methadone maintenance treatment (MMT), (c) case management plus voucher, or (d) usual care. Services were provided for 6…

  18. 45 CFR 1340.15 - Services and treatment for disabled infants.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT PROGRAM CHILD ABUSE AND NEGLECT PREVENTION AND... 45 Public Welfare 4 2013-10-01 2013-10-01 false Services and treatment for disabled infants. 1340...

  19. 45 CFR 1340.15 - Services and treatment for disabled infants.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT PROGRAM CHILD ABUSE AND NEGLECT PREVENTION AND... 45 Public Welfare 4 2014-10-01 2014-10-01 false Services and treatment for disabled infants. 1340...

  20. 45 CFR 1340.15 - Services and treatment for disabled infants.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT PROGRAM CHILD ABUSE AND NEGLECT PREVENTION AND... 45 Public Welfare 4 2012-10-01 2012-10-01 false Services and treatment for disabled infants. 1340...

  1. 45 CFR 1340.15 - Services and treatment for disabled infants.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT PROGRAM CHILD ABUSE AND NEGLECT PREVENTION AND... 45 Public Welfare 4 2010-10-01 2010-10-01 false Services and treatment for disabled infants. 1340...

  2. 45 CFR 1340.15 - Services and treatment for disabled infants.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT PROGRAM CHILD ABUSE AND NEGLECT PREVENTION AND... 45 Public Welfare 4 2011-10-01 2011-10-01 false Services and treatment for disabled infants. 1340...

  3. A prospective investigation of suicide ideation, attempts, and use of mental health service among adolescents in substance abuse treatment.

    PubMed

    Ramchand, Rajeev; Griffin, Beth Ann; Harris, Katherine M; McCaffrey, Daniel F; Morral, Andrew R

    2008-12-01

    This study examined suicide ideation, attempts, and subsequent mental health service among a sample of 948 youth from substance abuse treatment facilities across the United States. Youth were surveyed at intake and every 3 months for a 1-year period. Thirty percent of youth reported ideating in at least one interview, and 12% reported attempting suicide; almost half of all youth reported receiving outpatient mental health treatment at least once, and close to one-third of all youth reported being on prescription drugs for an emotional or behavioral problem. Higher levels of conduct disorder symptoms were associated with both ideation and attempts, while higher levels of depressive symptoms and being female were associated with ideation only. Among all youth, older youth were less likely to receive outpatient and prescription drug treatment, and Black and Hispanic youth were less likely to receive prescription drug treatment than White youth. Among youth who reported ideating, those with conduct disorder were less likely to receive prescription drug treatment 3 months later. These findings emphasize a high prevalence of suicide risk behavior in substance abuse treatment programs and provide insight into the specialized treatment youth in substance abuse treatment at risk for suicide currently receive. 2008 APA, all rights reserved

  4. Utilization of Substance Abuse Treatment: Gender Differences among Participants in an Aftercare Program.

    PubMed

    Yeom, Hyong Suk

    2015-01-01

    This study examined gender differences in the utilization of substance abuse treatment including inpatient, outpatient, and self-help services, using existing data sets from a National Institute on Drug Abuse study that enrolled 78 females and 141 males in a mixed-gender aftercare program in Massachusetts for a 2-year follow-up period. This study found that women came to the study in greater need of treatment than men. Women utilized significantly more outpatient treatment services than men. The characteristic of female per se led to more utilization of outpatient services, whereas the baseline characteristics of employed status and alcohol use led to less utilization of outpatient services.

  5. Health Reform for Communities: Financing Substance Abuse Services. Recommendations from a Join Together Policy Panel.

    ERIC Educational Resources Information Center

    Join Together, Boston, MA.

    Substance abuse treatment has been demonstrated to be effective in reducing not only substance use, but also the economic, health, and social costs associated with substance abuse. This document examines how health care reform can preserve and enhance community substance abuse services. The cost effectiveness of funding substance abuse prevention…

  6. Benefit–Cost in the California Treatment Outcome Project: Does Substance Abuse Treatment “Pay for Itself”?

    PubMed Central

    Ettner, Susan L; Huang, David; Evans, Elizabeth; Rose Ash, Danielle; Hardy, Mary; Jourabchi, Mickel; Hser, Yih-Ing

    2006-01-01

    Objective To examine costs and monetary benefits associated with substance abuse treatment. Data Sources Primary and administrative data on client outcomes and agency costs from 43 substance abuse treatment providers in 13 counties in California during 2000–2001. Study Design Using a social planner perspective, the estimated direct cost of treatment was compared with the associated monetary benefits, including the client's costs of medical care, mental health services, criminal activity, earnings, and (from the government's perspective) transfer program payments. The cost of the client's substance abuse treatment episode was estimated by multiplying the number of days that the client spent in each treatment modality by the estimated average per diem cost of that modality. Monetary benefits associated with treatment were estimated using a pre–posttreatment admission study design, i.e., each client served as his or her own control. Data Collection Treatment cost data were collected from providers using the Drug Abuse Treatment Cost Analysis Program instrument. For the main sample of 2,567 clients, information on medical hospitalizations, emergency room visits, earnings, and transfer payments was obtained from baseline and 9-month follow-up interviews, and linked to information on inpatient and outpatient mental health services use and criminal activity from administrative databases. Sensitivity analyses examined administrative data outcomes for a larger cohort (N=6,545) and longer time period (1 year). Principal Findings On average, substance abuse treatment costs $1,583 and is associated with a monetary benefit to society of $11,487, representing a greater than 7:1 ratio of benefits to costs. These benefits were primarily because of reduced costs of crime and increased employment earnings. Conclusions Even without considering the direct value to clients of improved health and quality of life, allocating taxpayer dollars to substance abuse treatment may be a wise

  7. Improving Substance Abuse Treatment: The National Treatment Plan Initiative. Changing the Conversation.

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Center for Substance Abuse Treatment.

    This report is the result of five expert panels and six regional public hearings around the country that focused on key persistent issues that have characterized discussions of substance abuse over the years: closing the treatment gap; reducing stigma and changing attitudes; improving and strengthening treatment systems; connecting services and…

  8. Adoption and Diffusion of Evidence-Based Addiction Medications in Substance Abuse Treatment

    PubMed Central

    Heinrich, Carolyn J; Cummings, Grant R

    2014-01-01

    ObjectiveTo examine the roles of facility-and state-level factors in treatment facilities’ adoption and diffusion of pharmaceutical agents used in addiction treatment. Data SourcesSecondary data from the National Survey of Substance Abuse Treatment Services (N-SSATS), Substance Abuse and Mental Health Services Administration (SAMHSA), Centers for Medicare and Medicaid Services, Alcohol Policy Information System, and Kaiser Family Foundation. Study DesignWe estimate ordered logit and multinomial logit models to examine the relationship of state and treatment facility characteristics to the adoption and diffusion of three pharmaceutical agents over 4 years when each was at a different stage of adoption or diffusion. Data CollectionN-SSATS data with facility codes, obtained directly from SAMHSA, were linked by state identifiers to the other publicly available, secondary data. Principal FindingsThe analysis confirms the importance of awareness and exposure to the adoption behavior of others, dissemination of information about the feasibility and effectiveness of innovations, geographical clustering, and licensing and accreditation in legitimizing facilities’ adoption and continued use of pharmacotherapies in addiction treatment. ConclusionsPolicy and administrative levers exist to increase the availability of pharmaceutical technologies and their continued use by substance abuse treatment facilities. PMID:23855719

  9. Trends in Mental Health and Substance Abuse Services at the Nation’s Community Health Centers: 1998–2003

    PubMed Central

    Druss, Benjamin G.; Bornemann, Thomas; Fry-Johnson, Yvonne W.; McCombs, Harriet G.; Politzer, Robert M.; Rust, George

    2008-01-01

    Objective. We examined trends in delivery of mental health and substance abuse services at the nation’s community health centers. Methods. Analyses used data from the Health Resources and Services Administration (HRSA), Bureau of Primary Care’s (BPHC) 1998 and 2003 Uniform Data System, merged with county-level data. Results. Between 1998 and 2003, the number of patients diagnosed with a mental health/substance abuse disorder in community health centers increased from 210 000 to 800 000. There was an increase in the number of patients per specialty mental health/substance abuse treatment provider and a decline in the mean number of patient visits, from 7.3 visits per patient to 3.5 by 2003. Although most community health centers had some on-site mental health/substance abuse services, centers without on-site services were more likely to be located in counties with fewer mental health/substance abuse clinicians, psychiatric emergency rooms, and inpatient hospitals. Conclusions. Community health centers are playing an increasingly central role in providing mental health/substance abuse treatment services in the United States. It is critical both to ensure that these centers have adequate resources for providing mental health/substance abuse care and that they develop effective linkages with mental health/substance abuse clinicians in the communities they serve. PMID:18687596

  10. Trends in Mental Health and Substance Abuse Services at the Nation’s Community Health Centers: 1998–2003

    PubMed Central

    Druss, Benjamin G.; Bornemann, Thomas; Fry-Johnson, Yvonne W.; McCombs, Harriet G.; Politzer, Robert M.; Rust, George

    2006-01-01

    Objective. We examined trends in delivery of mental health and substance abuse services at the nation’s community health centers. Methods. Analyses used data from the Health Resources and Services Administration (HRSA), Bureau of Primary Care’s (BPHC) 1998 and 2003 Uniform Data System, merged with county-level data. Results. Between 1998 and 2003, the number of patients diagnosed with a mental health/substance abuse disorder in community health centers increased from 210 000 to 800 000. There was an increase in the number of patients per specialty mental health/substance abuse treatment provider and a decline in the mean number of patient visits, from 7.3 visits per patient to 3.5 by 2003. Although most community health centers had some on-site mental health/substance abuse services, centers without on-site services were more likely to be located in counties with fewer mental health/substance abuse clinicians, psychiatric emergency rooms, and inpatient hospitals. Conclusions. Community health centers are playing an increasingly central role in providing mental health/substance abuse treatment services in the United States. It is critical both to ensure that these centers have adequate resources for providing mental health/substance abuse care and that they develop effective linkages with mental health/substance abuse clinicians in the communities they serve. PMID:17008573

  11. Barriers and Facilitators to Successful Transition from Long-Term Residential Substance Abuse Treatment

    PubMed Central

    Yuan, Yeqing; Herman, Daniel; Svikis, Dace; Nichols, Obie; Palmer, Erin; Deren, Sherry

    2016-01-01

    Although residential substance abuse treatment has been shown to improve substance use and other outcomes, relapse is common. This qualitative study explores factors that hinder and help individuals during the transition from long-term residential substance abuse treatment to the community. Semi-structured interviews were conducted with 32 individuals from residential substance abuse treatment. Based on the socio-ecological model, barriers and facilitators to transition were identified across five levels: individual, interpersonal, organizational, community, and policy. The major results indicate that primary areas of intervention needed to improve outcomes for these high-risk individuals include access to stable housing and employment, aftercare services and positive support networks; expanded discharge planning services and transitional assistance; and funding to address gaps in service delivery and to meet individuals’ basic needs. This study contributes to the literature by identifying transition barriers and facilitators from the perspectives of individuals in residential treatment, and by using the socio-ecological model to understand the complexity of this transition at multiple levels. Findings identify potential targets for enhanced support post-discharge from residential treatment. PMID:28132695

  12. 38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. 17... of Services of Other Federal Agencies § 17.80 Alcohol and drug dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or abuse...

  13. The employment of nurses in publicly funded substance abuse treatment programs.

    PubMed

    Knudsen, Hannah K; Abraham, Amanda J

    2012-10-01

    Little is known about the organizational and environmental factors associated with the employment of nurses in substance abuse treatment programs. Using data collected from the administrators of 250 publicly funded substance abuse treatment programs, this study examined the organizational and environmental correlates of nurse employment in these settings. Negative binomial regression models indicated that the number of nurses employed by treatment programs was positively associated with government ownership, location within a healthcare setting, and the availability of detoxification services. Outpatient-only programs employed fewer nurses than programs with inpatient/residential services. Two environmental factors were associated with nurse employment. Programs that more strongly endorsed a scale of financial barriers employed significantly fewer nurses, whereas programs indicating that funding from state contracts could be used to pay for healthcare providers employed significantly more nurses. These findings suggest that organizational decisions about employing nurses may reflect both the characteristics of the program and the funding environment. Future research should continue to examine the employment of nurses in substance abuse treatment settings, particularly given the shifting environment due to the implementation of healthcare reform.

  14. Outpatient substance abuse treatment and HIV prevention: an update.

    PubMed

    Pollack, Harold A; D'Aunno, Thomas; Lamar, Barbara

    2006-01-01

    Testing and counseling, along with community outreach, have been identified as valuable in the prevention of human immunodeficiency virus (HIV) and other blood-borne diseases. This article assesses the extent to which outpatient substance abuse treatment (OSAT) programs provide such services. Longitudinal data for 1988-2000 were analyzed from the National Drug Abuse Treatment System Survey (NDATSS). Random-effects regression was used to examine factors associated with the provision of prevention services. HIV testing, which had became more common between 1990 and 1995, continued to proliferate between 1995 and 2000. The proportion of units that provide HIV testing and counseling increased from 66% to 86%. The proportion of units that provide HIV community outreach increased significantly before 1995 but then slightly decreased from 77% to 73% between 1995 and 2000. In conclusion, HIV testing and counseling widely proliferated in OSAT care. However, OSAT units remain less likely to offer HIV community outreach services.

  15. Utilization of substance abuse treatment services under Medicare, 2001-2002.

    PubMed

    Vandivort, Rita; Teich, Judith L; Cowell, Alexander J; Chen, Hong

    2009-06-01

    In 2006, the Medicare program covered 37 million elderly persons and 7 million persons younger than 65 years, but little is known about substance abuse (SA) service utilization. Using the 5% Sample of Medicare claims data, the study examines individuals who used SA detoxification ("detox") and/or rehabilitation ("rehab") services under Medicare in 2001 and 2002. SA claimants less than 65 years of age (disabled) were compared to claimants more than 65 years of age (elderly). The disabled were more likely to have a co-occurring mental disorder than elderly claimants (50% vs. 14%) and more likely to have serious mental illness (21% vs. 2.3%). Disabled claimants were more than three times as likely to receive any detox service as elderly claimants (17% vs. 6%). The rate of claimants receiving rehab services within 30 days of detox is about one third for disabled claimants and one quarter for elderly claimants.

  16. Perceptions of staff attributes in substance abuse treatment.

    PubMed

    Grosenick, J K; Hatmaker, C M

    2000-10-01

    Qualified professional staff contribute significantly to successful health-care service delivery. Organizations view six categories of staff attributes as valued qualities of competent personnel: knowledge and experience, organizational citizenship, interpersonal skills, service orientation, personal attributes, and leadership skills. This study presents the perceptions regarding these and other staff attributes held by female clients and staff from a substance abuse treatment facility. Results indicated that four attributes were perceived as particularly influential in assisting women to reach treatment goals. These included knowledge and experience, supportiveness, nonthreatening behaviors, and availability. Attention to these variables may prove useful as treatment programs strive to improve client outcomes.

  17. Child Abuse and Neglect: The Impact on Texas Children, Families, and Communities and the Need for Treatment Services. A Report to the 71st Legislature.

    ERIC Educational Resources Information Center

    Texas State Dept. of Mental Health and Mental Retardation, Austin.

    The report provides a comprehensive review of child abuse and neglect concerns in Texas and offers a variety of recommendations. Data on the extent of the problem indicate that the need for treatment services has outstripped available resources. The direct and indirect costs of untreated child abuse are estimated. The joint study committee…

  18. The looming expansion and transformation of public substance abuse treatment under the Affordable Care Act.

    PubMed

    Buck, Jeffrey A

    2011-08-01

    Public substance abuse treatment services have largely operated as an independent part of the overall health care system, with unique methods of administration, funding, and service delivery. The Affordable Care Act of 2010 and other recent health care reforms, coupled with declines in state general revenue spending, will change this. Overall funding for these substance abuse services should increase, and they should be better integrated into the mainstream of general health care. Reform provisions are also likely to expand the variety of substance abuse treatment providers and shift services away from residential and stand-alone programs toward outpatient programs and more integrated programs or care systems. As a result, patients should have better access to care that is more medically based and person-centered.

  19. PROTECT: A Pilot Program to Integrate Mental Health Treatment Into Elder Abuse Services for Older Women.

    PubMed

    Sirey, Jo Anne; Halkett, Ashley; Chambers, Stephanie; Salamone, Aurora; Bruce, Martha L; Raue, Patrick J; Berman, Jacquelin

    2015-01-01

    The goal of this pilot program was to test the usefulness of adapted Problem-Solving Therapy (PST) and anxiety management, called PROTECT, integrated into elder abuse services to reduce depression and improve self-efficacy. Depressed women victims were randomized to receive elder abuse resolution services combined with either PROTECT or a mental health referral. At follow-up, the PROTECT group showed greater reduction in depressive symptoms and endorsed greater improved self-efficacy in problem-solving when compared to those in the Referral condition. These preliminary findings support the potential usefulness of PROTECT to alleviate depressive symptoms and enhance personal resources among abused older women.

  20. Partnerships and pathways of dissemination: the National Institute on Drug Abuse-Substance Abuse and Mental Health Services Administration Blending Initiative in the Clinical Trials Network.

    PubMed

    Martino, Steve; Brigham, Gregory S; Higgins, Christine; Gallon, Steve; Freese, Thomas E; Albright, Lonnetta M; Hulsey, Eric G; Krom, Laurie; Storti, Susan A; Perl, Harold; Nugent, Cathrine D; Pintello, Denise; Condon, Timothy P

    2010-06-01

    Since 2001, the National Drug Abuse Treatment Clinical Trials Network (CTN) has worked to put the results of its trials into the hands of community treatment programs, in large part through its participation in the National Institute on Drug Abuse-Substance Abuse and Mental Health Services Administration Blending Initiative and its close involvement with the Center for Substance Abuse Treatment's Addiction Technology Transfer Centers. This article describes (a) the CTN's integral role in the Blending Initiative, (b) key partnerships and dissemination pathways through which the results of CTN trials are developed into blending products and then transferred to community treatment programs, and (c) three blending initiatives involving buprenorphine, motivational incentives, and motivational interviewing. The Blending Initiative has resulted in high utilization of its products, preparation of more than 200 regional trainers, widespread training of service providers in most U.S. States, Puerto Rico, and the U.S. Virgin Islands and movement toward the development of Web-based implementation supports and technical assistance. Implications for future directions of the Blending Initiative and opportunities for research are discussed.

  1. Psychiatric Nursing's Role in Child Abuse: Prevention, Recognition, and Treatment.

    PubMed

    Ellington, Erin

    2017-11-01

    Child abuse affects hundreds of thousands of children in the United States each year. The effects from maltreatment extend beyond the physical injuries-the lasting effects on the child's mental health can be lifelong. Psychiatric nurses have a vital role to play in the prevention, recognition, and treatment of child abuse. [Journal of Psychosocial Nursing and Mental Health Services, 55(11), 16-20.]. Copyright 2017, SLACK Incorporated.

  2. Differences in drug treatment services based on profit status.

    PubMed

    Montoya, Isaac D

    2006-09-01

    The goal of this article is to examine whether profit status affects the provision of seven "core" drug treatment services and nine "auxiliary" treatment services. Data on the type of services provided by 8,606 treatment providers obtained from the National Survey of Substance Abuse Treatment Services (N-SSATS) collected by the Substance Abuse and Mental Health Services Administration (SAMHSA) in 2000 were used for this study. The types of services offered by the providers were modeled to be a function of the drug treatment providers' (DTP) profit status, DTP organizational and financial characteristics, staff's characteristics, clients' characteristics, and regional variables. A total of 16 logistic regressions were estimated. For-profit DTPs were found to be more likely to offer only two core services and were less likely to offer eight auxiliary services. However, after correcting for sample selection bias many differences in the supply of services between for-profit and nonprofit providers disappeared.

  3. Health Services Research for Drug and Alcohol Treatment and Prevention.

    PubMed

    McCarty, Dennis; Roman, Paul M; Sorensen, James; Weisner, Constance

    2009-01-01

    Health services research is a multidisciplinary field that examines ways to organize, manage, finance, and deliver high-quality care. This specialty within substance abuse research developed from policy analyses and needs assessments that shaped federal policy and promoted system development in the 1970s. After the authorization of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA), patient information systems supported studies of treatment processes and outcomes. Health services research grew substantially in the 1990s when NIAAA and NIDA moved into the National Institutes of Health and legislation allocated 15% of their research portfolio to services research. The next decade will emphasize research on quality of care, adoption and use of evidence-based practices (including medication), financing reforms and integration of substance abuse treatment with primary care and mental health services.

  4. Barriers and facilitators to successful transition from long-term residential substance abuse treatment.

    PubMed

    Manuel, Jennifer I; Yuan, Yeqing; Herman, Daniel B; Svikis, Dace S; Nichols, Obie; Palmer, Erin; Deren, Sherry

    2017-03-01

    Although residential substance abuse treatment has been shown to improve substance use and other outcomes, relapse is common. This qualitative study explores factors that hinder and help individuals during the transition from long-term residential substance abuse treatment to the community. Semi-structured interviews were conducted with 32 individuals from residential substance abuse treatment. Based on the socio-ecological model, barriers and facilitators to transition were identified across five levels: individual, interpersonal, organizational, community, and policy. The major results indicate that primary areas of intervention needed to improve outcomes for these high-risk individuals include access to stable housing and employment, aftercare services and positive support networks; expanded discharge planning services and transitional assistance; and funding to address gaps in service delivery and to meet individuals' basic needs. This study contributes to the literature by identifying transition barriers and facilitators from the perspectives of individuals in residential treatment, and by using the socio-ecological model to understand the complexity of this transition at multiple levels. Findings identify potential targets for enhanced support post-discharge from residential treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Gender and racial/ethnic disparities in the impact of HIV prevention programming in substance abuse treatment.

    PubMed

    Cao, Dingcai; Marsh, Jeanne C; Shin, Hee-Choon

    2008-01-01

    The objective of the study was to evaluate the capacity of HIV prevention programs offered in substance abuse treatment to reduce HIV-related risk behavior for women and men and for Black, Latino, and White groups. Prospective data was collected at intake, discharage, and 12 months post-treatment from 1992 to 1997 for the National Treatment Improvement Evaluation Study with a sample consisting of 3,142 clients from 59 service delivery units: 972 females, 1,870 males, 1,812 Blacks, 486 Latinos, and 844 Whites. Study findings show that receipt of HIV prevention programming as part of substance abuse treatment services resulted in reductions in HIV-related risk behavior for the sample overall and for women as well as men. However, although Blacks received more prevention services than Latinos and Whites, the significant positive effect of HIV services on reduced HIVrisk behavior held only for Whites. Racial/ethnic disparities exist in the capacity for HIV prevention programming offered as part of substance abuse treatment to reduce HIV-risk behavior. The findings highlight the need for the development of culturally competent service delivery strategies to enhance the impact of these services for all groups.

  6. Economic costs of drug abuse: financial, cost of illness, and services.

    PubMed

    Cartwright, William S

    2008-03-01

    This article examines costs as they relate to the financial costs of providing drug abuse treatment in private and public health plans, costs to society relating to drug abuse, and many smaller costing studies of various stakeholders in the health care system. A bibliography is developed from searches across PubMed, Web of Science, and other bibliographic sources. The review indicates that a wide collection of cost findings is available to policy makers. For example, the financial aspects of health plans have been dominated by considerations of actuarial costs of parity for drug abuse treatment. Cost-of-illness methods have been developed and extended to drug abuse costing to measure the national level of burden and are important to the economic evaluation of interventions at the program level. Costing is done in many small and focused studies, reflecting the interests of different stakeholders in the health care system. For costs in programs and health plans, as well as cost offsets of the impact of substance abuse treatment on medical expenditures, findings are surprisingly important to policy makers. Maintaining ongoing research that is highly policy relevant from the point of view of health services, more is needed on costing concepts and measurement applications.

  7. Predictors of substance abuse treatment need and receipt among homeless women.

    PubMed

    Tucker, Joan S; Wenzel, Suzanne L; Golinelli, Daniela; Zhou, Annie; Green, Harold D

    2011-04-01

    Many homeless women do not receive needed treatment for substance abuse. This study identified social network and other predisposing factors associated with perceived need for and receipt of substance abuse treatment among 273 homeless women who screened positive for past-year substance abuse. Perceived treatment need was more likely among women with drug-using sex partners, a denser network, and an arrest history but less likely for those with a minor child and a longer history of homelessness. Receiving treatment was more likely among women who received informational support from their sex partners and who had an arrest history but less likely among those who had a more street-based social network, had a minor child, considered themselves homeless, and recently needed mental health treatment. Treatment services researchers should attend more closely to social contextual factors, as well as the more traditional individual factors, to understand access and barriers to treatment. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. Disclosure of physical, emotional and sexual child abuse, help-seeking and access to abuse response services in two South African Provinces.

    PubMed

    Meinck, Franziska; Cluver, Lucie; Loening-Voysey, Heidi; Bray, Rachel; Doubt, Jenny; Casale, Marisa; Sherr, Lorraine

    2017-03-01

    Physical, emotional and sexual child abuse are major problems in South Africa. This study investigates whether children know about post-abuse services, if they disclose and seek services, and what the outcomes of help-seeking behaviour are. It examines factors associated with request and receipt of services. Confidential self-report questionnaires were completed by adolescents aged 10-17 (n = 3515) in South Africa. Prevalence of frequent (>weekly) physical abuse was 7.4%, frequent emotional abuse 12.4%, and lifetime contact sexual abuse 9.0%. 98.6% could name one suitable confidante or formal service for abuse disclosure, but only 20.0% of abuse victims disclosed. Of those, 72% received help. Most common confidantes were caregivers and teachers. Of all abuse victims, 85.6% did not receive help due to non-disclosure or inactivity of services, and 14.4% received help: 4.9% from formal health or social services and 7.1% through community vigilante action. Emotional abuse, sexual abuse and female gender were associated with higher odds of help-seeking. While children in South Africa showed high knowledge of available services, access to and receipt of formal services among abused children was low. Notably fewer children received help from formal services than through community vigilante action. Urgent action is needed to improve service access for child abuse victims.

  9. Group Treatment for Men with Intellectual Disability and Sexually Abusive Behaviour: Service User Views

    ERIC Educational Resources Information Center

    Hays, Sarah-Jane; Murphy, Glynis H.; Langdon, Peter E.; Rose, David; Reed, Tracy

    2007-01-01

    Background: Men with intellectual disability (ID) and sexually abusive behaviour are a disempowered and marginalised group. Nevertheless, as service users, they can be consulted and involved in a variety of different ways, including ascertaining their views of the services they receive. Method: A group of 16 men with ID and sexually abusive…

  10. Prior Substance Abuse and Related Treatment History Reported by Recent Victims of Sexual Assault

    PubMed Central

    Resnick, Heidi S.; Walsh, Kate; Schumacher, Julie A.; Kilpatrick, Dean G.; Acierno, Ron

    2013-01-01

    To inform intervention approaches, the current study examined prevalence and comorbidity of recent use and history of abuse of alcohol, marijuana, and other illicit drugs as well as history of substance treatment among a sample of female victims of sexual assault seeking post-assault medical care. Demographic variables and prior history of assault were also examined to further identify factors relevant to treatment or prevention approaches. Participants were 255 women and adolescent girls seeking post sexual assault medical services who completed an initial follow-up assessment on average within 3 months post-assault. The majority (72.9%) reported recent substance use prior to assault, approximately 40% reported prior substance abuse history, and 12.2% reported prior substance treatment history. Prior history of assault was associated with recent drug use and history of drug abuse as well as substance treatment. Among those with prior histories of substance abuse and assault, assault preceded substance abuse onset in the majority of cases. Almost all those with prior treatment history reported recent drug or alcohol use. A portion of sexual assault survivors seen for acute medical services may benefit from facilitated referral for substance abuse treatment in addition to counseling at the time of screening. Assessment and intervention approaches should target alcohol, marijuana, and other illicit drug use and abuse. Substance use and associated impairment may serve as a rape tactic by perpetrators of assault. Substance use at the time of assault does not imply blame on the part of assault victims. Previous findings indicate that rape poses high risk of PTSD particularly among women with prior history of assault. Screening and intervention related to substance abuse should be done with recognition of the increased vulnerability it may pose with regard to assault and the high risk of PTSD within this population. PMID:23396174

  11. Behavioral Health and Substance Abuse Treatment Services Locator

    MedlinePlus

    ... in the United States or U.S. Territories for substance abuse/addiction and/or mental health problems. PLEASE NOTE: ... and Spanish for individuals and family members facing substance abuse and mental health issues. 24 hours a day, ...

  12. How do mental health services respond when child abuse or neglect become known? A literature review.

    PubMed

    Read, John; Harper, David; Tucker, Ian; Kennedy, Angela

    2018-06-05

    Child abuse and neglect are strongly associated with many subsequent mental health problems. This review summarizes the research on how adult mental health services respond when child abuse or neglect become known. MEDLINE, PsycINFO, and Scopus were searched for studies with rates of responding in various ways to child abuse and neglect by mental health professionals. Thirteen studies were identified: seven case note reviews, three surveys of staff, and three sets of interviews with service users. Rates of inclusion of abuse or neglect in treatment plans ranged from 12% to 44%. Rates of referral to abuse-related therapy ranged from 8% to 23%. Rates were lower for neglect than for abuse and were also lower for men and people with a diagnosis of psychosis. Two per cent or less of all cases were referred to legal authorities. The studies varied in focus and methodology, but all indicated inadequate clinical practice. The rates of abused or neglected people referred for therapy are actually lower than indicated by this review because most users of adult mental health services are not asked about abuse or neglect in the first place. The barriers to good practice, and the need for trauma-informed services, are discussed. © 2018 Australian College of Mental Health Nurses Inc.

  13. Barriers to Successful Treatment Completion in Child Sexual Abuse Survivors

    ERIC Educational Resources Information Center

    McPherson, Paul; Scribano, Philip; Stevens, Jack

    2012-01-01

    Child sexual abuse (CSA) often requires psychological treatment to address the symptoms of victim trauma. Barriers to entry and completion of counseling services can compromise long-term well-being. An integrated medical and mental health evaluation and treatment model of a child advocacy center (CAC) has the potential to reduce barriers to mental…

  14. Effects of integrated trauma treatment on outcomes in a racially/ethnically diverse sample of women in urban community-based substance abuse treatment.

    PubMed

    Amaro, Hortensia; Dai, Jianyu; Arévalo, Sandra; Acevedo, Andrea; Matsumoto, Atsushi; Nieves, Rita; Prado, Guillermo

    2007-07-01

    This study presents findings from a quasiexperimental, nonequivalent, group-design study with repeated measures that explored the effects of integrated trauma-informed services on the severity of substance abuse, mental health, posttraumatic stress disorder (PTSD) symptomatology among women with histories of trauma in urban, community-based substance abuse treatment. The study also explored if the model of integrated services was equally beneficial for women of various racial/ethnic groups. Participants in the study were 342 women receiving substance abuse treatment in intervention and comparison sites. Results indicated that at 6 and 12 month follow-ups, those in the trauma-informed intervention group, in contrast to the comparison group, had significantly better outcomes in drug abstinence rates in the past 30 days as well as in mental health and PTSD symptomatology. Results also showed that, overall, integrated services were beneficial for women across the different racial/ethnic groups in substance abuse treatment, although some differences appear to exist across racial/ethnic groups in improving addiction severity and mental health and PTSD symptomatology.

  15. Effects of Integrated Trauma Treatment on Outcomes in a Racially/Ethnically Diverse Sample of Women in Urban Community-based Substance Abuse Treatment

    PubMed Central

    Dai, Jianyu; Arévalo, Sandra; Acevedo, Andrea; Matsumoto, Atsushi; Nieves, Rita; Prado, Guillermo

    2007-01-01

    This study presents findings from a quasiexperimental, nonequivalent, group-design study with repeated measures that explored the effects of integrated trauma-informed services on the severity of substance abuse, mental health, posttraumatic stress disorder (PTSD) symptomatology among women with histories of trauma in urban, community-based substance abuse treatment. The study also explored if the model of integrated services was equally beneficial for women of various racial/ethnic groups. Participants in the study were 342 women receiving substance abuse treatment in intervention and comparison sites. Results indicated that at 6 and 12 month follow-ups, those in the trauma-informed intervention group, in contrast to the comparison group, had significantly better outcomes in drug abstinence rates in the past 30 days as well as in mental health and PTSD symptomatology. Results also showed that, overall, integrated services were beneficial for women across the different racial/ethnic groups in substance abuse treatment, although some differences appear to exist across racial/ethnic groups in improving addiction severity and mental health and PTSD symptomatology. PMID:17356904

  16. Individual and system influences on waiting time for substance abuse treatment.

    PubMed

    Carr, Carey J A; Xu, Jiangmin; Redko, Cristina; Lane, D Timothy; Rapp, Richard C; Goris, John; Carlson, Robert G

    2008-03-01

    Waiting time is a contemporary reality of many drug abuse treatment programs, resulting in substantial problems for substance users and society. Individual and system factors that influence waiting time are diverse and may vary at different points in the treatment continuum. This study assessed waiting time preceding clinical assessment at a centralized intake unit and during the period after the assessment but before treatment entry. The present study included 577 substance abusers who were enrolled in a large clinical trial of two brief treatment interventions in a midsize metropolitan area in Ohio. Bivariate analyses identified individual and system factors that influenced preassessment and postassessment waiting time, as well as total wait to treatment services. Multivariate analyses demonstrated that longer wait time for an assessment is influenced by being court referred, less belief in having a substance abuse problem, and less desire for change. A shorter wait to actually enter treatment is predicted by having a case manager, being more ready for treatment, and having less severe employment and alcohol problems. The different influences present during the two waiting periods suggest that assessment and treatment programs need to implement system changes and entry enhancement interventions that are specific to the needs of substance abusers at each waiting period.

  17. Readiness to adopt a performance measurement system for substance abuse treatment: Findings from the Service Quality Measures initiative.

    PubMed

    Myers, B; Petersen Williams, P; Johnson, K; Govender, R; Manderscheid, R; Koch, J R

    2017-01-30

    A performance measurement system - the Service Quality Measures (SQM) initiative - has been developed to monitor the quality of South Africa (SA)'s substance abuse treatment services. Identifying factors associated with readiness to adopt this system may inform strategies to facilitate its robust implementation. To examine factors associated with readiness to adopt a performance measurement system among SA substance abuse treatment providers. We surveyed 81 treatment providers from 13 treatment sites in the Western Cape, SA. The survey examined awareness, resources, organisational climate, leadership support and readiness to adopt the SQM system. Regression analysis was used to identify factors associated with readiness to adopt this system. Readiness to adopt the SQM initiative was high (M=5.64, standard deviation 1.63). In bivariate analyses, caseload size (F=3.73 (degrees of freedom (df)=3.70), p=0.015), awareness (r=0.78, p<0.0001), leadership support (r=0.70, p<0.0001), resources (r=0.65, p<0.0001), openness to change (r=0.372, p=0.001), and external pressure to change were associated with readiness to adopt the SQM. In multivariate analyses, only awareness of the SQM initiative (B=0.34, standard error (SE) 0.08, t=4.4, p<0.0001) and leadership support (B=0.45, SE 0.11, t=4.0, p<0.0001) were significantly associated with readiness to adopt this system. While treatment providers report high levels of readiness to adopt the SQM system, findings show that the likelihood of adoption can be further increased through improved provider awareness and enhanced leadership support for this health innovation.

  18. Managed Care’s Dual Impact on Outpatient Substance Abuse Treatment: Methadone Maintenance vs. Drug Free

    PubMed Central

    Sindelar, Jody L.; Olmstead, Todd A.

    2013-01-01

    The number and type of services offered at substance abuse treatment (SAT) facilities are important aspects of the quality of care. Managed care (MC) is a growing presence in SAT and has been shown to affect the provision of treatment. We expand on earlier work and examine the impact of managed care on the number and type of services offered by methadone maintenance (MM) and drug-free (DF) outpatient treatment facilities. We use the econometric technique of instrumental variables to address the issue of endogeneity of MC and service offerings, thereby allowing a causal interpretation of results. Using data from the 2000 National Survey of Substance Abuse Treatment Services, we find that MC significantly increases the total number of services offered in MM outpatient facilities by four, yet decreases the number by two in DF outpatient facilities. We also show how the impact on specific services differs by modality and provide explanations for our findings. PMID:24062595

  19. Organizational and client determinants of cost in outpatient substance abuse treatment.

    PubMed

    Beaston-Blaakman, Aaron; Shepard, Donald; Horgan, Constance; Ritter, Grant

    2007-03-01

    Understanding variation in the cost of outpatient substance abuse treatment is important for improving the delivery and financing of care. Studies that examine how the cost of treatment relates to treatment program and client characteristics can provide important data about variables that affect unit costs of treatment. Such analyses can inform those who are responsible for setting appropriate reimbursement rates and can give important cost data to program directors responsible for delivering cost-effective treatment. The aim of this study is to describe the results from cost function analyses of outpatient substance abuse treatment programs sampled in the Alcohol and Drug Services Study (ADSS). The ADSS is a national study conducted in the late 1990s to collect organizational, client, and cost data of the specialty sector. The authors examined how organizational and client characteristics affect the cost per episode and the cost per enrollment day of outpatient care. The analysis incorporates organizational variables such ownership, average length of stay, and visits per enrollment day, as well as client characteristics such as gender, age, and primary drug of choice. For further applicability for current treatment policy, the ADSS cost data were inflated from 1997 to 2005 dollars. Mixed model regressions using log-log and log-linear relationships were developed. Several organizational characteristics have statistically significant coefficients in the model estimating cost per episode, including log of point prevalence (-0.53, p<.01), log of average length of stay (0.73, p<.01), log of visits per enrollment day (0.45, p<.01), log of labor index (0.50, p<.01), proportion of counselor time spent in direct counseling (-0.52, p<.01), and location outside a metropolitan area (-0.19. p<.05). None of the client variables are statistically significant in this model. The analysis of cost per enrollment day indicates diseconomies of scope for programs that provide a broader

  20. Comprehensive Substance Abuse Services for Homeless Persons with Alcohol and Other Drug Problems.

    ERIC Educational Resources Information Center

    Kirby, Michael W., Jr.; Braucht, G. Nicholas

    Homeless people with alcohol and other drug problems present the traditional substance abuse services delivery provider with special challenges. This paper discusses the optimal designs of comprehensive treatment services for homeless persons with alcohol and other drug problems. Most importantly, the homeless must have immediate access to a safe…

  1. Leadership styles of service professionals aiding women of abuse: enhancing service delivery.

    PubMed

    Haeseler, Lisa Ann

    2013-01-01

    Leadership styles of service professionals--including social workers and teachers--in the area of family abuse were investigated. Leadership characteristics of the professionals were measured by their responses to a survey. Results indicated that the interviewed service professionals demonstrated productive leadership traits. Study findings are congruent with leadership styles described in the research. Holistic and collaborative services are required to enhance care for women of abuse, as their needs are multifaceted and complex. Specific leadership styles promote better care for women; leaders need to collaboratively initiate and deliver more interdisciplinary and unified service.

  2. Barriers to receiving substance abuse treatment among rural pregnant women in Kentucky.

    PubMed

    Jackson, Afton; Shannon, Lisa

    2012-12-01

    Research presenting outcomes for women who enter substance abuse treatment during pregnancy consistently shows benefits. While treatment has nearly universal benefits, there are many barriers to seeking substance abuse treatment for pregnant women. The purpose of this study is to explore barriers for rural pregnant women seeking substance abuse treatment. There were three eligibility criteria for study participation: (1) aged 18 and older, (2) pregnant, and (3) undergoing short-term inpatient detoxification at the University of Kentucky Chandler Medical Center. Eighty-five rural women (N = 85) were included in the analysis. Substance use history and previous treatment were assessed with measures adapted from the Addiction Severity Index. Treatment barriers were measured with three qualitative questions and were coded into four overarching categories: availability, accessibility, affordability, and acceptability barriers. This sample had an extensive substance use history. Almost all participants had used alcohol (98%), marijuana (98%), illicit opiates (99%), and cigarettes (97%). On average, participants reported about two barriers to receiving treatment (Mean = 1.8; SD = 1.3), with over 80% of the sample reporting having experienced any barrier to treatment. The majority experienced acceptability (51%) and accessibility (49%) barriers. Twenty-six percent (26%) of the sample reported availability barriers. A smaller percentage of participants reported affordability barriers (13%). Rural pregnant women seeking substance abuse treatment face many obstacles to receiving needed treatment. More studies on barriers to substance abuse treatment among rural pregnant women are needed. Identifying these barriers can help in improving treatment access and services.

  3. Possible Barriers to Enrollment in Substance Abuse Treatment among a Diverse Sample of Asian Americans and Pacific Islanders: Opinions of Treatment Clients

    PubMed Central

    Masson, Carmen L.; Shopshire, Michael S.; Sen, Soma; Hoffman, Kim; Hengl, Nicholas; Bartolome, John; McCarty, Dennis; Sorensen, James L.; Iguchi, Martin

    2012-01-01

    This mixed methods study examined motivations and barriers to substance abuse treatment entry and treatment continuation among Asian American and Pacific Islander (AAPI) substance users. AAPI substance users (N = 61) were recruited from substance abuse treatment programs in California and Hawaii. Semi-structured interviews and interviewer-administered surveys assessed barriers and facilitators to entering substance abuse treatment. Barriers included peer pressure, family influences, and face loss concerns. Facilitators included peer support, involvement in the criminal justice system, a perceived need for treatment, and culturally competent substance abuse treatment services. Family and peer influences may act as both facilitators and impediments. AAPI substance using populations face many of the same individual-level and structural and systems barriers to entry to treatment as other substance using populations. However, similar to other racial/ethnic minority groups, it is important to address cultural differences and develop culturally competent substance abuse treatments for the AAPI population. PMID:22985677

  4. Possible barriers to enrollment in substance abuse treatment among a diverse sample of Asian Americans and Pacific Islanders: opinions of treatment clients.

    PubMed

    Masson, Carmen L; Shopshire, Michael S; Sen, Soma; Hoffman, Kim A; Hengl, Nicholas S; Bartolome, John; McCarty, Dennis; Sorensen, James L; Iguchi, Martin Y

    2013-03-01

    This mixed methods study examined motivations and barriers to substance abuse treatment entry and treatment continuation among Asian American and Pacific Islander (AAPI) substance users. AAPI substance users (N = 61) were recruited from substance abuse treatment programs in California and Hawaii. Semi-structured interviews and interviewer-administered surveys assessed barriers and facilitators to entering substance abuse treatment. Barriers included peer pressure, family influences, and face loss concerns. Facilitators included peer support, involvement in the criminal justice system, a perceived need for treatment, and culturally competent substance abuse treatment services. Family and peer influences may act as both facilitators and impediments. AAPI substance using populations face many of the same individual-level and structural and systems barriers to entry to treatment as other substance using populations. However, similar to other racial/ethnic minority groups, it is important to address cultural differences and develop culturally competent substance abuse treatments for the AAPI population. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Feasibility of integrating mental health screening and services into routine elder abuse practice to improve client outcomes.

    PubMed

    Sirey, Jo Anne; Berman, Jacquelin; Salamone, Aurora; DePasquale, Alyssa; Halkett, Ashley; Raeifar, Elmira; Banerjee, Samprit; Bruce, Martha L; Raue, Patrick J

    2015-01-01

    The goal of this pilot program was to test the feasibility of mental health screening among elder abuse victims and of offering those victims a brief psychotherapy for depression and anxiety. Elder abuse victims who sought assistance from a large, urban elder abuse service were screened for depression and anxiety using standardized measures. Clients with clinically significant depression (PHQ-9) or anxiety (GAD-7) were randomized to receive one of three different interventions concurrent with abuse resolution services. Staff were able to screen 315 individuals, with 34% of clients scoring positive for depression or anxiety. Of those with mental health needs, only 15% refused all services. The mental health intervention (PROTECT) was successfully implemented in two different formats with collaboration between staff workers. These findings support both the need for mental health care among elder abuse victims and the feasibility of integrating mental health screening and treatment into routine elder abuse practice.

  6. Supervisory Turnover in Outpatient Substance Abuse Treatment

    PubMed Central

    Knight, Danica K.; Broome, Kirk M.; Edwards, Jennifer R.; Flynn, Patrick M.

    2009-01-01

    Staff turnover is a significant issue within substance abuse treatment, with implications for service delivery and organizational health. This study examined factors associated with turnover among supervisors in outpatient substance abuse treatment. Turnover was conceptualized as being an individual response to organizational-level influences, and predictors represent aggregate program measures. Participants included 532 staff (including 467 counselors and 65 clinical/program directors) from 90 programs in four regions of the USA. Using logistic regression, analyses of structural factors indicated that programs affiliated with a parent organization and those providing more counseling hours to clients had higher turnover rates. When measures of job attitudes were included, only parent affiliation and collective appraisal of satisfaction were related to turnover. Subsequent analyses identified a trend toward increased supervisory turnover when satisfaction was low following the departure of a previous supervisor. These findings suggest that organizational-level factors can be influential in supervisory turnover. PMID:19949883

  7. Improving mental health service responses to domestic violence and abuse.

    PubMed

    Trevillion, Kylee; Corker, Elizabeth; Capron, Lauren E; Oram, Siân

    2016-10-01

    Domestic violence and abuse is a considerable international public health problem, which is associated with mental disorders in both women and men. Nevertheless, victimization and perpetration remain undetected by mental health services. This paper reviews the evidence on mental health service responses to domestic violence, including identifying, referring, and providing care for people experiencing or perpetrating violence. The review highlights the need for mental health services to improve rates of identification and responses to domestic violence and abuse, through the provision of specific training on domestic violence and abuse, the implementation of clear information sharing protocols and evidence-based interventions, and the establishment of care referral pathways. This review also highlights the need for further research into mental health service users who perpetrate domestic violence and abuse.

  8. Electronic health records: essential tools in integrating substance abuse treatment with primary care

    PubMed Central

    Tai, Betty; Wu, Li-Tzy; Clark, H Westley

    2012-01-01

    While substance use problems are considered to be common in medical settings, they are not systematically assessed and diagnosed for treatment management. Research data suggest that the majority of individuals with a substance use disorder either do not use treatment or delay treatment-seeking for over a decade. The separation of substance abuse services from mainstream medical care and a lack of preventive services for substance abuse in primary care can contribute to under-detection of substance use problems. When fully enacted in 2014, the Patient Protection and Affordable Care Act 2010 will address these barriers by supporting preventive services for substance abuse (screening, counseling) and integration of substance abuse care with primary care. One key factor that can help to achieve this goal is to incorporate the standardized screeners or common data elements for substance use and related disorders into the electronic health records (EHR) system in the health care setting. Incentives for care providers to adopt an EHR system for meaningful use are part of the Health Information Technology for Economic and Clinical Health Act 2009. This commentary focuses on recent evidence about routine screening and intervention for alcohol/drug use and related disorders in primary care. Federal efforts in developing common data elements for use as screeners for substance use and related disorders are described. A pressing need for empirical data on screening, brief intervention, and referral to treatment (SBIRT) for drug-related disorders to inform SBIRT and related EHR efforts is highlighted. PMID:24474861

  9. Improving service practices: collaborative care for women of abuse.

    PubMed

    Haeseler, Lisa Ann

    2013-01-01

    This original qualitative research inquiry is based on a phenomenological research dissertation case study. This article information and content that is gathered helps to better inform providers in the field of social services and those who are social workers and administrators in social services. This research investigated key factors, traits, or attributes that strive to improve service care for women of domestic violence abuse. Findings support current and relevant research to enhance aid to women of abuse. Results strongly detail that professionals must work more cooperatively as an all-channels network of comprehensive care to women. Because women of domestic violence abuse require such multifaced complex care due to the interwoven issues familial abuse brings, results support that service practitioners can best meet the needs of these women through an ecological or life-space understanding for improved care, achieved by infusing an inter-disciplinary systems-based, inter-agency and intra-agency framework.

  10. Drug Abuse Treatment in Prisons. Treatment Research Report.

    ERIC Educational Resources Information Center

    National Inst. for Advanced Studies, Washington, DC.

    This report, based on a 1979 national survey of drug abuse treatment programs in the prisons of the 50 states and the District of Columbia, presents data on 160 operational programs. Descriptive information on the identification of drug-dependent inmates and the provision of drug abuse treatment by state adult correctional institutions is…

  11. Rates of trauma-informed counseling at substance abuse treatment facilities: reports from over 10,000 programs.

    PubMed

    Capezza, Nicole M; Najavits, Lisa M

    2012-04-01

    Trauma-informed treatment increasingly is recognized as an important component of service delivery. This study examined differences in treatment-related characteristics of facilities that offer moderate or high levels of trauma-informed counseling versus those that offer no or low levels of such counseling. Responses from 13,223 substance abuse treatment facilities surveyed in 2009 by the National Survey of Substance Abuse Treatment Services (NSSATS) were used. A majority (66.6%) of facilities reported using trauma counseling sometimes or always or often. Facilities that provided moderate or high levels of trauma counseling were more likely to provide additional treatment services, such as disease testing and specialized group therapy, as well as child care, employment counseling, and other ancillary services. A majority of facilities reported provision of trauma counseling. Additional training and resources may be needed for programs that reported low rates of trauma counseling.

  12. Gender Disparities in Utilization and Outcome of Comprehensive Substance Abuse Treatment Among Racial/Ethnic Groups

    PubMed Central

    Guerrero, Erick G.; Marsh, Jeanne C.; Cao, Dingcai; Shin, Hee-Choon; Andrews, Christina

    2014-01-01

    This study examined gender differences within Black, Latino, and White subgroups in the utilization of comprehensive services and their relation to posttreatment substance use. Survey data were collected during the National Treatment Improvement Evaluation Study (NTIES), a prospective, longitudinal, multisite study of substance abuse treatment programs and their clients in the United States. The analytic sample consisted of 1,812 Blacks (734 women and 1,078 men), 486 Latinos (147 women and 339 men), and 844 Whites (147 women and 339 men) from 59 service delivery organizations. Results related to service utilization indicated that compared to men, women in all racial and ethnic groups needed and received more services targeted to their needs and reported more positive relations with service providers. Gender was a significant moderator of the relationship between service receipt and treatment outcomes for all racial and ethnic groups, but especially for the Latino subsample. Findings point to the need to consider race-specific gender differences in the development of culturally competent, comprehensive substance abuse treatment. PMID:24560127

  13. Substance Abuse Treatment in Persons with HIV/AIDS: Challenges in Managing Triple Diagnosis

    PubMed Central

    Durvasula, Ramani; Miller, Theodore R.

    2014-01-01

    This paper provides a review of the current literature addressing substance abuse treatment in persons living with HIV/AIDS. Clinical management of HIV must account for the “triple diagnosis” of HIV, psychiatric diagnosis, and substance use disorders and requires integrated treatment services that focus beyond just mitigation of substance use and psychiatric and medical symptoms but also address other health behaviors. Because clinical management of HIV/AIDS has shifted significantly with the advent of highly active antiretroviral therapies (HAART) in the mid 1990's, a literature review focusing on literature published since 2000, and using relevant key words was conducted using a wide range of literature search databases. This literature review was complemented by studies to expand on specific treatment modalities for which there was a dearth of literature addressing HIV infected cohorts and to provide discussion of issues around substance abuse treatment as an HIV prevention tool. Existing models of substance abuse treatment including cognitive behavioral therapy and motivational interviewing have proven to be useful for enhancing adherence and reducing substance use in outpatient populations, while methadone maintenance and directly observed treatment have been useful with specific subgroups of users. Contextualization of services heightens the likelihood of successful outcomes and relapse prevention. PMID:24274175

  14. The Economic Cost of Substance Abuse Treatment in the State of Florida

    ERIC Educational Resources Information Center

    Alexandre, Pierre K.; Beulaygue, Isabelle C.; French, Michael T.; McCollister, Kathryn E.; Popovici, Ioana; Sayed, Bisma A.

    2012-01-01

    Objective: Public and private stakeholders of substance abuse treatment services require economic cost data to guide program evaluations and funding decisions. Background: Rigorous cost assessments have been conducted for several treatment programs across the United States, but a systematic and comprehensive evaluation of programs in a particular…

  15. Training in the Prevention and Treatment of Child Abuse and Neglect. The User Manual Series.

    ERIC Educational Resources Information Center

    Broadhurst, Diane D.; MacDicken, Robert A.

    Intended primarily for persons or agencies responsible for providing training to professionals and interested citizens involved in delivery of services to abusive and neglectful families, the manual addresses the importance of training in the identification, reporting, diagnosis, treatment, and prevention of child abuse and neglect. Chapters focus…

  16. Residential Treatment of Substance Abusing Adolescents: Trends in the Post-Managed Care Era

    ERIC Educational Resources Information Center

    MacMaster, Samuel A.; Ellis, Rodney A.; Cooper, Lyle

    2005-01-01

    This paper explores historical and recent trends in the delivery of residential adolescent substance abuse treatment, looking specifically at the impact of managed care on the service delivery system. Three historical eras are conceptualized by the authors: (1) an era prior to managed care in which services were provided on a fee for service basis…

  17. Childhood Sexual Abuse Patterns, Psychosocial Correlates, and Treatment Outcomes among Adults in Drug Abuse Treatment

    ERIC Educational Resources Information Center

    Boles, Sharon M.; Joshi, Vandana; Grella, Christine; Wellisch, Jean

    2005-01-01

    This study reports on the effects of having a history of childhood sexual abuse (CSA) on treatment outcomes among substance abusing men and women (N = 2,434) in a national, multisite study of drug treatment outcomes. A history of CSA was reported by 27.2% of the women and 9.2% of the men. Controlling for gender, compared to patients without CSA,…

  18. Cultural Issues in Substance Abuse Treatment.

    ERIC Educational Resources Information Center

    Cortes, Dharma E.; Ja, Davis; Noboa, Abdin; Perry, Vincent; Robinson, Robert; Rodriguez, Domingo; Stubben, Jerry

    This monograph provides a tool to help providers and other substance abuse treatment professionals gain a greater understanding of the cultural, social, political, and economic forces affecting substance abuse treatment among Hispanic Americans, African Americans, Asian Americans/Pacific Islanders, and American Indians/Alaska Natives. An…

  19. Growth and Empowerment for Indigenous Australians in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Berry, Stacey L.; Crowe, T. P.; Deane, F. P.; Billingham, M.; Bhagerutty, Y.

    2012-01-01

    This paper describes psychosocial outcomes of an Indigenous residential substance abuse rehabilitation centre in Australia, examines the sensitivity to change of the new Growth and Empowerment Measure (GEM), and explores the degree to which service users value cultural components of the treatment program. Participants were 57 Indigenous and 46…

  20. Residential Substance Abuse Treatment for Urban American Indians and Alaska Natives, Part II: Costs.

    PubMed

    McFarland, Bentson H; Walker, Dale; Silk-Walker, Patricia

    2017-01-01

    The present study examined costs of two residential substance abuse treatment programs designed for urban American Indians and Alaska Natives (AI/ANs). Costs for one agency were well within national norms, while costs at the other program were less than expected from nationwide data. Economies of scale accounted for much of the difference between observed and expected costs. Culturally specific residential substance abuse treatment services can be provided to urban AI/ANs within budgets typically found at mainstream programs.

  1. Preventing Elder Abuse: The Texas Plan for a Coordinated Service Delivery System. Collaborative Elder Abuse Prevention Project.

    ERIC Educational Resources Information Center

    McDaniel, Garry L.

    The Texas Department of Human Services, in collaboration with 13 other public and private organizations, co-sponsored a statewide Collaborative Elder Abuse Prevention project. The goal of this project is to develop a comprehensive, long-range plan for the prevention of elder abuse, a method for achieving a coordinated service delivery system for…

  2. Substance Abuse Treatment Facility Locator

    MedlinePlus

    ... None / Reverse   Treatment for non-substance abuse addiction disorder   Treatment for gambling disorder   Treatment for internet use disorder Detoxification All / None / Reverse   Alcohol ...

  3. PERCEIVED FEASIBILITY OF ESTABLISHING DEDICATED ELDER ABUSE PROGRAMS OF CARE AT HOSPITAL-BASED SEXUAL ASSAULT/DOMESTIC VIOLENCE TREATMENT CENTETR.

    PubMed

    Du Mont, Janice; Mirzaei, Aftab; Macdonald, Sheila; White, Meghan; Kosa, Daisy; Reimer, Linda

    2014-12-01

    Elder abuse is an increasingly important issue that must be addressed in a systematic and coordinated way. Our objective was to evaluate the perceived feasibility of establishing an elder abuse care program at hospital-based sexual assault and domestic violence treatment centers in Ontario, Canada. In July 2012, a questionnaire focused on elder abuse care was distributed to all of Ontario's Sexual Assault/Domestic Violence Treatment Centre (SA/DVTC) Program Coordinators/Managers. We found that the majority of Program Coordinators/ Managers favored expansion of their program mandates to include an elder abuse care program. However, these respondents viewed collaboration with a large network of well trained professionals and available services in the community that address elder abuse as integral to responding in a coordinated manner. The expansion of health services to address the needs of abused older adults in a comprehensive and integrated manner should be considered as an important next step for hospital-based violence care programs worldwide.

  4. Understanding Service Utilization in Cases of Elder Abuse to Inform Best Practices.

    PubMed

    Burnes, David; Rizzo, Victoria M; Gorroochurn, Prakash; Pollack, Martha H; Lachs, Mark S

    2016-10-01

    Elder abuse (EA) case resolution is contingent upon victims accepting and pursuing protective service interventions. Refusal/underutilization of services is a major problem. This study explored factors associated with extent of EA victim service utilization (SU). Data were collected from a random sample of EA cases (n = 250) at a protective service program in New York City. In cases involving financial abuse, higher SU was associated with females, poor health, perceived danger, previous help-seeking, and self or family referral. In physical abuse cases, higher SU was associated with family referral and previous help-seeking; lower SU was related to Hispanic race/ethnicity, being married, and child/grandchild perpetrator. In emotional abuse cases, higher SU was associated with self or family referral, victim-perpetrator gender differential, perceived danger, and previous help-seeking; lower SU was related to child/grandchild perpetrator. Findings carry implications for best practices to retain and promote service use among elder victims of abuse. © The Author(s) 2014.

  5. Socioeconomic differences in adolescent substance abuse treatment participation and long-term outcomes.

    PubMed

    Lui, Camillia K; Sterling, Stacy A; Chi, Felicia W; Lu, Yun; Campbell, Cynthia I

    2017-05-01

    Socioeconomic status (SES) has been consistently linked to poorer access, utilization and outcomes of health care services, but this relationship has been understudied in adolescent substance abuse treatment research. This study examined SES differences in adolescent's treatment participation and long-term outcomes of abstinence and 12-step attendance over five years after treatment. Data are from 358 adolescents (ages 13-18) who were recruited at intake to substance abuse treatment between 2000 and 2002 at four Kaiser Permanente Northern California outpatient treatment programs. Follow-up interviews of adolescents and their parents were conducted at 1, 3, and 5years, with over 80% response rates across time points. Using parent SES as a proxy for adolescent SES, no socioeconomic differences were found in treatment initiation, treatment retention, or long-term abstinence from alcohol or drugs. Parent education, but not parent income, was significantly associated with 12-step attendance post-treatment such that adolescents with higher parent education were more likely to attend than those with lower parent education. Findings suggest a lack of socioeconomic disparities in substance abuse treatment participation in adolescence, but potential disparities in post-treatment 12-step attendance during the transition from adolescence to young adulthood. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Improving Parolees' Participation in Drug Treatment and Other Services through Strengths Case Management.

    PubMed

    Prendergast, Michael; Cartier, Jerome J

    2008-01-01

    In an effort to increase participation in community aftercare treatment for substance-abusing parolees, an intervention based on a transitional case management (TCM) model that focuses mainly on offenders' strengths has been developed and is under testing. This model consists of completion, by the inmate, of a self-assessment of strengths that informs the development of the continuing care plan, a case conference call shortly before release, and strengths case management for three months post-release to promote retention in substance abuse treatment and support the participant's access to designated services in the community. The post-release component consists of a minimum of one weekly client/case manager meeting (in person or by telephone) for 12 weeks. The intervention is intended to improve the transition process from prison to community at both the individual and systems level. Specifically, the intervention is designed to improve outcomes in parolee admission to, and retention in, community-based substance-abuse treatment, parolee access to other needed services, and recidivism rates during the first year of parole. On the systems level, the intervention is intended to improve the communication and collaboration between criminal justice agencies, community-based treatment organizations, and other social and governmental service providers. The TCM model is being tested in a multisite study through the Criminal Justice Drug Abuse Treatment Studies (CJ-DATS) research cooperative funded by the National Institute of Drug Abuse.

  7. Substance Abuse Treatment: Group Therapy. Treatment Improvement Protocol (TIP) Series 41

    ERIC Educational Resources Information Center

    Gilbert, Jonathan Max; Hills, Susan; Rife, Mary Lou

    2005-01-01

    This Treatment Improvement Protocol (TIP) presents an overview of the role and efficacy of group therapy in substance abuse treatment. TIPs are best-practice guidelines for the treatment of substance use disorders that make the latest research in substance abuse treatment available to counselors and educators. The content was generated by a panel…

  8. Predictors of Stimulant Abuse Treatment Outcomes in Severely Mentally Ill Outpatients

    PubMed Central

    Angelo, Frank N.; McDonell, Michael G.; Lewin, Michael R.; Srebnik, Debra; Lowe, Jessica; Roll, John; Ries, Richard

    2012-01-01

    Background Severe mental illness is often exclusionary criteria for studies examining factors that influence addiction treatment outcome. Therefore, little is known about predictors of treatment response of individuals receiving psychosocial treatments for addictions who suffer from co-occurring severe mental illness. Methods The impact of demographic, substance abuse severity, psychiatric severity, and service utilization variables on in-treatment performance (i.e., longest duration of abstinence) in a 12-week contingency management (CM) intervention for stimulant abuse in 96 severely mentally ill adults was investigated. A 4-step linear regression was used to identify independent predictors of in-treatment abstinence. Results This model accounted for 37.4% of variance in the longest duration of abstinence outcome. Lower levels of stimulant use (i.e., stimulant-negative urine test) and psychiatric severity (i.e., lower levels of psychiatric distress), as well as higher rates of outpatient treatment utilization at study entry were independently associated with longer duration of drug abstinence. Conclusion These data suggest that individuals with low levels of stimulant use and psychiatric severity, as well as those actively engaged in services are most likely to succeed in a typical CM intervention. For others, modifications to CM interventions, such as increasing the value of reinforcement or adding CM to evidence based psychiatric interventions may improve treatment outcomes. PMID:23273776

  9. [Suspected child abuse in paediatric emergency service].

    PubMed

    Sabaté Rotés, A; Sancosmed Ron, M; Cebrián Rubio, R; Canet Ponsa, M; Martín González, M

    2009-07-01

    To describe the epidemiology of child abuse in an emergency department of a tertiary paediatric hospital. Descriptive and retrospective study from January 2008 to January 2006 including patients less than sixteen years of age who were suspected of being abused during the examination in the emergency department. Child maltreatment was 0.07% of all paediatric emergencies (45% physical abuse, 35% sexual abuse and 20% neglect). Mean age of 6 years old, with no gender differences. 86% were suspected of maltreatment. An adult living with the child was suspected in 67% of cases. Social and judicial procedures were activated. A total of 24 children were admitted, 14 under medical criteria and the rest in order to protect the child; 2 had serious neurological consequences and one died. Eight patients were discharged to social service care centres. We believe it is necessary to improve the pediatrician's knowledge of child abuse and to create specialized units.

  10. Factors Related to Medicaid Payment Acceptance at Outpatient Substance Abuse Treatment Programs

    PubMed Central

    Terry-McElrath, Yvonne M; Chriqui, Jamie F; McBride, Duane C

    2011-01-01

    Objective To examine factors associated with Medicaid acceptance for substance abuse (SA) services by outpatient SA treatment programs. Data Sources Secondary analysis of 2003–2006 National Survey of Substance Abuse Treatment Services data combined with state Medicaid policy and usage measures and other publicly available data. Study Design We used cross-sectional analyses, including state fixed effects, to assess relationships between SA treatment program Medicaid acceptance and (1) program-level factors, (2) county-level sociodemographics and treatment program density, and (3) state-level population characteristics, SA treatment-related factors, and Medicaid policy and usage. Data Extraction Methods State Medicaid policy data were compiled based on reviews of state Medicaid-related statutes/regulations and Medicaid plans. Other data were publicly available. Principal Findings Medicaid acceptance was significantly higher for programs: (a) that were publicly funded and in states with Medicaid policy allowing SA treatment coverage; (b) with accreditation/licensure and nonprofit/government ownership, as well as mental- and general-health focused programs; and (c) in counties with lower household income. Conclusions SA treatment program Medicaid acceptance related to program-, county, and state-level factors. The data suggest the importance of state policy and licensure/accreditation requirements in increasing SA program Medicaid access. PMID:21105870

  11. 28 CFR 550.53 - Residential Drug Abuse Treatment Program (RDAP).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Residential Drug Abuse Treatment Program... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.53 Residential Drug Abuse Treatment... components: (1) Unit-based component. Inmates must complete a course of activities provided by drug abuse...

  12. 28 CFR 550.53 - Residential Drug Abuse Treatment Program (RDAP).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Residential Drug Abuse Treatment Program... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.53 Residential Drug Abuse Treatment... components: (1) Unit-based component. Inmates must complete a course of activities provided by drug abuse...

  13. 28 CFR 550.53 - Residential Drug Abuse Treatment Program (RDAP).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Residential Drug Abuse Treatment Program... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.53 Residential Drug Abuse Treatment... components: (1) Unit-based component. Inmates must complete a course of activities provided by drug abuse...

  14. 28 CFR 550.53 - Residential Drug Abuse Treatment Program (RDAP).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Residential Drug Abuse Treatment Program... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.53 Residential Drug Abuse Treatment... components: (1) Unit-based component. Inmates must complete a course of activities provided by drug abuse...

  15. 28 CFR 550.53 - Residential Drug Abuse Treatment Program (RDAP).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Residential Drug Abuse Treatment Program... INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.53 Residential Drug Abuse Treatment... components: (1) Unit-based component. Inmates must complete a course of activities provided by drug abuse...

  16. Drug treatment services for adult offenders: The state of the state

    PubMed Central

    Taxman, Faye S.; Perdoni, Matthew L.; Harrison, Lana D.

    2007-01-01

    We conducted a national survey of prisons, jails, and community correctional agencies to estimate the prevalence of entry into and accessibility of correctional programs and drug treatment services for adult offenders. Substance abuse education and awareness is the most prevalent form of service provided, being offered in 74% of prisons, 61% of jails, and 53% of community correctional agencies; at the same time, remedial education is the most frequently available correctional program in prisons (89%) and jails (59.5%), whereas sex offender therapy (57.2%) and intensive supervision (41.9%) dominate in community correctional programs. Most substance abuse services provided to offenders are offered through correctional programs such as intensive supervision, day reporting, vocational education, and work release, among others. Although agencies report a high frequency of providing substance abuse services, the prevalence rates are misleading because less than a quarter of the offenders in prisons and jails and less than 10% of those in community correctional agencies have access to these services through correctional agencies; in addition, these are predominantly drug treatment services that offer few clinical services. Given that drug-involved offenders are likely to have dependence rates that are four times greater than those among the general public, the drug treatment services and correctional programs available to offenders do not appear to be appropriate for the needs of this population. The National Criminal Justice Treatment Practices survey provides a better understanding of the distribution of services and programs across prisons, jails, and community correctional agencies and allows researchers and policymakers to understand some of the gaps in services and programs that may negatively affect recidivism reduction efforts. PMID:17383549

  17. TFA Systems: A Unique Group Treatment of Spouse Abusers.

    ERIC Educational Resources Information Center

    Clow, Daniel R.; And Others

    1992-01-01

    Presents a group treatment model using Thought-Feeling-Action (TFA) Systems, an offense- and offender-specific group treatment for abusers. Describes use of TFA Systems in group of court-referred male spouse-abusers. Reviews evolution of TFA Systems, then focuses on TFA Systems treatment of spouse abusers. Notes that system can be adapted to other…

  18. The role of culture in substance abuse treatment programs for American Indian and Alaska Native communities.

    PubMed

    Legha, Rupinder Kaur; Novins, Douglas

    2012-07-01

    Culture figures prominently in discussions regarding the etiology of alcohol and substance abuse in American Indian and Alaska Native (AI/AN) communities, and a substantial body of literature suggests that it is critical to developing meaningful treatment interventions. However, no study has characterized how programs integrate culture into their services. Furthermore, reports regarding the associated challenges are limited. Twenty key informant interviews with administrators and 15 focus groups with clinicians were conducted in 18 alcohol and substance abuse treatment programs serving AI/AN communities. Transcripts were coded to identify relevant themes. Substance abuse treatment programs for AI/AN communities are integrating culture into their services in two discrete ways: by implementing specific cultural practices and by adapting Western treatment models. More important, however, are the fundamental principles that shape these programs and their interactions with the people and communities they serve. These foundational beliefs and values, defined in this study as the core cultural constructs that validate and incorporate AI/AN experience and world view, include an emphasis on community and family, meaningful relationships with and respect for clients, a homelike atmosphere within the program setting, and an “open door” policy for clients. The primary challenges for integrating these cultural practices include AI/AN communities' cultural diversity and limited socioeconomic resources to design and implement these practices. The prominence of foundational beliefs and values is striking and suggests a broader definition of culture when designing services. This definition of foundational beliefs and values should help other diverse communities culturally adapt their substance abuse interventions in more meaningful ways.

  19. Military Dependents: Services Provide Limited Confidentiality in Family Abuse Cases

    DTIC Science & Technology

    2000-04-01

    regarding family abuse. To respond to this mandate, we determined (1) the extent of reported spousal and child abuse within the military, (2) the degree...violence and as emotional and financial maltreatment, including any actions that harm or limit the spouse’s freedom of choice. Child abuse includes...military services has established a Family Advocacy Program to provide family counseling and to help ensure the safety of alleged spousal and child abuse victims.

  20. Psychiatric symptom typology in a sample of youth receiving substance abuse treatment services: associations with self-reported child maltreatment and sexual risk behaviors.

    PubMed

    Oshri, Assaf; Tubman, Jonathan G; Jaccard, James

    2011-11-01

    Latent profile analysis (LPA) was used to classify 394 adolescents undergoing substance use treatment, based on past year psychiatric symptoms. Relations between profile membership and (a) self-reported childhood maltreatment experiences and (b) current sexual risk behavior were examined. LPA generated three psychiatric symptom profiles: Low-, High- Alcohol-, and High- Internalizing Symptoms profiles. Analyses identified significant associations between profile membership and childhood sexual abuse and emotional neglect ratings, as well as co-occurring sex with substance use and unprotected intercourse. Profiles with elevated psychiatric symptom scores (e.g., internalizing problems, alcohol abuse and dependence symptoms) and more severe maltreatment histories reported higher scores for behavioral risk factors for HIV/STI exposure. Heterogeneity in psychiatric symptom patterns among youth receiving substance use treatment services, and prior histories of childhood maltreatment, have significant implications for the design and delivery of HIV/STI prevention programs to this population.

  1. Social Workers in the Substance Abuse Treatment Field: A Snapshot of Service Activities

    ERIC Educational Resources Information Center

    Smith, Mickey J. W.; Whitaker, Tracy; Weismiller, Toby

    2006-01-01

    This article describes the results of the first Practice Research Network (PRN) survey conducted by the National Association of Social Workers, a collaborative project funded by the Center for Substance Abuse Treatment. The objectives of the PRN survey were to develop broad knowledge about social work practices and more specific knowledge about…

  2. Characteristics of drug-abusing women with children in residential treatment: a preliminary evaluation of program retention and treatment completion.

    PubMed

    Simons, Lori

    2008-01-01

    An ex post facto study was conducted to investigate treatment outcomes for 80 women and 168 children admitted into a residential substance-abuse treatment program. The results indicated childhood emotional neglect is a barrier for remaining in and completing treatment for African-American women with comorbid psychological disorders but not for those with crack cocaine dependent disorders. African-American women with comorbid psychological disorders were also three times more likely to dropout of treatment. In addition, there were relatively few differences for between drug-exposed and nonexposed children. However, the results indicated that children of substance-abusing women who completed treatment were more likely to have behavioral problems, to receive early intervention services, and to have mothers as legal guardians by the end of treatment. Implications for gender-specific interventions for African-American women and their children in residential treatment are discussed.

  3. Implementing Effective Substance Abuse Treatments in General Medical Settings: Mapping the Research Terrain

    PubMed Central

    Ducharme, Lori J.; Chandler, Redonna K.; Harris, Alex H. S.

    2015-01-01

    The National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Drug Abuse (NIDA), and Veterans Health Administration (VHA) share an interest in promoting high quality, rigorous health services research to improve the availability and utilization of evidence-based treatment for substance use disorders (SUD). Recent and continuing changes in the healthcare policy and funding environments prioritize the integration of evidence-based substance abuse treatments into primary care and general medical settings. This area is a prime candidate for implementation research. Recent and ongoing implementation projects funded by these agencies are reviewed. Research in five areas is highlighted: screening and brief intervention for risky drinking; screening and brief intervention for tobacco use; uptake of FDA-approved addiction pharmacotherapies; safe opioid prescribing; and disease management. Gaps in the portfolios, and priorities for future research, are described. PMID:26233697

  4. Implementing Effective Substance Abuse Treatments in General Medical Settings: Mapping the Research Terrain.

    PubMed

    Ducharme, Lori J; Chandler, Redonna K; Harris, Alex H S

    2016-01-01

    The National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Drug Abuse (NIDA), and Veterans Health Administration (VHA) share an interest in promoting high quality, rigorous health services research to improve the availability and utilization of evidence-based treatment for substance use disorders (SUD). Recent and continuing changes in the healthcare policy and funding environments prioritize the integration of evidence-based substance abuse treatments into primary care and general medical settings. This area is a prime candidate for implementation research. Recent and ongoing implementation projects funded by these agencies are reviewed. Research in five areas is highlighted: screening and brief intervention for risky drinking; screening and brief intervention for tobacco use; uptake of FDA-approved addiction pharmacotherapies; safe opioid prescribing; and disease management. Gaps in the portfolios, and priorities for future research, are described. Published by Elsevier Inc.

  5. Substance abuse treatment in the Commonwealth of Massachusetts: gaps, consequences and solutions.

    PubMed

    Brolin, Mary F; Horgan, Constance; Amaro, Hortensia; Doonan, Michael

    2005-11-17

    This issue brief outlines five strategies for improving the quality of treatment in Massachusetts: (1) Engaging detoxification clients in a broader continuum of treatment, (2) Improving retention in treatment, (3) Providing client/family-centered services, (4) Increasing the use of evidence-based treatment approaches, and (5) Supporting recovery to address the chronic nature of substance use disorders. These strategies are essential to maximizing the impact of our substance abuse dollars. We need to do it right and then expand access to treatment more broadly and fill the treatment gap. Although not the focus of this report we need to think harder about upfront prevention and efforts to encourage more people to seek care. Part of the public strategy also requires better coordination between BSAS, MassHealth, provider organizations, and other state agencies, including criminal justice and mental health agencies. Through these efforts we can reduce the costs and consequences of substance abuse and build a healthier, more productive community.

  6. Multidimensional Implementation Evaluation of a Residential Treatment Program for Adolescent Substance Abuse

    ERIC Educational Resources Information Center

    Faw, Leyla; Hogue, Aaron; Liddle, Howard A.

    2005-01-01

    The authors applied contemporary methods from the evaluation literature to measure implementation in a residential treatment program for adolescent substance abuse. A logic model containing two main components was measured. Program structure (adherence to the intended framework of service delivery) was measured using data from daily activity logs…

  7. The Protected Addiction: Exploring Staff Beliefs toward Integrating Tobacco Dependence into Substance Abuse Treatment Services

    ERIC Educational Resources Information Center

    Teater, Barbra; Hammond, Gretchen Clark

    2009-01-01

    Survey research was used to explore the beliefs of 963 staff members regarding the myths to treating tobacco dependence and the integration of tobacco dependence into substance abuse treatment programs. The staff represented a mixture of residential, outpatient, and prevention-based gender-specific (women only) treatment centers throughout Ohio.…

  8. Substance abuse treatment in persons with HIV/AIDS: challenges in managing triple diagnosis.

    PubMed

    Durvasula, Ramani; Miller, Theodore R

    2014-01-01

    Clinical management of HIV must account for the "triple diagnosis" of HIV, psychiatric diagnosis, and substance use disorders and requires integrated treatment services that focus beyond just mitigation of substance use and psychiatric and medical symptoms but also address other health behaviors. Because clinical management of HIV/AIDS has shifted significantly with the advent of highly active antiretroviral therapies (HAART) in the mid 1990s, a literature review focusing on literature published since 2000, and using relevant key words was conducted using a wide range of literature search databases. This literature review was complemented by studies to expand on specific treatment modalities for which there was a dearth of literature addressing HIV infected cohorts and to provide discussion of issues around substance abuse treatment as an HIV prevention tool. Existing models of substance abuse treatment including cognitive behavioral therapy and motivational interviewing have proven to be useful for enhancing adherence and reducing substance use in outpatient populations, while methadone maintenance and directly observed treatment have been useful with specific subgroups of users. Contextualization of services heightens the likelihood of successful outcomes and relapse prevention.

  9. Treatment Service Patterns and Organizational Structures: An Analysis of Programs in DATOS-A.

    ERIC Educational Resources Information Center

    Delany, Peter J.; Broome, Kirk M.; Flynn, Patrick M.; Fletcher, Bennett W.

    2001-01-01

    Examined availability of various treatment services within a national sample of programs treating adolescent drug abuse patients. Created treatment service delivery profiles and examined them in context of organizational variables. Found that distinct profiles of services existed within residential and outpatient modalities and that these service…

  10. Predictors of quit attempts among smokers enrolled in substance abuse treatment.

    PubMed

    Martínez, Cristina; Guydish, Joseph; Le, Thao; Tajima, Barbara; Passalacqua, Emma

    2015-01-01

    This study investigates factors predicting past year quit attempts among smokers enrolled in substance abuse treatment in New York State. Data were drawn from two prior cross-sectional surveys conducted among clients treated in 10 randomly selected substance abuse treatment programs. Among 820 clients recruited, 542 self-identified as current smokers, and 485 provided information about their quit attempts. The main outcome was reporting a quit smoking attempt in the past year, dichotomized as quit attempters or non-quit attempters. Univariate and multivariate logistic regression analyses were performed to explore predictors of attempting to quit. Half of substance abuse clients in treatment programs reported a past year quit attempt. Quit attempters were more likely to be in a preparation and contemplation stage of change (preparation: OR=2.68, 95% CI: 1.51-4.77; contemplation: OR=2.96 95% CI: 1.61-5.42), reported more positive attitudes toward quitting (OR=1.49; 95% CI: 1.11-1.99) and received more cessation services than non-quit attempters (OR=1.21; 95% CI: 1.11-1.99). Addressing patient attitudes about quitting smoking, having clinicians address smoking in the course of addiction treatment, and offering interventions to increase readiness to quit may contribute to increased quit attempts in smokers enrolled in addiction treatment programs. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Process Evaluation in Corrections-Based Substance Abuse Treatment.

    ERIC Educational Resources Information Center

    Wolk, James L.; Hartmann, David J.

    1996-01-01

    Argues that process evaluation is needed to validate prison-based substance abuse treatment effectiveness. Five groups--inmates, treatment staff, prison staff, prison administration, and the parole board--should be a part of this process evaluation. Discusses these five groups relative to three stages of development of substance abuse treatment in…

  12. Substance abuse treatment and services by criminal justice and other funding sources.

    PubMed

    Arfken, Cynthia L; Kubiak, Sheryl Pimlott

    2009-01-01

    Studies have found funding source, whether public or private, is associated with treatment and services offered in community-based agencies. However, the association of criminal justice funding with community-based treatment and services is unknown. Using a mixed method case study approach with 34 agencies within one state we assessed administrators' perspectives of the most important funding source, treatment and services offered. We found that agencies rely on multiple funding sources and the source rated most important was associated with treatment and services offered in the agency. Those agencies citing a criminal justice entity as the most important funder were more likely to offer specific ancillary services and adopt motivational interviewing than those citing private funds. Although client characteristics or training opportunities may determine these services and practices, the agency's most important funding source may have implications for services offered.

  13. Behavioral health services utilization among older adults identified within a state abuse hotline database.

    PubMed

    Schonfeld, Lawrence; Larsen, Rebecca G; Stiles, Paul G

    2006-04-01

    This study examined the extent to which older adults identified in a statewide abuse hotline registry utilized behavioral health services. This is important as mental health issues have been identified as a high priority for filling gaps in services for victims of mistreatment. We compared Medicaid and Medicare claims data for two groups of older adults: those using health services and identified within a statewide abuse hotline information system and those claimants not identified within the hotline database. Behavioral health service use was greater among those identified in the abuse hotline database. The penetration rate (percentage of service users out of all enrollees) for Medicaid behavioral health service claims was more than twice that of other service users, with costs of services about 30% greater. Analyses of Medicare data revealed that the penetration rate for those in the hotline data was almost 6 times greater at approximately twice the cost compared to other service users. The results provide evidence for previous assumptions that mistreated individuals experience a higher rate of behavioral health disorders. As mental health screening by adult protective services is rarely conducted, the results suggest the need to train investigators and other service providers to screen older adults for behavioral health and substance-abuse issues as well as physical signs of abuse. Further research on the relationship of abuse to behavioral health might focus on collection of additional data involving more specific victim-related characteristics and comparisons of cases of mistreatment versus self-neglect.

  14. Domestic violence and treatment seeking: a longitudinal study of low-income women and mental health/substance abuse care.

    PubMed

    Cheng, Tyrone C; Lo, Celia C

    2014-01-01

    A study with 591 low-income women examined domestic violence's role in treatment seeking for mental health or substance abuse problems. (The women resided in one of two California counties.) Following Aday's behavioral model of health services utilization, the secondary data analysis considered the women's need, enabling, and predisposing factors. Generalized estimating equations analyzed the women's longitudinal records of treatment seeking. Results showed that those in the sample who were likely to seek treatment had experienced three or more controlling behaviors and only one abusive behavior. Multivariate data analysis showed treatment-seeking women were likely to be white and older; responsible for few dependent children; not graduates of high school; employed; not participating in Medicaid; diagnosed; and perceiving a need for treatment. The implications of these results for services and policies are discussed.

  15. A descriptive survey of types, spread and characteristics of substance abuse treatment centers in Nigeria.

    PubMed

    Onifade, Peter O; Somoye, Edward B; Ogunwobi, Olorunfemi O; Ogunwale, Adegboyega; Akinhanmi, Akinwande O; Adamson, Taiwo A

    2011-09-18

    Nigeria, the most populous country in Africa and the 8th most populous in the world with a population of over 154 million, does not have current data on substance abuse treatment demand and treatment facilities; however, the country has the highest one-year prevalence rate of Cannabis use (14.3%) in Africa and ranks third in Africa with respect to the one-year prevalence rate of cocaine (0.7%) and Opioids (0.7%) use. This study aimed to determine the types, spread and characteristics of the substance abuse treatment centers in Nigeria. The study was a cross sectional survey of substance abuse treatment centers in Nigeria. Thirty-one units were invited and participated in filling an online questionnaire, adapted from the European Treatment Unit/Program Form (June 1997 version). All the units completed the online questionnaire. A large proportion (48%) was located in the South-West geopolitical zone of the country. Most (58%) were run by Non-Governmental Organizations. Half of them performed internal or external evaluation of treatment process or outcome. There were a total of 1043 for all categories of paid and volunteer staff, with an average of 33 staff per unit. Most of the funding came from charitable donations (30%). No unit provided drug substitution/maintenance therapy. The units had a total residential capacity of 566 beds. New client admissions in the past one year totalled 765 (mean = 48, median = 26.5, min = 0, max = 147) and 2478 clients received services in the non-residential units in the past year. No unit provided syringe exchange services. The study revealed a dearth of substance abuse treatment units (and of funds for the available ones) in a country with a large population size and one of the highest prevalence rates of substance abuse in Africa. The available units were not networked and lacked a directory or an evaluation framework. To provide an environment for effective monitoring, funding and continuous quality improvement, the units need to

  16. Addressing substance abuse and violence in substance use disorder treatment and batterer intervention programs.

    PubMed

    Timko, Christine; Valenstein, Helen; Lin, Patricia Y; Moos, Rudolf H; Stuart, Gregory L; Cronkite, Ruth C

    2012-09-07

    Substance use disorders and perpetration of intimate partner violence (IPV) are interrelated, major public health problems. We surveyed directors of a sample of substance use disorder treatment programs (SUDPs; N=241) and batterer intervention programs (BIPs; N=235) in California (70% response rate) to examine the extent to which SUDPs address IPV, and BIPs address substance abuse. Generally, SUDPs were not addressing co-occurring IPV perpetration in a formal and comprehensive way. Few had a policy requiring assessment of potential clients, or monitoring of admitted clients, for violence perpetration; almost one-quarter did not admit potential clients who had perpetrated IPV, and only 20% had a component or track to address violence. About one-third suspended or terminated clients engaging in violence. The most common barriers to SUDPs providing IPV services were that violence prevention was not part of the program's mission, staff lacked training in violence, and the lack of reimbursement mechanisms for such services. In contrast, BIPs tended to address substance abuse in a more formal and comprehensive way; e.g., one-half had a policy requiring potential clients to be assessed, two-thirds required monitoring of substance abuse among admitted clients, and almost one-half had a component or track to address substance abuse. SUDPs had clients with fewer resources (marriage, employment, income, housing), and more severe problems (both alcohol and drug use disorders, dual substance use and other mental health disorders, HIV + status). We found little evidence that services are centralized for individuals with both substance abuse and violence problems, even though most SUDP and BIP directors agreed that help for both problems should be obtained simultaneously in separate programs. SUDPs may have difficulty addressing violence because they have a clientele with relatively few resources and more complex psychological and medical needs. However, policy change can modify

  17. Demographic and substance abuse trends among pregnant and non-pregnant women: eleven years of treatment admission data.

    PubMed

    McCabe, Jennifer E; Arndt, Stephan

    2012-11-01

    The objective of this study was to identify demographic and substance abuse trends among pregnant women entering treatment over eleven years. This study compiled the publicly available Treatment Episode Datasets from the Substance Abuse Mental Health Services Administration from 1998 to 2008. Subjects included 1,724,479 women entering publicly funded substance abuse treatment for the first time, 81,818 of whom were pregnant. Compared to non-pregnant women, pregnant women were more likely to be younger, minority, never married, less educated, homeless, and on public-assistance or have no income. Referrals from health care providers (HCPs) among pregnant women entering treatment have stayed consistently low while referrals from the criminal justice system accounted for the largest portion of pregnant women entering treatment. Over the past eleven years, there has been a general decline in alcohol abuse and an increase in drug abuse among women entering treatment; this trend was more pronounced in pregnant women. Unlike their non-pregnant counterparts, pregnant women were more likely to report marijuana, not alcohol, as their primary problem substance as well as other drugs like methamphetamine and cocaine. Over the past eleven years, trends in the demographics and patterns of substance abuse among women have changed; some of these trends were unique to pregnant women. A large proportion of pregnant women entering treatment are referred by the criminal justice system. Knowledge surrounding the demographics and abuse patterns of pregnant women entering treatment can inform HCPs and community programs in their screening and outreach efforts.

  18. Therapeutic Substance Abuse Treatment for Incarcerated Women

    PubMed Central

    Finfgeld-Connett, Deborah; Johnson, E. Diane

    2011-01-01

    The purpose of this qualitative systematic review was to explicate attributes of optimal therapeutic strategies for treating incarcerated women who have a history of substance abuse. An expansive search of electronic databases for qualitative research reports relating to substance abuse treatment for incarcerated women was conducted. Nine qualitative research reports comprised the sample for this review. Findings from these reports were extracted, placed into a data analysis matrix, coded, and categorized. Memos were written, and strategies for treating incarcerated women with alcohol problems were identified. Therapeutic effects of treatment programs for incarcerated women with substance-abuse problems appear to be enhanced when trust-based relationships are established, individualized and just care is provided, and treatment facilities are separate from the general prison environment. PMID:21771929

  19. Nurse turnover in substance abuse treatment programs affiliated with the National Drug Abuse Treatment Clinical Trials Network.

    PubMed

    Knudsen, Hannah K; Abraham, Amanda J; Roman, Paul M; Studts, Jamie L

    2011-04-01

    Voluntary nurse turnover, which is costly and disrupts patient care, has not been studied as an organizational phenomenon within substance abuse treatment organizations. In this exploratory study, we examined the frequency and correlates of nurse turnover within treatment programs affiliated with the National Drug Abuse Treatment Clinical Trials Network. During face-to-face interviews conducted in 2005-2006, 215 program administrators reported the number of nurses currently employed. Leaders of programs with nursing staff then described the number of nurses who had voluntarily quit in the past year, the degree to which filling vacant nursing positions was difficult, and the average number of days to fill a vacant position. About two thirds of these programs had at least one nurse on staff. In programs with nurses, the average rate of voluntary turnover was 15.0%. Turnover was significantly lower in hospital-based programs and programs offering adolescent treatment but higher in facilities offering residential treatment. Most of the administrators indicated that filling vacant nurse positions was difficult and took more than 2 months to complete. These findings suggest that nurse turnover is a significant issue facing many substance abuse treatment facilities. Efforts to improve retention of the addiction treatment workforce should be expanded to include nursing professionals. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. A prospective examination of service use by abused and neglected children followed up into adulthood.

    PubMed

    Yanos, Philip T; Czaja, Sally J; Widom, Cathy Spatz

    2010-08-01

    This study sought to determine whether abused and neglected children are more likely than those without childhood maltreatment to use health and social services as adults and whether psychiatric status mediates or moderates the relationship. A prospective cohort design was used. Individuals with documented cases of physical and sexual abuse and neglect (ages 0-10) and nonvictimized children matched on age, sex, and race-ethnicity were interviewed in adulthood (mean age 41 years). Past-year service use (general medical, mental health, substance abuse, and social) was assessed during 2003-2004 interviews (maltreated group, N=458; control group, N=349). Psychiatric status (posttraumatic stress disorder [PTSD], drug abuse, and major depressive disorder) was assessed during 1989-1995 (mean age 29) by structured interview. Individuals with histories of childhood abuse and neglect were significantly more likely than their control group counterparts to use mental health services (odds ratio [OR]=1.60, 95% confidence interval [CI]=1.04-2.45) and social services (OR=2.95, CI=2.19-3.97) in adulthood. Psychiatric status in young adulthood (PTSD and major depressive disorder) partially mediated the relationship between childhood maltreatment and use of mental health services, whereas major depression and drug abuse moderated the relationship between maltreatment and use of any services and general medical services. In adulthood, individuals with documented histories of childhood abuse and neglect are more likely than persons without such histories to use some types of services, and psychiatric status mediates and moderates these relationships. Findings have implications for the provision of services to persons with childhood abuse and neglect.

  1. Tobacco Cessation Interventions and Smoke-Free Policies in Mental Health and Substance Abuse Treatment Facilities - United States, 2016.

    PubMed

    Marynak, Kristy; VanFrank, Brenna; Tetlow, Sonia; Mahoney, Margaret; Phillips, Elyse; Jamal Mbbs, Ahmed; Schecter, Anna; Tipperman, Doug; Babb, Stephen

    2018-05-11

    Persons with mental or substance use disorders or both are more than twice as likely to smoke cigarettes as persons without such disorders and are more likely to die from smoking-related illness than from their behavioral health conditions (1,2). However, many persons with behavioral health conditions want to and are able to quit smoking, although they might require more intensive treatment (2,3). Smoking cessation reduces smoking-related disease risk and could improve mental health and drug and alcohol recovery outcomes (1,3,4). To assess tobacco-related policies and practices in mental health and substance abuse treatment facilities (i.e., behavioral health treatment facilities) in the United States (including Puerto Rico), CDC and the Substance Abuse and Mental Health Services Administration (SAMHSA) analyzed data from the 2016 National Mental Health Services Survey (N-MHSS) and the 2016 National Survey of Substance Abuse Treatment Services (N-SSATS). In 2016, among mental health treatment facilities, 48.9% reported screening patients for tobacco use, 37.6% offered tobacco cessation counseling, 25.2% offered nicotine replacement therapy (NRT), 21.5% offered non-nicotine tobacco cessation medications, and 48.6% prohibited smoking in all indoor and outdoor locations (i.e., smoke-free campus). In 2016, among substance abuse treatment facilities, 64.0% reported screening patients for tobacco use, 47.4% offered tobacco cessation counseling, 26.2% offered NRT, 20.3% offered non-nicotine tobacco cessation medications, and 34.5% had smoke-free campuses. Full integration of tobacco cessation interventions into behavioral health treatment, coupled with implementation of tobacco-free campus policies in behavioral health treatment settings, could decrease tobacco use and tobacco-related disease and could improve behavioral health outcomes among persons with mental and substance use disorders (1-4).

  2. Contrasting jail diversion and in-jail services for mental illness and substance abuse: do they serve the same clients?

    PubMed

    Draine, Jeffrey; Blank, Amy; Kottsieper, Petra; Solomon, Phyllis

    2005-01-01

    Baseline data from a study of jail diversion services and in-jail behavioral health services were used to examine the differences in clients served by these two models of responding to people with co-occurring mental health and substance abuse problems in the criminal justice system. Clients of the diversion service had more acute psychiatric symptoms and were more likely to have a diagnosis of psychosis NOS. Clients of the in-jail service were more likely to have been on probation or parole in the past and to have received substance abuse treatment. Different service models may attract and serve different populations of clients. Diversion services may cast a wider net that includes clients who may not have otherwise been involved in forensic services. Copyright (c) 2005 John Wiley & Sons, Ltd.

  3. Characteristics of Sexually Abused Children and Their Nonoffending Mothers Followed by Child Welfare Services: The Role of a Maternal History of Child Sexual Abuse.

    PubMed

    Baril, Karine; Tourigny, Marc; Paillé, Pierre; Pauzé, Robert

    2016-07-01

    Considering the importance of mother's support in the adaptation of a sexually abused child, it is relevant to determine if the mothers and children involved in an intergenerational cycle of child sexual victimization differ from dyads in which only the child has been abused. The purpose of this study was to compare mother-child dyads with sexually abused children according to whether the mother had herself been victim of child sexual abuse. The sample included 87 dyads with sexually abused children aged 3-18 years old and their mothers (44 reporting maternal and child abuse), followed by social welfare services of the province of Quebec (Canada). The two groups of mothers were compared on their past family abuse experiences and past family relations, their mental health history, their current psychological distress, their parenting behaviors, and their current levels of family functioning. Children were compared on their adaptation. Multivariate analyses indicated that mothers reporting child sexual abuse were more likely to report more other maltreatments in their childhood and greater prevalence of lifetime history of alcohol abuse disorders, dysthymia, and panic disorder compared with mothers who had not experienced CSA. Compared to children whose mothers had not experienced CSA, those whose mothers had experienced CSA showed higher rates of problems behaviors and were more likely to report having been sexually abused by a trusted person. These results highlight the specific clinical needs for the assessment and treatment for sexually abused children whose mothers experienced child sexual abuse.

  4. Substance Abuse Treatment And Family Therapy. A Treatment Improvement Protocol (TIP) Series 39

    ERIC Educational Resources Information Center

    Gilbert, Jonathan Max; Oliff, Helen; Sutton, David; Bartlett, Catalina; Henderson, Randi

    2004-01-01

    This Treatment Improvement Protocol (TIP) addresses substance abuse treatment in the context of family therapy. TIPs are best-practice guidelines for the treatment of substance use disorders that make the latest research in substance abuse treatment available to counselors and educators. The content was generated by a panel of experts in the…

  5. Failure to get into substance abuse treatment.

    PubMed

    Fisher, Dennis G; Reynolds, Grace L; D'Anna, Laura H; Hosmer, David W; Hardan-Khalil, Kholoud

    2017-02-01

    Among substance abusers in the US, the discrepancy in the number who access substance abuse treatment and the number who need treatment is sizable. This results in a major public health problem of access to treatment. The purpose of this study was to examine characteristics of Persons Who Use Drugs (PWUDs) that either hinder or facilitate access to treatment. 2646 participants were administered the Risk Behavior Assessment (RBA) and the Barratt Impulsiveness Scale. The RBA included the dependent variable which was responses to the question "During the last year, have you ever tried, but been unable, to get into a drug treatment or detox program?" In multivariate analysis, factors associated with being unable to access treatment included: Previously been in drug treatment (OR=4.51), number of days taken amphetamines in the last 30days (OR=1.18), traded sex for drugs (OR=1.53), homeless (OR=1.73), Nonplanning subscale of the Barratt Impulsiveness Scale (OR=1.19), age at interview (OR=0.91), and sexual orientation, with bisexual men and women significantly more likely than heterosexuals to have tried but been unable to get into treatment. The answers to the question on "why were you unable to get into treatment" included: No room, waiting list; not enough money, did not qualify, got appointment but no follow through, still using drugs, and went to jail before program start. As expected, findings suggest that limiting organizational and financial obstacles to treatment may go a long way in increasing drug abuse treatment accessibility to individuals in need. Additionally, our study points to the importance of developing approaches for increasing personal planning skills/reducing Nonplanning impulsivity among PWUDs when they are in treatment as a key strategy to ensure access to additional substance abuse treatment in the future. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Isomorphism and external support in conflicting institutional environments: a study of drug abuse treatment units.

    PubMed

    D'Aunno, T; Sutton, R I; Price, R H

    1991-09-01

    Using institutional theory, we developed predictions about organizational units that moved from an environment making consistent demands to one making conflicting demands. Many community mental health centers have diversified into drug abuse treatment. The units providing those services face conflicting demands from the traditional mental health sector and the new drug abuse treatment sector about which clients to serve, how to assess their problems, and who should provide treatment. We propose that in response to such demands these units will adopt apparently conflicting practices. Also, isomorphism with the traditional sector will be positively associated with external support from parent mental health centers and other actors in the mental health sector. Results generally support those predictions.

  7. Multifamily Therapy in Substance Abuse Treatment with Women.

    ERIC Educational Resources Information Center

    Boylin, William M.; Doucette, Joseph; Jean, Mary F.

    1997-01-01

    Describes the establishment of a multifamily therapy program within an adult substance abuse treatment facility. Reports on a study in which the effectiveness of multifamily therapy was assessed with regard to women in treatment. Findings indicate that multifamily therapy is an extremely positive intervention for female substance abuse clients.…

  8. Evaluation of Drug Abuse Treatment Effectiveness: Summary of the DARP Followup Research. Treatment Research Report.

    ERIC Educational Resources Information Center

    Simpson, D. Dwayne; Sells, S. B.

    The Drug Abuse Reporting Program (DARP) was initiated in 1969 as a federally supported client reporting system for community-based drug abuse treatment programs. Posttreatment follow-up interviews were conducted with over 4,000 persons from 34 treatment agencies to describe major findings from the drug abuse treatment research of the DARP relating…

  9. Comorbid psychiatric and alcohol abuse/dependence disorders: psychosocial stress, abuse, and personal history factors of those in treatment.

    PubMed

    De Bernardo, Gina L; Newcomb, Michael; Toth, Amanda; Richey, Gary; Mendoza, Richard

    2002-01-01

    Factors related to comorbid versus only substance disorders are essential to understanding and treating these complex problems. Medical records of sixty-nine inpatients at a private rehabilitation hospital in Southern California were reviewed to determine the associations between personal history factors and (1) comorbid psychiatric and substance abuse disorders and (2) participant's self-assessed progress in treatment. Results revealed significant differences between dual diagnosis patients (alcohol abuse/dependence and an affective disorder) and alcohol abuse/dependence only in regard to gender, previous diagnosis, length of illness, suicide attempts, psychotropic medication history, maternal emotional, physical and sexual abuse, paternal abuse, legal difficulties, and psychosocial stressors. No significant differences between substance abusing patients and dually diagnosed patients were found in terms of self-assessment of progress in treatment. Significant correlations were found between self-assessed progress in treatment and major depression (versus bipolar disorder), use of psychotropic medication, and less abuse from mother or primary caretaker. Identification of these personal history factors may be useful in developing and implementing treatment plans.

  10. Psychosocial Factors that Shape Substance Abuse and Related Mental Health of Women Military Veterans who Use Community-Based Services.

    PubMed

    Evans, Elizabeth A; Glover, Dawn L; Washington, Donna L; Hamilton, Alison B

    2018-02-27

    Women Veterans who use the Veterans Health Administration (VA) have high rates of substance abuse and poorer health than non-Veteran women. Less is known about the psychosocial needs of women Veterans who seek care in non-VA settings. We provide a grounded description of factors that impact substance abuse, mental health, and related quality of life of women Veterans who use non-VA community-based health and social services. Utilizing a mixed methods design, we conducted semi-structured in-person interviews with 22 women Veterans in Los Angeles in 2013-2015. The current health of these women Veterans was shaped by substance abuse and several other factors, including: histories of trauma (in childhood, during military service) and discrimination, and associated mental health conditions; post-military socio-economic stressors; shifting social roles and adverse social support; and lost personal identity after military service. Psychosocial factors collectively underscore areas in which delivery of health and social services to women Veterans being treated in non-VA settings could be improved: (1) diffuse, implement, and sustain evidence-based gender-sensitive substance abuse treatment; (2) address traumas contributing to poor health; (3) recognize stress proliferation processes erode women's capacity to access healthcare or cope with stressors in healthy ways; (4) champion women Veterans who embody resilience and thereby can help others to form empowered personal identities of health and wellness. Findings can inform interventions and services that ameliorate vulnerability to substance abuse and other health risks among women Veterans.

  11. Can Addiction-Related Self-Help/Mutual Aid Groups Lower Demand for Professional Substance Abuse Treatment?

    ERIC Educational Resources Information Center

    Humphreys, Keith

    1998-01-01

    Discusses the potential of self-help/mutual-aid groups as a way to reduce the demand for professional substance-abuse treatment and proposes a model that combines the two approaches for cost-effective and therapeutically effective networks of services. (SLD)

  12. Integrating Substance Abuse Treatment and Child Welfare Services: Findings from the Illinois Alcohol and Other Drug Abuse Waiver Demonstration

    ERIC Educational Resources Information Center

    Ryan, Joseph P.; Marsh, Jeanne C.; Testa, Mark F.; Louderman, Richard

    2006-01-01

    Alcohol and other drug abuse is a major problem for children and families involved with public child welfare. Substance abuse compromises appropriate parenting practices and increases the risk of child maltreatment. A substantial proportion of substantiated child abuse and neglect reports involve parental substance abuse. Once in the system,…

  13. Treatment of Substance Abusing Patients with Comorbid Psychiatric Disorders

    PubMed Central

    Kelly, Thomas M.; Daley, Dennis C.; Douaihy, Antoine B.

    2011-01-01

    Objective To update clinicians on the latest in evidence-based treatments for substance use disorders (SUD) and non-substance use disorders among adults and suggest how these treatments can be combined into an evidence based process that enhances treatment effectiveness in comorbid patients. Method Articles were extracted from Pubmed using the search terms “dual diagnosis,” “comorbidity” and “co-occurring” and were reviewed for evidence of effectiveness for pharmacologic and psychotherapeutic treatments of comorbidity. Results Twenty-four research reviews and 43 research trials were reviewed. The preponderance of the evidence suggests that antidepressants prescribed to improve substance-related symptoms among patients with mood and anxiety disorders are either not highly effective or involve risk due to high side-effect profiles or toxicity. Second-generation antipsychotics are more effective for treatment of schizophrenia and comorbid substance abuse and current evidence suggests clozapine, olanzapine and risperidone are among the best. Clozapine appears to be the most effective of the antipsychotics for reducing alcohol, cocaine and cannabis abuse among patients with schizophrenia. Motivational interviewing has robust support as a highly effective psychotherapy for establishing a therapeutic alliance. This finding is critical since retention in treatment is essential for maintaining effectiveness. Highly structured therapy programs that integrate intensive outpatient treatments, case management services and behavioral therapies such as Contingency Management (CM) are most effective for treatment of severe comorbid conditions. Conclusions Creative combinations of psychotherapies, behavioral and pharmacological interventions offer the most effective treatment for comorbidity. Intensity of treatment must be increased for severe comorbid conditions such as the schizophrenia/cannabis dependence comorbidity due to the limitations of pharmacological

  14. Domestic violence and abuse: an exploration and evaluation of a domestic abuse nurse specialist role in acute health care services.

    PubMed

    McGarry, Julie

    2017-08-01

    The aim of this study was to explore the experiences of clinical staff in responding to disclosure of domestic violence and abuse, and to evaluate the effectiveness of training and support provided by a dedicated Domestic Abuse Nurse Specialist across one acute National Health Service Trust in the UK. The impact of domestic violence and abuse is well documented and is far reaching. Health care professionals have a key role to play in the effective identification and management of abuse across a range of settings. However, there is a paucity of evidence regarding the constituents of effective support for practitioners within wider nonemergency hospital-based services. A qualitative approach semi-structured interviews (n = 11) with clinical staff based in one acute care Trust in the UK. Interviews were informed by an interview guide and analysed using the Framework approach. The organisation of the nurse specialist role facilitated a more cohesive approach to management at an organisational level with training and ongoing support identified as key facets of the role by practitioners. Time constraints were apparent in terms of staff training and this raises questions with regard to the status continuing professional development around domestic violence and abuse. Domestic violence and abuse continues to exert a significant and detrimental impact on the lives and health of those who encounter abuse. Health care services in the UK and globally are increasingly on the frontline in terms of identification and management of domestic violence and abuse. This is coupled with the growing recognition of the need for adequate support structures to be in place to facilitate practitioners in providing effective care for survivors of domestic violence and abuse. This study provides an approach to the expansion of existing models and one which has the potential for further exploration and application in similar settings. © 2016 John Wiley & Sons Ltd.

  15. Filling Service Gaps: Providing Intensive Treatment Services for Offenders

    PubMed Central

    Young, Douglas W.; Farrell, Jill L.; Henderson, Craig E.; Taxman, Faye S.

    2009-01-01

    Consistent with the few studies that have previously examined treatment prevalence and access in the adult and juvenile justice systems, the recent National Criminal Justice Treatment Practices (NCJTP) survey indicated that there is a particular need to expand intensive treatment modalities for offenders in both institutional and community corrections settings. Applying multilevel modeling techniques to NCJTP survey data, this study explores conditions and factors that may underlie the wide variation among states in the provision of intensive treatment for offenders. Results indicate that states' overall rates of substance abuse and dependence, funding resources, and the state governor's political party affiliation were significantly associated with intensive treatment provision. Numerous factors that have been implicated in recent studies of evidence-based practice adoption, including state agency executives' views regarding rehabilitation, agency culture and climate, and other state-level measures (e.g., household income, crime rates, expenditures on treatment for the general population) were not associated with treatment provision. Future research should examine further variations in offenders' service needs, the role of legislators' political affiliations, and how other factors may interact with administrator characteristics in the adoption and expansion of intensive treatment services for offenders. PMID:19261394

  16. Filling service gaps: Providing intensive treatment services for offenders.

    PubMed

    Young, Douglas W; Farrell, Jill L; Henderson, Craig E; Taxman, Faye S

    2009-08-01

    Consistent with the few studies that have previously examined treatment prevalence and access in the adult and juvenile justice systems, the recent National Criminal Justice Treatment Practices (NCJTP) survey indicated that there is a particular need to expand intensive treatment modalities for offenders in both institutional and community corrections settings. Applying multilevel modeling techniques to NCJTP survey data, this study explores conditions and factors that may underlie the wide variation among states in the provision of intensive treatment for offenders. Results indicate that states' overall rates of substance abuse and dependence, funding resources, and the state governor's political party affiliation were significantly associated with intensive treatment provision. Numerous factors that have been implicated in recent studies of evidence-based practice adoption, including state agency executives' views regarding rehabilitation, agency culture and climate, and other state-level measures (e.g., household income, crime rates, expenditures on treatment for the general population) were not associated with treatment provision. Future research should examine further variations in offenders' service needs, the role of legislators' political affiliations, and how other factors may interact with administrator characteristics in the adoption and expansion of intensive treatment services for offenders.

  17. School-Based Counseling of Abused Children

    ERIC Educational Resources Information Center

    Brassard, Marla R.; Rivelis, Erin; Diaz, Vielka

    2009-01-01

    Abused children experience high rates of behavior, emotional, and learning problems but infrequently receive treatment. Most services provided to abused children and their families are not based on any clear evidence that they work. A number of evidence-based treatments (EBTs), demonstrated to be safe and effective in treating a range of…

  18. Racial/ethnic differences in access to substance abuse treatment.

    PubMed

    Lo, Celia C; Cheng, Tyrone C

    2011-05-01

    A secondary dataset, Collaborative Psychiatric Epidemiology Surveys (CPES), 2001-2003, was employed to examine racial/ethnic differences in access to specialty and non-specialty substance abuse treatment (compared with no access to treatment). The study found that non-Hispanic White Americans were (1) likelier than members of all racial/ethnic minority groups (other than Hispanics) to address substance abuse by accessing care through specialty addiction-treatment facilities, and were (2) also less likely to access substance abuse care through non-specialty facilities. Because non-specialty facilities may have staffs whose professional training does not target treating chronic, bio-psycho-social illness such as substance abuse, our results imply that treatment facilities deemed non-specialty may need to enhance staff training, in order to ensure individuals are properly screened for substance use conditions and are referred for or provided with effective counseling and medications as appropriate.

  19. Understanding Treatment Readiness in Recently Assessed, Pre-Treatment Substance Abusers

    PubMed Central

    Rapp, Richard C.; Xu, Jiangmin; Carr, Carey A.; Timothy Lane, D.; Redko, Cristina; Wang, Jichuan; Carlson, Robert G.

    2007-01-01

    The goal of this study was to more fully understand readiness for treatment in a pre-treatment sample of 446 substance abusers. Structural Equation Modeling (SEM) was used to: (1) examine the relationships between readiness factors identified in the Pre-Treatment Readiness Scale; and (2) identify the effects of predisposing, illness, and inhibiting determinants on the factors. As with in-treatment samples, Problem Recognition was found to influence Treatment Readiness, although through a different intervening factor, Desire for Change rather than Desire for Help. A fourth factor, Treatment Reluctance, was also influenced by the Desire for Change factor. Fixed characteristics such as age and gender had minimal influences on readiness factors, as did inhibiting characteristics that reflected recent functioning. Illness characteristics including drug severity and perceived treatment barriers had a more robust influence on readiness factors. This study provides an increased understanding of readiness for treatment among pre-treatment substance abusers and also supported the construct validity of the Pre-Treatment Readiness Scale. PMID:19274847

  20. Motivation and maltreatment history among youth entering substance abuse treatment.

    PubMed

    Rosenkranz, Susan E; Henderson, Joanna L; Muller, Robert T; Goodman, Ilana R

    2012-03-01

    Research has established that maltreatment experiences are common in the life histories of youth with substance abuse problems, and efforts are now moving in the direction of enhancing our understanding of the unique clinical presentations and treatment needs of this population. The current study endeavored to contribute to this body of research by examining associations between experiences of maltreatment and levels of motivation among youth entering outpatient substance abuse treatment. Upon admission, 188 youth (131 males, 57 females) completed a package of self-report questionnaires including measures of motivation to change, motivation for treatment, and history of maltreatment experiences. Results indicated that youth with histories of all forms of maltreatment examined tended to be more aware of the problematic aspects of their substance use, more ready to engage in treatment, more motivated by feelings of shame, and more motivated by external influences. Emotional abuse was the form of maltreatment that predicted level of motivation most strongly. Emotional abuse was particularly strongly associated with the form of motivation reflecting shame regarding substance use, predicting this form of motivation over and above other factors previously reported to be associated with motivation, such as severity of substance abuse and age. While clinicians are increasingly attending to exposure to traumatic events among youth entering substance abuse treatment, these findings suggest that attending to experiences of emotional abuse is also important. Such experiences appear to be related to treatment motivation and may be important to treatment processes and outcomes for these vulnerable youth. PsycINFO Database Record (c) 2012 APA, all rights reserved.

  1. Beyond Munchausen syndrome by proxy: identification and treatment of child abuse in a medical setting.

    PubMed

    Stirling, John

    2007-05-01

    The condition widely known as Munchausen syndrome by proxy comprises both physical abuse and medical neglect and is also a form of psychological maltreatment. Although it is a relatively rare form of child abuse, pediatricians need to have a high index of suspicion when faced with seemingly inexplicable findings or treatment failures. The fabrication of a pediatric illness is a form of child abuse and not merely a mental health disorder, and there is a possibility of an extremely poor prognosis if the child is left in the home. In this statement, factors are identified that may help the physician recognize this insidious type of child abuse that occurs in a medical setting, and recommendations are provided for physicians regarding when to report a case to their state's child protective service agency.

  2. Oversight on Community Services Administration, Child Abuse Prevention and Treatment, and Adoption Opportunities, and Native American Programs Act. Hearing before the Subcommittee on Aging, Family and Human Services of the Committee on Labor and Human Resources. United States Senate, Ninety-Seventh Congress, First Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

    Oversight hearings were conducted on April 23, 1981 in reference to social service block grants for the Community Services Administration, child abuse prevention and treatment and adoption programs, and Native American Programs Act. Testimonies for support of block grants advocated ability of States to decide how program resources can best be…

  3. Screening homeless youth for histories of abuse: prevalence, enduring effects, and interest in treatment.

    PubMed

    Keeshin, Brooks R; Campbell, Kristine

    2011-06-01

    To identify the incidence of self-reported physical and sexual child abuse among homeless youth, the self-perceived effects of past abuse, and current interest in treatment for past abuse among homeless youth with histories of abuse. Homeless and street-involved persons aged 18-23 filled out a questionnaire and participated in a structured assessment of histories of abuse, tobacco use and substance abuse. Sixty-four homeless youth in Salt Lake City, Utah completed the study, 43 males and 21 females. Eighty-four percent screened positive for childhood physical and/or sexual abuse occurring before the age of 18; 42% screened positive for both physical and sexual abuse; 72% reported still being affected by their abuse. Among all abuse victims, 44% were interested in treatment for their abuse history and 62% of homeless youth who reported still being affected by their abuse were interested in treatment. Individuals were more likely to be interested in treatment if they were female, had not completed high school or had been previously asked about family dysfunction. Many victims who declined treatment offered spontaneous insight into their decision. Interest in treatment was similar to interest in treatment for other behaviors such as smoking and substance abuse. Histories of abuse are common among homeless youth. A majority of those reporting a history of abuse are still affected by their abuse. Interest in treatment for a history of abuse was comparable to interest in treatment for other morbidities in the homeless youth population such as tobacco use and substance abuse. Our finding that homeless youth continue to be impacted by their abuse and are interested in treatment should prompt more screening for histories of abuse. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. Substance Abuse Treatment Admissions Aged 12 to 14. The TEDS Report

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration, 2011

    2011-01-01

    This report uses data from the Treatment Episode Data Set (TEDS) for 2008 to provide information on the characteristics of youths aged 12 to 14 admitted to substance abuse treatment. In 2008, approximately 23,770 substance abuse treatment admissions were adolescents aged 12 to 14. The two most frequently reported primary substances of abuse among…

  5. Substance abuse treatment for women who are under correctional supervision in the community: a systematic review of qualitative findings.

    PubMed

    Finfgeld-Connett, Deborah; Johnson, E Diane

    2011-01-01

    This systematic review was conducted to more fully analyze qualitative research findings relating to community-based court-supervised substance abuse treatment for women and to make recommendations regarding treatment enhancement. Five reports of qualitative research met the inclusion criteria. Findings from these reports were extracted and analyzed using constant comparative methods. Women who are referred to court-sanctioned substance abuse treatment programs may initially be reluctant to participate. Once engaged, however, they advocate for a full complement of well-financed comprehensive services. To optimize treatment effectiveness, women recommend gender-specific programs in which ambivalence is diminished, hope is instilled, and care is individualized.

  6. 28 CFR 550.56 - Community Transitional Drug Abuse Treatment Program (TDAT).

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Community Transitional Drug Abuse... JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.56 Community Transitional Drug Abuse Treatment Program (TDAT). (a) For inmates to successfully complete all components of...

  7. 28 CFR 550.56 - Community Transitional Drug Abuse Treatment Program (TDAT).

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Community Transitional Drug Abuse... JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.56 Community Transitional Drug Abuse Treatment Program (TDAT). (a) For inmates to successfully complete all components of...

  8. 28 CFR 550.56 - Community Transitional Drug Abuse Treatment Program (TDAT).

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Community Transitional Drug Abuse... JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.56 Community Transitional Drug Abuse Treatment Program (TDAT). (a) For inmates to successfully complete all components of...

  9. 28 CFR 550.56 - Community Transitional Drug Abuse Treatment Program (TDAT).

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Community Transitional Drug Abuse... JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.56 Community Transitional Drug Abuse Treatment Program (TDAT). (a) For inmates to successfully complete all components of...

  10. 28 CFR 550.56 - Community Transitional Drug Abuse Treatment Program (TDAT).

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Community Transitional Drug Abuse... JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS Drug Abuse Treatment Program § 550.56 Community Transitional Drug Abuse Treatment Program (TDAT). (a) For inmates to successfully complete all components of...

  11. Mental and Physical Health Needs of Lesbian, Gay, and Bisexual Clients in Substance Abuse Treatment.

    PubMed

    Flentje, Annesa; Livingston, Nicholas A; Roley, Jason; Sorensen, James L

    2015-11-01

    Lesbian, gay, and bisexual (LGB) orientation predicts greater substance use, treatment utilization, and poorer mental and physical health, but health needs of LGB individuals in substance abuse treatment remain largely unknown. The purpose of this study was to identify differences in mental and physical health needs of LGB individuals in substance abuse treatment. Substance abuse treatment admissions data from the County of San Francisco were used in this investigation of differences in mental and physical health problems and service utilization between LGB (n=1,441) and heterosexual individuals (n=11,770). LGB individuals were more likely to have mental health diagnoses (adjORs ranging from 1.86 to 4.00) and current mental health prescription medications (adjORs from 1.79 to 4.99) than heterosexual counterparts. Gay and bisexual men and bisexual women but not lesbian women, were more likely to be receiving mental health treatment. Gay men and bisexual women were more likely than heterosexual counterparts to report physical health problems. Gay and bisexual men and bisexual women but not lesbian women were more likely to be receiving health care. There were no differences between LGB individuals and heterosexual counterparts in the number of emergency room visits or hospital overnight stays. This study found that LGB individuals entering substance abuse treatment have greater mental and physical health needs than heterosexual counterparts. Implications for healthcare integration, research, and practice are discussed. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Vaccines against drugs of abuse: a viable treatment option?

    PubMed

    Kantak, Kathleen M

    2003-01-01

    Drug addiction is a chronically relapsing brain disorder. There is an urgent need for new treatment options for this disease because the relapse rate among drug abusers seeking treatment is quite high. During the past decade, many groups have explored the feasibility of using vaccines directed against drugs of abuse as a means of eliminating illicit drug use as well as drug overdose and neurotoxicity. Vaccines work by inducing drug-specific antibodies in the bloodstream that bind to the drug of abuse and prevent its entry into the brain. The majority of work in this area has been conducted with vaccines and antibodies directed against cocaine and nicotine. On the basis of preclinical work, vaccines for cocaine and nicotine are now in clinical trials because they can offer long-term protection with minimal treatment compliance. In addition, vaccines and antibodies for phencyclidine, methamphetamine and heroin abuse are currently under development. An underlying theme in this research is the need for high concentrations of circulating drug-specific antibodies to reduce drug-seeking and drug-taking behaviour when the drug is repeatedly available, especially in high doses. Although vaccines against drugs of abuse may become a viable treatment option, there are several drawbacks that need to be considered. These include: a lack of protection against a structurally dissimilar drug that produces the same effects as the drug of choice;a lack of an effect on drug craving that predisposes an addict to relapse; and tremendous individual variability in antibody formation. Forced or coerced vaccination is not likely to work from a scientific perspective, and also carries serious legal and ethical concerns. All things considered, vaccination against a drug of abuse is likely to work best with individuals who are highly motivated to quit using drugs altogether and as part of a comprehensive treatment programme. As such, the medical treatment of drug abuse will not be radically

  13. Identifying the substance abuse treatment needs of caregivers involved with child welfare.

    PubMed

    Chuang, Emmeline; Wells, Rebecca; Bellettiere, John; Cross, Theodore P

    2013-07-01

    Parental substance use significantly increases risk of child maltreatment, but is often under-identified by child protective services. This study examined how agency use of standardized substance use assessments and child welfare investigative caseworker education, experience, and caseload affected caseworkers' identification of parental substance abuse treatment needs. Data are from a national probability sample of permanent, primary caregivers involved with child protective services whose children initially remained at home and whose confidential responses on two validated instruments indicated harmful substance use or dependence. Investigative caseworkers reported use of a formal assessment in over two thirds of cases in which substance use was accurately identified. However, weighted logistic regression indicated that agency provision of standardized assessment instruments was not associated with caseworker identification of caregiver needs. Caseworkers were also less likely to identify substance abuse when their caseloads were high and when caregivers were fathers. Implications for agency practice are discussed. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Identifying the Substance Abuse Treatment Needs of Caregivers Involved with Child Welfare

    PubMed Central

    Wells, Rebecca; Bellettiere, John; Cross, Theodore P.

    2013-01-01

    Parental substance use significantly increases risk of child maltreatment, but is often under-identified by child protective services. This study examined how agency use of standardized substance use assessments and child welfare investigative caseworker education, experience, and caseload affected caseworkers’ identification of parental substance abuse treatment needs. Data are from a national probability sample of permanent, primary caregivers involved with child protective services whose children initially remained at home and whose confidential responses on two validated instruments indicated harmful substance use or dependence. Investigative caseworkers reported use of a formal assessment in over two thirds of cases in which substance use was accurately identified. However, weighted logistic regression indicated that agency provision of standardized assessment instruments was not associated with caseworker identification of caregiver needs. Caseworkers were also less likely to identify substance abuse when their caseloads were high and when caregivers were fathers. Implications for agency practice are discussed. PMID:23453481

  15. Prefrontal Cortex and Drug Abuse Vulnerability: Translation to Prevention and Treatment Interventions

    PubMed Central

    Perry, Jennifer L.; Joseph, Jane E.; Jiang, Yang; Zimmerman, Rick S.; Kelly, Thomas H.; Darna, Mahesh; Huettl, Peter; Dwoskin, Linda P.; Bardo, Michael T.

    2010-01-01

    Vulnerability to drug abuse is related to both reward seeking and impulsivity, two constructs thought to have a biological basis in the prefrontal cortex (PFC). This review addresses similarities and differences in neuroanatomy, neurochemistry and behavior associated with PFC function in rodents and primates. Emphasis is placed on monoamine and amino acid neurotransmitter systems located in anatomically distinct subregions: medial prefrontal cortex (mPFC); lateral prefrontal cortex (lPFC); anterior cingulate cortex (ACC); and orbitofrontal cortex (OFC). While there are complex interconnections and overlapping functions among these regions, each is thought to be involved in various functions related to health-related risk behaviors and drug abuse vulnerability. Among the various functions implicated, evidence suggests that mPFC is involved in reward processing, attention and drug reinstatement; lPFC is involved in decision-making, behavioral inhibition and attentional gating; ACC is involved in attention, emotional processing and self-monitoring; and OFC is involved in behavioral inhibition, signaling of expected outcomes and reward/punishment sensitivity. Individual differences factors (e.g., age and sex) influence functioning of these regions, which, in turn, impacts drug abuse vulnerability. Implications for the development of drug abuse prevention and treatment strategies aimed at engaging PFC inhibitory processes that may reduce risk-related behaviors are discussed, including the design of effective public service announcements, cognitive exercises, physical activity, direct current stimulation, feedback control training and pharmacotherapies. A major challenge in drug abuse prevention and treatment rests with improving intervention strategies aimed at strengthening PFC inhibitory systems among at-risk individuals. PMID:20837060

  16. Group Treatment of Sexually Abused Latency-Age Girls.

    ERIC Educational Resources Information Center

    Zaidi, Lisa Y.; Gutierrez-Kovner, Victoria M.

    1995-01-01

    Describes a pilot group developed to address the traumagenic stigmatization, powerlessness, betrayal, and sexualization that characterize victims of sexual abuse. Treatment modules developed within this framework focused on: group cohesiveness, discussion of specific abuse experiences, coping strategies, sexuality, victimization prevention, and…

  17. HIV Risk Behavior Among Methamphetamine Users Entering Substance Abuse Treatment in Cape Town, South Africa.

    PubMed

    Meade, Christina S; Lion, Ryan R; Cordero, Daniella M; Watt, Melissa H; Joska, John A; Gouse, Hetta; Burnhams, Warren

    2016-10-01

    South Africa is experiencing a growing methamphetamine problem, and there is concern that methamphetamine use may accelerate HIV transmission. There has been little research on the HIV prevention needs of methamphetamine users receiving substance abuse treatment in South Africa. This study assessed the prevalence and correlates of HIV risk behaviors among 269 methamphetamine users entering substance abuse treatment in two clinics in Cape Town. The prevalence of sexual risk behaviors was high among sexually active participants: 34 % multiple partners, 26 % unprotected intercourse with a casual partner, and 24 % sex trading for money/methamphetamine. The strongest predictor of all sexual risk behaviors was concurrent other drug use. Over half had not been HIV tested in the past year, and 25 % had never been tested, although attitudes toward HIV testing were overwhelmingly positive. This population of primarily heterosexual, non-injecting methamphetamine users is a high-risk group in need of targeted HIV prevention interventions. Substance abuse treatment is an ideal setting in which to reach methamphetamine users for HIV services.

  18. The cost-effectiveness of rapid HIV testing in substance abuse treatment: results of a randomized trial.

    PubMed

    Schackman, Bruce R; Metsch, Lisa R; Colfax, Grant N; Leff, Jared A; Wong, Angela; Scott, Callie A; Feaster, Daniel J; Gooden, Lauren; Matheson, Tim; Haynes, Louise F; Paltiel, A David; Walensky, Rochelle P

    2013-02-01

    The President's National HIV/AIDS Strategy calls for coupling HIV screening and prevention services with substance abuse treatment programs. Fewer than half of US community-based substance abuse treatment programs make HIV testing available on-site or through referral. We measured the cost-effectiveness of three HIV testing strategies evaluated in a randomized trial conducted in 12 community-based substance abuse treatment programs in 2009: off-site testing referral, on-site rapid testing with information only, on-site rapid testing with risk-reduction counseling. Data from the trial included patient demographics, prior testing history, test acceptance and receipt of results, undiagnosed HIV prevalence (0.4%) and program costs. The Cost-Effectiveness of Preventing AIDS Complications (CEPAC) computer simulation model was used to project life expectancy, lifetime costs, and quality-adjusted life years (QALYs) for HIV-infected individuals. Incremental cost-effectiveness ratios (2009 US $/QALY) were calculated after adding costs of testing HIV-uninfected individuals; costs and QALYs were discounted at 3% annually. Referral for off-site testing is less efficient (dominated) compared to offering on-site testing with information only. The cost-effectiveness ratio for on-site testing with information is $60,300/QALY in the base case, or $76,300/QALY with 0.1% undiagnosed HIV prevalence. HIV risk-reduction counseling costs $36 per person more without additional benefit. A strategy of on-site rapid HIV testing offer with information only in substance abuse treatment programs increases life expectancy at a cost-effectiveness ratio <$100,000/QALY. Policymakers and substance abuse treatment leaders should seek funding to implement on-site rapid HIV testing in substance abuse treatment programs for those not recently tested. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  19. The Cost-effectiveness of Rapid HIV Testing in Substance Abuse Treatment: Results of a Randomized Trial*

    PubMed Central

    Schackman, Bruce R.; Metsch, Lisa R.; Colfax, Grant N.; Leff, Jared A.; Wong, Angela; Scott, Callie A.; Feaster, Daniel J.; Gooden, Lauren; Matheson, Tim; Haynes, Louise F.; Paltiel, A. David; Walensky, Rochelle P.

    2012-01-01

    BACKGROUND The President’s National HIV/AIDS Strategy calls for coupling HIV screening and prevention services with substance abuse treatment programs. Fewer than half of US community-based substance abuse treatment programs make HIV testing available on-site or through referral. METHODS We measured the cost-effectiveness of three HIV testing strategies evaluated in a randomized trial conducted in 12 community-based substance abuse treatment programs in 2009: off-site testing referral, on-site rapid testing with information only, on-site rapid testing with risk reduction counseling. Data from the trial included patient demographics, prior testing history, test acceptance and receipt of results, undiagnosed HIV prevalence (0.4%) and program costs. The Cost Effectiveness of Preventing AIDS Complications (CEPAC) computer simulation model was used to project life expectancy, lifetime costs, and quality-adjusted life years (QALYs) for HIV-infected individuals. Incremental cost-effectiveness ratios (2009 US $/QALY) were calculated after adding costs of testing HIV-uninfected individuals; costs and QALYs were discounted at 3% annually. RESULTS Referral for off-site testing is less efficient (dominated) compared to offering on-site testing with information only. The cost-effectiveness ratio for on-site testing with information is $60,300/QALY in the base case, or $76,300/QALY with 0.1% undiagnosed HIV prevalence. HIV risk-reduction counseling costs $36 per person more without additional benefit. CONCLUSIONS A strategy of on-site rapid HIV testing offer with information only in substance abuse treatment programs increases life expectancy at a cost-effectiveness ratio <$100,000/QALY. Policymakers and substance abuse treatment leaders should seek funding to implement on-site rapid HIV testing in substance abuse treatment programs for those not recently tested. PMID:22971593

  20. An Overview of the Effectiveness of Adolescent Substance Abuse Treatment Models.

    ERIC Educational Resources Information Center

    Muck, Randolph; Zempolich, Kristin A.; Titus, Janet C.; Fishman, Marc; Godley, Mark D.; Schwebel, Robert

    2001-01-01

    Describes current approaches to adolescent substance abuse treatment, including the 12-step treatment approach, behavioral treatment approach, family-based treatment approach, and therapeutic community approach. Summarizes research that assesses the effectiveness of these models, offering findings from the Center for Substance Abuse Treatment's…

  1. Sexual Abuse Prevention: A Training Program for Developmental Disabilities Service Providers

    ERIC Educational Resources Information Center

    Bowman, Rachel A.; Scotti, Joseph R.; Morris, Tracy L.

    2010-01-01

    Persons with developmental disabilities are at an increased risk for becoming victims of sexual abuse. Research has revealed that the largest group of identified perpetrators of sexual abuse is developmental disability service providers. The purpose of the present study was to develop, implement, and evaluate the effectiveness of a sexual abuse…

  2. Mental health indicator interaction in predicting substance abuse treatment outcomes in nevada.

    PubMed

    Greenfield, Lawrence; Wolf-Branigin, Michael

    2009-01-01

    Indicators of co-occurring mental health and substance abuse problems routinely collected at treatment admission in 19 State substance abuse treatment systems include a dual diagnosis and a State mental health (cognitive impairment) agency referral. These indicators have yet to be compared as predictors of treatment outcomes. 1. Compare both indices as outcomes predictors individually and interactively. 2. Assess relationship of both indices to other client risk factors, e.g., physical/sexual abuse. Client admission and discharge records from the Nevada substance abuse treatment program, spanning 1995-2001 were reviewed (n = 17,591). Logistic regression analyses predicted treatment completion with significant improvement (33%) and treatment readmission following discharge (21%). Using Cox regression, the number of days from discharge to treatment readmission was predicted. Examined as predictors were two mental health indicators and their interaction with other admission and treatment variables controlled. Neither mental health indicator alone significantly predicted any of the three outcomes; however, the interaction between the two indicators significantly predicted each outcome (p < .05). Having both indices was highly associated with physical/sexual abuse, domestic violence, homelessness, out of labor force and prior treatment. Indicator interactions may help improve substance abuse treatment outcomes prediction.

  3. The Substance Abuse Treatment Workforce of South Africa

    PubMed Central

    Watson, Donnie W.; Rataemane, Solomon; Rataemane, Lusanda; Ntlhe, Nomvuyo; Rawson, Richard

    2009-01-01

    The purpose of this paper is to describe characteristics of substance abuse treatment counselors in the Republic of South Africa, including demographics, education, training, and job duties. Counselors recruited from 24 treatment centers completed a survey after signing informed consent. Counselors were primarily female (75%), racially diverse (36.4% White, 30.8% Black, 18.9% Coloured, 12.6% Indian or Asian, and 1.4% Cape Malay), and were 38 years old on average. The majority (62.3%) held at least an equivalent of a bachelor’s degree, and just under half (49%) were registered social workers. Counselors had a mean of 5.3 years’ experience in substance abuse treatment. The substance abuse treatment workforce of South Africa appears to be young and educated, yet only one third of the counselors had any formal training in Cognitive Behavioral Therapy. South African counselors could benefit from more training in evidence-based techniques. PMID:21037947

  4. Trend Analysis of Substance Abuse Treatment Admissions in New Orleans From 2000-2012: A Population-Based Comparison Pre- and Post-Hurricane Katrina.

    PubMed

    Shuler, Monique N; Wallington, Sherrie F; Qualls-Hampton, Raquel Y; Podesta, Arwen E; Suzuki, Sumihiro

    2016-10-14

    Substance abuse treatment following a natural disaster is often met with challenges. If treatment is available, facilities may be unequipped to service an influx of patients or provide specialized care for unique populations. This paper seeks to evaluate trends in substance abuse treatment over time and assess changes pre- and post-Hurricane Katrina. Substance abuse treatment admission data (N = 42,678) from New Orleans, Louisiana, for years 2000 through 2012 were obtained from the Treatment Episode Data Set. Admissions were examined to evaluate demographic, socioeconomic, psychiatric, and criminality trends in substance abuse treatment and assess changes following Hurricane Katrina. Treatment admissions have decreased from 2000 to 2012. About one in five admissions had a psychiatric illness in addition to a substance abuse problem. A staggering 76% of admissions with a psychiatric illness were referred by the criminal justice system post-Katrina as compared to pre-Katrina. Rates of alcohol and marijuana admissions have remained stable from 2000 to 2012. Cocaine/crack admissions have declined and admissions who abused heroin have increased over time. Treatment admissions stabilized following Hurricane Katrina; however, since 2009, they have begun to decline. Targeted exploration of factors affecting admission to treatment in New Orleans with populations such as the homeless, those with a psychiatric illness in addition to a substance abuse problem, and those referred by the criminal justice system is essential. The results of this study assist in identifying variations in substance abuse treatment characteristics for those admitted to treatment in New Orleans.

  5. Women as Child Abusers: Indicators, Treatment, and Policy Directions.

    ERIC Educational Resources Information Center

    Kemp, Donna R.; And Others

    Child abuse is a major problem in the United States. Policy concerning child abuse involves a criminal justice approach, a treatment approach, and a prevention approach. Prevention programs have focused on identifying and serving high-risk groups and on preventive education. A study was conducted to examine issues related to child abuse. Four…

  6. Managed care and the quality of substance abuse treatment.

    PubMed

    Shepard, Donald S; Daley, Marilyn; Ritter, Grant A; Hodgkin, Dominic; Beinecke, Richard H

    2002-12-01

    In the US, the spiraling costs of substance abuse and mental health treatment caused many state Medicaid agencies to adopt managed behavioral health care (MBHC) plans during the 1990s. Although research suggests that these plans have successfully reduced public sector spending, their impact on the quality of substance abuse treatment has not been established. The Massachusetts Medicaid program started a risk-sharing contract with MHMA, a private, for-profit specialty managed behavioral health care (MBHC) carve-out vendor on July 1, 1992. This paper evaluates the carve-out s impact on spending per inpatient episode and three proxy measures of quality: (i) access to inpatient treatment (ii) 30-day re-admissions and (iii) continuity of care. Medicaid claims for inpatient treatment were collapsed into episodes. Clients were tracked across the five-year period and an interrupted time series design was used to compare the three quality outcomes and spending in the year prior to (FY1992) and the four years during MHMA (FY1993-FY1996). Logistic and linear regression models were used to control for race, disability status, age, gender and primary diagnosis. Despite a 99% reduction in the use of hospital-based settings, access to 24-hour services overall increased by 38%, largely due to an expansion in the use of freestanding detoxification and acute residential services. Continuity improved by 73%. Nevertheless, rates of 7-day (58%) and 30-day (24%) readmission increased significantly, even after controlling for increases in disability status. Per episode spending decreased by 76% ($2,773), characterized by a dramatic spending reduction in FY1993 that was maintained but not augmented in subsequent years. The carve-out had mixed effects on the quality of substance abuse treatment. While one of the three measures (readmission rates) deteriorated, two improved (access and continuity). Rapid re-admissions were strongly associated with shorter lengths of stay, suggesting that

  7. Child Abuse/Neglect: A Guide for Detection, Prevention, and Treatment in Bureau of Community Health Services (BCHS) Programs and Projects.

    ERIC Educational Resources Information Center

    Community Health Service (DHEW/PHS), Bethesda, MD.

    Intended for personnel of ambulatory health care facilities, the manual provides guidelines for the detection, prevention, and treatment of child abuse and neglect cases. Provided in the introduction is a statement of purpose, a brief history of child abuse, a definition (from the federal law), and incidence estimates. Identification is discussed…

  8. A brief report on Hispanic youth marijuana use: Trends in substance abuse treatment admissions in the United States.

    PubMed

    Marzell, Miesha; Sahker, Ethan; Pro, George; Arndt, Stephan

    2017-01-01

    Increases in Hispanic youth admissions to substance abuse treatment programs for marijuana use are a growing public health concern. In this study, we investigated trends in Hispanic youth from 1995 to 2012 utilizing the Treatment Episode Data Set-Admissions of the Substance Abuse Mental Health Services Administration. Hispanic youth marijuana admissions are associated with youth 15-17 years old, in high school, and living in a dependent situation. Notably, female admissions increased at greater rates than males. Results also point to decreasing tolerance of minor marijuana use by schools and community agencies. Findings highlight the need for targeted, culturally specific, and cost-effective treatment and prevention efforts.

  9. Substance Abuse Prevalence and Treatment Among Latinos and Latinas

    PubMed Central

    Alvarez, Josefina; Jason, Leonard A.; Olson, Bradley D.; Ferrari, Joseph R.; Davis, Margaret I.

    2010-01-01

    SUMMARY Substance abuse prevalence rates for Latinos/as generally mirror those of the general U.S. population; however, a number of indicators of assimilation to U.S. culture as well as sociodemographic variables predict substance use and abuse among this group. Latinos/as have poorer outcomes in substance abuse treatment programs. Yet there is little empirical evidence that explains the problems these individuals experience in treatment, and there are few studies on the use and effectiveness of mutual help groups among this population. New developments in the conceptualization and measurement of acculturation will lead to a greater understanding of the role of culture in the prevalence and treatment of substance-related problems. PMID:18192207

  10. Monitoring and Evaluation of Substance Abuse Services in South Africa: Implications for Policy and Practice

    ERIC Educational Resources Information Center

    Myers, Bronwyn; Burnhams, Nadine Harker; Fakier, Nuraan

    2010-01-01

    Although outcomes monitoring and the collection of other performance data holds benefits for service managers and policy makers, the extent to which these data are collected by South African substance abuse service providers is unknown. To describe (i) the extent to which substance abuse service providers in South Africa monitor and evaluate their…

  11. Case-mix tool, costs and effectiveness in improving primary care mental health and substance abuse services.

    PubMed

    Riihimäki, Kirsi; Heiska-Johansson, Ainomaija; Ketola, Eeva

    2018-02-01

    Despite its importance in improving care and developing services, high-quality data evaluating cost-effectiveness and services in different case-mix populations is scarce in primary care. The objective was to investigate the service use of those mental health and substance abuse patients, who use lots of services. Primary health care diagnosis-related groups (pDRG) is a tool to evaluate service provider system and improve efficiency, productivity and quality. We viewed all pDRG results available from the year 2015 concerning municipal mental health and substance abuse services. In primary care mental health and substance abuse services, the most common ICD-10-codes were depression and substance abuse. One-fifth of patients produced 57% of costs. Their medium of appointments was 16 per year versus 6 per year of all patients. Only 54% of their diagnoses were recorded in the electronic health records versus 75% of all patients. They made 5.7 different pDRG episodes, including 1.8 episodes of depression, per patient. The average episode cost for this patient group was 301€. pDRG makes health care production transparent also in mental health and substance abuse services. It is easy to identify patients, who use a lot of services and thus induce the majority of costs, and focus on their needs in managing and developing services.

  12. Childhood Sexual Abuse, Adult Psychiatric Morbidity, and Criminal Outcomes in Women Assessed by Medium Secure Forensic Service

    ERIC Educational Resources Information Center

    Dolan, Mairead; Whitworth, Helen

    2013-01-01

    There is little literature on childhood sexual abuse in women seen by forensic services. A cohort of 225 cases of women seen by forensic services in a medium secure unit in the UK were examined, and childhood sexual abuse and non-childhood sexual abuse cases were compared. Over half the sample had a history of childhood sexual abuse, and 5.6% of…

  13. Is the Diagnosis of Physical Abuse Changed when Child Protective Services Consults a Child Abuse Pediatrics Subspecialty Group as a Second Opinion?

    ERIC Educational Resources Information Center

    Anderst, James; Kellogg, Nancy; Jung, Inkyung

    2009-01-01

    Objectives: To characterize the changes regarding the diagnosis of physical abuse provided to Child Protective Services (CPS) when CPS asks a Child Abuse Pediatrics (CAP) specialty group for a second opinion and works in concert with that CAP group. Methods: Subjects were reported to CPS for suspected physical abuse and were first evaluated by a…

  14. The Substance Abuse Counseling Workforce: Education, Preparation, and Certification

    ERIC Educational Resources Information Center

    Rieckmann, Traci; Farentinos, Christiane; Tillotson, Carrie J.; Kocarnik, Jonathan; McCarty, Dennis

    2011-01-01

    The National Drug Abuse Treatment Clinical Trials Network (CTN) is an alliance of drug abuse treatment programs and research centers testing new interventions and implementation factors for treating alcohol and drug use disorders. A workforce survey distributed to those providing direct services in 295 treatment units in the CTN obtained responses…

  15. Use of the evidence base in substance abuse treatment programs for American Indians and Alaska Natives: pursuing quality in the crucible of practice and policy.

    PubMed

    Novins, Douglas K; Aarons, Gregory A; Conti, Sarah G; Dahlke, Dennis; Daw, Raymond; Fickenscher, Alexandra; Fleming, Candace; Love, Craig; Masis, Kathleen; Spicer, Paul

    2011-06-16

    A variety of forces are now shaping a passionate debate regarding the optimal approaches to improving the quality of substance abuse services for American Indian and Alaska Native communities. While there have been some highly successful efforts to meld the traditions of American Indian and Alaska Native tribes with that of 12-step approaches, some American Indian and Alaska Natives remain profoundly uncomfortable with the dominance of this Euro-American approach to substance abuse treatment in their communities. This longstanding tension has now been complicated by the emergence of a number of evidence-based treatments that, while holding promise for improving treatment for American Indian and Alaska Natives with substance use problems, may conflict with both American Indian and Alaska Native and 12-step healing traditions. We convened a panel of experts from American Indian and Alaska Native communities, substance abuse treatment programs serving these communities, and researchers to discuss and analyze these controversies in preparation for a national study of American Indian and Alaska Native substance abuse services. While the panel identified programs that are using evidence-based treatments, members still voiced concerns about the cultural appropriateness of many evidence-based treatments as well as the lack of guidance on how to adapt them for use with American Indians and Alaska Natives. The panel concluded that the efforts of federal and state policymakers to promote the use of evidence-based treatments are further complicating an already-contentious debate within American Indian and Alaska Native communities on how to provide effective substance abuse services. This external pressure to utilize evidence-based treatments is particularly problematic given American Indian and Alaska Native communities' concerns about protecting their sovereign status. Broadening this conversation beyond its primary focus on the use of evidence-based treatments to other

  16. Use of the evidence base in substance abuse treatment programs for American Indians and Alaska natives: pursuing quality in the crucible of practice and policy

    PubMed Central

    2011-01-01

    Background A variety of forces are now shaping a passionate debate regarding the optimal approaches to improving the quality of substance abuse services for American Indian and Alaska Native communities. While there have been some highly successful efforts to meld the traditions of American Indian and Alaska Native tribes with that of 12-step approaches, some American Indian and Alaska Natives remain profoundly uncomfortable with the dominance of this Euro-American approach to substance abuse treatment in their communities. This longstanding tension has now been complicated by the emergence of a number of evidence-based treatments that, while holding promise for improving treatment for American Indian and Alaska Natives with substance use problems, may conflict with both American Indian and Alaska Native and 12-step healing traditions. Discussion We convened a panel of experts from American Indian and Alaska Native communities, substance abuse treatment programs serving these communities, and researchers to discuss and analyze these controversies in preparation for a national study of American Indian and Alaska Native substance abuse services. While the panel identified programs that are using evidence-based treatments, members still voiced concerns about the cultural appropriateness of many evidence-based treatments as well as the lack of guidance on how to adapt them for use with American Indians and Alaska Natives. The panel concluded that the efforts of federal and state policymakers to promote the use of evidence-based treatments are further complicating an already-contentious debate within American Indian and Alaska Native communities on how to provide effective substance abuse services. This external pressure to utilize evidence-based treatments is particularly problematic given American Indian and Alaska Native communities' concerns about protecting their sovereign status. Summary Broadening this conversation beyond its primary focus on the use of evidence

  17. The first decade of the National Drug Abuse Treatment Clinical Trials Network: bridging the gap between research and practice to improve drug abuse treatment.

    PubMed

    Tai, Betty; Straus, Michele M; Liu, David; Sparenborg, Steven; Jackson, Ron; McCarty, Dennis

    2010-06-01

    The National Institute on Drug Abuse established the National Drug Abuse Treatment Clinical Trials Network (CTN) in 1999 to improve the quality of addiction treatment using science as the vehicle. The network brings providers from community-based drug abuse treatment programs and scientists from university-based research centers together in an alliance that fosters bidirectional communication and collaboration. Collaboration enhanced the relevance of research to practice and facilitated the development and implementation of evidence-based treatments in community practice settings. The CTN's 20 completed trials tested pharmacological, behavioral, and integrated treatment interventions for adolescents and adults; more than 11,000 individuals participated in the trials. This article reviews the rationale for the CTN, describes the translation of its guiding principles into research endeavors, and anticipates the future evolution of clinical research within the Network.

  18. Outpatient Cocaine Abuse Treatment: Predictors of Success.

    ERIC Educational Resources Information Center

    Westhuis, David J.; Gwaltney, Lisa; Hayashi, Reiko

    2001-01-01

    Uses data from the U.S. Army's Alcohol and Drug Abuse Prevention and Control Program to analyze which treatment and demographic variables have an effect on cocaine treatment outcomes. Results suggest the following treatment variables had an effect on outcomes: type of treatment; length of time in treatment; and the length of time since the patient…

  19. [Gender and accessibility barriers to treatment in alcohol abuse patients in the Autonomous Region of Valencia].

    PubMed

    Tomás-Dols, Sofía; Valderrama-Zurián, Juan Carlos; Vidal-Infer, Antonio; Samper-Gras, Teresa; Hernández-Martínez, Ma Carmen; Torrijo-Rodrigo, Ma José

    2007-01-01

    This study aimed at identifying the factors that contribute to delaying the access of alcohol abuse patients to specific treatment centres in the Autonomous Region of Valencia (Spain). 563 patients from Addictive Behaviours Units (UCA) and Alcohology Units (UA) were interviewed. A survey was conducted which included items on previous requested treatment in other centres and on barriers of accessibility to treatment in specific ambulatory centres. A descriptive analysis and t-student and ANOVA with Scheffé post-hoc tests were carried out. 59.7% of respondents said they had requested previous treatment in non-specific resources due to physical or psychical trouble that they now relate to their alcohol use although they did not do so at the time, in addition to being motivated by their own alcohol abuse (42.8%). The most attended resources were Primary Care and Specialist Unit Care. Women showed a higher demand for treatment in Mental Health Services (p < 0,05). The most important treatment barriers were included in the axis "unawareness of illness and related problems" (2.2; dt = 0,6). Women obtained higher scores in the axes "stigmatisation and environment response" and "treatment intrinsic factors". gender differences in barriers that delay access to treatment do exist. It is necessary to build gender-adapted intervention guidelines to be used in Primary Care and Mental Health services to reduce the accessibility barriers to treatment.

  20. Comparison of cigarette smoking knowledge, attitudes, and practices among staff in perinatal and other substance abuse treatment settings.

    PubMed

    Miller-Thomas, Tonya; Leoutsakos, Jeannie-Marie S; Terplan, Mishka; Brigham, Emily P; Chisolm, Margaret S

    2014-01-01

    Despite the high prevalence and known morbidity and mortality caused by cigarette smoking, 60% to 70% of substance abuse treatment programs lack smoking cessation counseling or fail to offer pharmacotherapy for smoking cessation, including those programs designed to meet the needs of drug-dependent pregnant patients. Previous studies of staff knowledge, attitudes, and practices (S-KAP) at general substance abuse/HIV treatment programs have suggested that staff may contribute to the deficiency in smoking cessation treatment in these settings. It is not known whether similar deficiencies exist at perinatal substance abuse treatment programs. This study compared cigarette S-KAP in perinatal substance abuse (n = 41) and general substance abuse/HIV treatment (Veterans Affairs [VA] medical center, hospital-, and community-based) workforce samples (n = 335). Significant differences were seen between the 2 groups on all measures, but perinatal staff compared favorably to general staff only on measures of barriers to smoking cessation services. Perinatal staff compared unfavorably on all other measures: knowledge, beliefs/attitudes, self-efficacy, and smoking cessation practices. Pair-wise comparisons of knowledge and beliefs/attitudes revealed a significant difference between perinatal and VA staff; of self-efficacy, between perinatal and staff at all other settings; and of smoking cessation practices, between perinatal and VA and community-based staff. These results-showing deficiencies of perinatal staff on most S-KAP measures-are concerning and suggest that identifying gaps in and improving S-KAP in perinatal substance abuse programs is urgently needed, for which the VA may provide an efficacious model.

  1. Economic evaluation of drug abuse treatment and HIV prevention programs in pregnant women: a systematic review.

    PubMed

    Ruger, Jennifer Prah; Lazar, Christina M

    2012-01-01

    Drug abuse and transmission of HIV during pregnancy are public health problems that adversely affect pregnant women, their children and surrounding communities. Programs that address this vulnerable population have the ability to be cost-effective due to resulting cost savings for mother, child and society. Economic evaluations of programs that address these issues are an important tool to better understand the costs of services and create sustainable healthcare systems. This study critically examined economic evaluations of drug abuse treatment and HIV prevention programs in pregnant women. A systematic review was conducted using the criteria recommended by the Panel on Cost-Effectiveness in Health and Medicine and the British Medical Journal (BMJ) checklist for economic evaluations. The search identified 6 economic studies assessing drug abuse treatment for pregnant women, and 12 economic studies assessing programs that focus on prevention of mother-to-child transmission (PMTCT) of HIV. Results show that many programs for drug abuse treatment and PMTCT among pregnant women are cost-effective or even cost-saving. This study identified several shortcomings in methodology and lack of standardization of current economic evaluations. Efforts to address methodological challenges will help make future studies more comparable and have more influence on policy makers, clinicians and the public. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. An ecological systems examination of elder abuse: a week in the life of adult protective services.

    PubMed

    Wangmo, Tenzin; Teaster, Pamela B; Grace, James; Wong, Wilson; Mendiondo, Marta S; Blandford, Caitlin; Fisher, Steve; Fardo, David W

    2014-01-01

    Using Bronfenbrenner's ecological systems model, this study examined allegations of elder abuse made to Kentucky Adult Protective Services (APS) and the investigation that followed, in order to understand how APS addressed the needs of abused elders. Elder abuse allegations made to APS during the study week were collected using 3 study tools. Allegations and resulting investigations were analyzed. During the study week, APS received 1,002 calls alleging elder abuse. Of these, 483 were categorized as reports needing protective services, with 177 reports screened in for investigation and 167 actually investigated. Results describe characteristics of abuse calls, investigations, victims, perpetrators, and total investigation times. Substantiation ratio, recidivism, and whether investigation increased or decreased the risk of abuse were also assessed. An examination of APS casework through the lens of nested systems frames the study findings and discussion. Such an examination has the potential to improve the quality of services provided to older adults.

  3. Financial abuse of older people by a family member: a difficult terrain for service providers in Australia.

    PubMed

    Adams, Valerie Margaret; Bagshaw, Dale; Wendt, Sarah; Zannettino, Lana

    2014-01-01

    Financial abuse by a family member is the most common form of abuse experienced by older Australians, and early intervention is required. National online surveys of 228 chief executive officers and 214 aged care service providers found that, while they were well placed to recognize financial abuse, it was often difficult to intervene successfully. Problems providers encountered included difficulties in detecting abuse, the need for consent before they could take action, the risk that the abusive family member would withdraw the client from the service, and a lack of resources to deal with the complexities inherent in situations of financial abuse.

  4. The First Decade of the National Drug Abuse Treatment Clinical Trials Network: Bridging the Gap Between Research and Practice to Improve Drug Abuse Treatment

    PubMed Central

    Tai, Betty; Straus, Michele M.; Liu, David; Sparenborg, Steven; Jackson, Ron; McCarty, Dennis

    2010-01-01

    The National Institute on Drug Abuse established the National Drug Abuse Treatment Clinical Trials Network (CTN) in 1999 to improve the quality of addiction treatment using science as the vehicle. The network brings providers from community-based drug abuse treatment programs and scientists from university-based research centers together in an alliance that fosters bi-directional communication and collaboration. Collaboration enhanced the relevance of research to practice and facilitated the development and implementation of evidence-based treatments in community practice settings. The CTN’s 20 completed trials tested pharmacological, behavioral, and integrated treatment interventions for adolescents and adults; more than 11,000 individuals participated in the trials. This paper reviews the rationale for the CTN, describes the translation of its guiding principles into research endeavors, and anticipates the future evolution of clinical research within the Network. PMID:20307794

  5. 45 CFR Appendix to Part 1340 - Interpretative Guidelines Regarding 45 CFR 1340.15-Services and Treatment for Disabled Infants

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...-Services and Treatment for Disabled Infants Appendix to Part 1340 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT...

  6. 45 CFR Appendix to Part 1340 - Interpretative Guidelines Regarding 45 CFR 1340.15-Services and Treatment for Disabled Infants

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...-Services and Treatment for Disabled Infants Appendix to Part 1340 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT...

  7. 45 CFR Appendix to Part 1340 - Interpretative Guidelines Regarding 45 CFR 1340.15-Services and Treatment for Disabled Infants

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...-Services and Treatment for Disabled Infants Appendix to Part 1340 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT...

  8. 45 CFR Appendix to Part 1340 - Interpretative Guidelines Regarding 45 CFR 1340.15-Services and Treatment for Disabled Infants

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...-Services and Treatment for Disabled Infants Appendix to Part 1340 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT...

  9. 45 CFR Appendix to Part 1340 - Interpretative Guidelines Regarding 45 CFR 1340.15-Services and Treatment for Disabled Infants

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...-Services and Treatment for Disabled Infants Appendix to Part 1340 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, CHILD ABUSE AND NEGLECT PREVENTION AND TREATMENT...

  10. Attachment and alliance in the treatment of depressed, sexually abused women.

    PubMed

    Smith, Phillip N; Gamble, Stephanie A; Cort, Natalie A; Ward, Erin A; He, Hua; Talbot, Nancy L

    2012-02-01

    Depression among women with sexual abuse histories is less treatment responsive than in general adult samples. One contributor to poorer treatment outcomes may be abused women's difficulties in forming and maintaining secure relationships, as reflected in insecure attachment styles, which could also impede the development of a positive therapeutic alliance. The current study examines how attachment orientation (i.e. anxiety and avoidance) and development of the working alliance are associated with treatment outcomes among depressed women with histories of childhood sexual abuse. Seventy women seeking treatment in a community mental health center who had Major Depressive Disorder and a childhood sexual abuse history were randomized to Interpersonal Psychotherapy or treatment as usual. Greater attachment avoidance and weaker working alliance were each related to worse depression symptom outcomes; these effects were independent of the presence of comorbid Borderline Personality Disorder and Post-Traumatic Stress Disorder. The effect of avoidant attachment on outcomes was not mediated by the working alliance. Further, working alliance had a stronger effect on depression outcomes in the Interpersonal Psychotherapy group. Understanding the influence of attachment style and the working alliance on treatment outcomes can inform efforts to improve the treatments for depressed women with a history of childhood sexual abuse. © 2012 Wiley Periodicals, Inc.

  11. Substance abuse prevention and treatment within the criminal justice system: an overview of the issues.

    PubMed

    Campbell-Heider, Nancy; Baird, Carolyn

    2012-02-01

    Many nurses, especially those in addictions, work directly in the prison system and or relate to inmates before or after institutionalization for criminal activity. This connection led to the theme of the 2009 Annual Education Conference held in Albuquerque, New Mexico, entitled "Substance Abuse Prevention and Treatment: Working with the Criminal Justice Systems." The conference was partially funded through an award from the Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Prevention (grant # SP015963) and focused on identifying the special risk factors for and barriers to the treatment of addictions for those who enter the criminal justice system. The conference, presented in collaboration with the American Association of Nurse Attorneys (AANA) highlighted the tremendous need for more access to addictions and mental health providers in the criminal justice system. Papers presented at that conference confirmed that nurses can make a real difference in the health of inmates, especially those of us engaged in addictions and mental health practices, and inspired this specially focused edition of the Journal of Addictions Nursing. The purpose of this editorial is to provide an overview of the addictions problems affecting individuals under supervision in the criminal justice system, barriers to treatment within this system, and the cost-benefits of evidence based treatment.

  12. Treatment for Abused and Neglected Children. The User Manual Series.

    ERIC Educational Resources Information Center

    Martin, Harold P.

    This manual brings current knowledge about the needs of abused and neglected children together with practical ideas about what can be done to meet those needs. Designed primarily for use by child protective service (CPS) workers, the manual may also be used by other professionals dealing with child abuse and neglect. Chapter 1 briefly discusses…

  13. Service Patterns of Adult Survivors of Childhood versus Adult Sexual Assault/Abuse

    ERIC Educational Resources Information Center

    Grossman, Susan F.; Lundy, Marta; Bertrand, Cathy; Ortiz, Cynthia; Tomas-Tolentino, Grace; Ritzema, Kim; Matson, Julia

    2009-01-01

    This analysis compared the characteristics and service patterns of adult survivors of childhood sexual assault/abuse and adult survivors of adult sexual assault/abuse. Utilizing data from sexual assault crisis centers serving survivors in a Midwestern state over a six year period and controlling for revictimization, we describe and compare the…

  14. 45 CFR 96.126 - Capacity of treatment for intravenous substance abusers.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.126 Capacity of treatment... programs that receive funding under the grant and that treat individuals for intravenous substance abuse to... 45 Public Welfare 1 2014-10-01 2014-10-01 false Capacity of treatment for intravenous substance...

  15. 45 CFR 96.126 - Capacity of treatment for intravenous substance abusers.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.126 Capacity of treatment... programs that receive funding under the grant and that treat individuals for intravenous substance abuse to... 45 Public Welfare 1 2013-10-01 2013-10-01 false Capacity of treatment for intravenous substance...

  16. 45 CFR 96.126 - Capacity of treatment for intravenous substance abusers.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.126 Capacity of treatment... programs that receive funding under the grant and that treat individuals for intravenous substance abuse to... 45 Public Welfare 1 2012-10-01 2012-10-01 false Capacity of treatment for intravenous substance...

  17. 45 CFR 96.126 - Capacity of treatment for intravenous substance abusers.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.126 Capacity of treatment... programs that receive funding under the grant and that treat individuals for intravenous substance abuse to... 45 Public Welfare 1 2011-10-01 2011-10-01 false Capacity of treatment for intravenous substance...

  18. 45 CFR 96.126 - Capacity of treatment for intravenous substance abusers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.126 Capacity of treatment... programs that receive funding under the grant and that treat individuals for intravenous substance abuse to... 45 Public Welfare 1 2010-10-01 2010-10-01 false Capacity of treatment for intravenous substance...

  19. Cost-benefit analysis of drug treatment services: review of the literature*

    PubMed

    Cartwright, William S.

    2000-03-01

    BACKGROUND: How valuable is public investment in treatment for drug abuse and dependency in the real world of everyday practice? Does drug abuse treatment provide benefits and how are they valued? What are the costs of obtaining outcomes and benefits? Cost-benefit analysis attempts to answer these questions in a standard analytic framework. AIMS: This paper reviews cost-benefit analyses with scientific merit so that analysts will have a current picture of the state of the research. It will also give public decision-makers information with regards to the available evidence for policy purposes. METHOD: Bibliographic searches were performed. Studies were obtained through the assistance of the Parklawn Health Library system, a component of the US Public Health Service. Selected studies were from the scientific literature with the exception of eight studies published as governmental reports. RESULTS: Cost-benefit studies have fallen into the following categories: (i) planning models for delivery systems in states and cities; (ii) short-term follow-up studies of individuals, (iii) single individual programs and (iv) state system's monitoring of outcomes. In 18 cost-benefit studies, a persistent finding is that benefits exceed costs, even when not all benefits are accounted for in the analysis. Much variation is found in the implementation of cost-benefit methods, and this is detailed across discussions of effectiveness, benefits and costs. Studies have emphasized the cost savings to society from the reduction in external costs created by the behavioral consequences of addiction and drug use. DISCUSSION: Economic analysis of drug treatment requires sophisticated conceptualization and measurement. Cost-benefit analysis of drug treatment has been a significant analytical exercise since the early 1970s when the public drug treatment system was founded in the United States. CONCLUSION: Drug abuse treatment services may be considered as contributing positive economic returns

  20. Managed care, networks and trends in hospital care for mental health and substance abuse treatment in Massachusetts: 1994-1999.

    PubMed

    Fleming, Elaine; Lien, Hsienming; Ma, Ching-To Albert; McGuire, Thomas G

    2003-03-01

    Rates of inpatient care for mental health and substance abuse treatment have been reported to fall after the introduction of managed care, but the actual decline may be overstated. Almost all managed care impact studies are based on pre-post comparisons, which have two drawbacks: secular downward trends may be attributed to a managed care effect and self-selection may exaggerate the impact of managed care. Therefore it is useful to examine long-term population-based trends in use associated with the growth of managed care. This paper examines trends in inpatient care for mental health and substance abuse treatment in Massachusetts between 1994 and 1999 by service provider and payer. We analyze how managed care impacts the trends in mental health and substance abuse care. We provide an overview of the health market in Massachusetts and compare trends in mental health and substance abuse services with all inpatient services. To analyze the impact of managed care, we compare the per discharge cost of managed care and fee for service plans in Medicare and Medicaid. Finally, we examine the role played by hospital networks in managed care. The reduction in service costs for mental health and substance abuse, about 25% in six years, is mostly due to the decline in the average cost per inpatient episode. This is only slightly greater than the decline in costs for all inpatient care. Managed care has reduced both the quantity (average length of stay) and intensity of health care (expenditure per day). Simulations suggest that the creation of hospital networks by managed care accounts for around 50% of the differential between the average costs of the HMO and FFS sectors. We find that the cost reductions in mental health and substance abuse services are larger than for physical health, but not by much. The average length of stay and average day cost is lower for managed care plans than for FFS plans, and much of this difference is attributable to the hospitals managed care

  1. Child Sexual Abuse: Intervention and Treatment Issues. The User Manual Series.

    ERIC Educational Resources Information Center

    Faller, Kathleen Coulborn

    This manual describes professional practices in intervention and treatment of sexual abuse and discusses how to address the problems of sexually abused children and their families. It makes an assumption that the reader has basic information about sexual abuse. The discussion focuses primarily on the child's guardian as the abuser. The manual…

  2. Identifying and responding to gaps in domestic abuse services for older women.

    PubMed

    Shiel, Rebecca

    2016-07-01

    Domestic abuse is widespread and indiscriminate. Older women living with domestic abuse report more health-related concerns than any other group, and demonstrate a higher incidence of significant mental health issues. Research suggests that older women who have experienced domestic abuse are not having their psychological and physical support needs met by existing services. This article examines the physical and mental health issues that older women face as a result of abusive relationships, and the barriers to seeking help. Multidisciplinary healthcare professionals can facilitate the therapeutic engagement of older women living with domestic abuse. Refuges and related interventions are limited in terms of the support they can offer, however, research suggests that developing a stepped approach, tailored to suit older women's needs, could be beneficial.

  3. Co-Occurring Disorders in Substance Abuse Treatment: Issues and Prospects

    PubMed Central

    Flynn, Patrick M.; Brown, Barry S.

    2008-01-01

    This paper explores the epidemiology of co-occurring disorders with an emphasis on the implications of study findings for the functioning and potential of substance abuse treatment. Severity of disorder is discussed as an issue that may have particular significance for the selection of specialized as opposed to traditional substance abuse treatment forms. Exploration is made, as well, of the resources currently available to substance abuse treatment, especially the human resources available, and the implications of resource availability for undertaking initiatives specific to co-occurring disorder. Findings from standard and enhanced treatment for comorbid individuals are examined in an effort to clarify areas of need for specialized and typical treatment personnel. Issues are raised for consideration by the clinical research and treatment provider communities in terms of assessment and diagnosis, manpower and training, and response to the challenge of relapse in this population. PMID:17574791

  4. Distress tolerance interacts with circumstances, motivation, and readiness to predict substance abuse treatment retention.

    PubMed

    Ali, Bina; Green, Kerry M; Daughters, Stacey B; Lejuez, C W

    2017-10-01

    Our understanding of the conditions that influence substance abuse treatment retention in urban African American substance users is limited. This study examined the interacting effect of circumstances, motivation, and readiness (CMR) with distress tolerance to predict substance abuse treatment retention in a sample of urban African American treatment-seeking substance users. Data were collected from 81 African American substance users entering residential substance abuse treatment facility in an urban setting. Participants completed self-reported measures on CMR and distress tolerance. In addition, participants were assessed on psychiatric comorbidities, substance use severity, number of previous treatments, and demographic characteristics. Data on substance abuse treatment retention were obtained using administrative records of the treatment center. Logistic regression analysis found that the interaction of CMR and distress tolerance was significant in predicting substance abuse treatment retention. Higher score on CMR was significantly associated with increased likelihood of treatment retention in substance users with higher distress tolerance, but not in substance users with lower distress tolerance. Findings of the study indicate that at higher level of distress tolerance, favorable external circumstances, higher internal motivation, and greater readiness to treatment are important indicators of substance abuse treatment retention. The study highlights the need for assessing CMR and distress tolerance levels among substance users entering treatment, and providing targeted interventions to increase substance abuse treatment retention and subsequent recovery from substance abuse among urban African American substance users. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Substance abuse and rehabilitation: responding to the global burden of diseases attributable to substance abuse.

    PubMed

    Wu, Li-Tzy

    2010-10-01

    Alcohol, tobacco, and illegal drug use are pervasive throughout the world. Substance use problems are among the major contributors to the global disease burden, which includes disability and mortality. The benefits of treatment far outweigh the economic costs. Despite the availability of treatment services, however, the vast majority of people with substance use disorders do not seek or use treatment. Barriers to and unmet need for evidence-based treatment are widespread even in the United States. Women, adolescents, and young adults are especially vulnerable to adverse effects from substance abuse, but they face additional barriers to getting evidence-based treatment or other social/medical services. Substance use behaviors and the diseases attributable to substance use problems are preventable and modifiable. Yet the ever-changing patterns of substance use and associated problems require combined research and policy-making efforts from all parts of the world to establish a viable knowledge base to inform for prevention, risk-reduction intervention, effective use of evidence-based treatment, and rehabilitation for long-term recovery. The new international, open-access, peer-reviewed Substance Abuse and Rehabilitation (SAR) journal strives to provide an effective platform for sharing ideas for solutions and disseminating research findings globally. Substance use behaviors and problems have no boundaries. The journal welcomes papers from all regions of the world that address any aspect of substance use, abuse/dependence, intervention, treatment, and policy. The "open-access" journal makes cutting edge knowledge freely available to practitioners and researchers worldwide, and this is particularly important for addressing the global disease burden attributable to substance abuse.

  6. The comparative effectiveness of Integrated treatment for Substance abuse and Partner violence (I-StoP) and substance abuse treatment alone: a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Research has shown that treatments that solely addressed intimate partner violence (IPV) perpetration were not very effective in reducing IPV, possibly due to neglecting individual differences between IPV perpetrators. A large proportion of IPV perpetrators is diagnosed with co-occurring substance use disorders and it has been demonstrated that successful treatment of alcohol dependence among alcohol dependent IPV perpetrators also led to less IPV. The current study investigated the relative effectiveness of Integrated treatment for Substance abuse and Partner violence (I-StoP) to cognitive behavioral treatment addressing substance use disorders including only one session addressing partner violence (CBT-SUD+) among patients in substance abuse treatment who repeatedly committed IPV. Substance use and IPV perpetration were primary outcome measures. Method Patients who entered substance abuse treatment were screened for IPV. Patients who disclosed at least 7 acts of physical IPV in the past year (N = 52) were randomly assigned to either I-StoP or CBT-SUD+. Patients in both conditions received 16 treatment sessions. Substance use and IPV perpetration were assessed at pretreatment, halfway treatment and posttreatment in blocks of 8 weeks. Both completers and intention-to-treat (ITT) analyses were performed. Results Patients (completers and ITT) in both conditions significantly improved regarding substance use and IPV perpetration at posttreatment compared with pretreatment. There were no differences in outcome between conditions. Completers in both conditions almost fully abstained from IPV in 8 weeks before the end of treatment. Conclusions Both I-StoP and CBT-SUD+ were effective in reducing substance use and IPV perpetration among patients in substance abuse treatment who repeatedly committed IPV and self-disclosed IPV perpetration. Since it is more cost and time-effective to implement CBT-SUD+ than I-StoP, it is suggested to treat IPV perpetrators

  7. The Relative Effectiveness of 10 Adolescent Substance Abuse Treatment Programs in the United States. Technical Report

    ERIC Educational Resources Information Center

    Morral, Andrew R.; McCaffrey, Daniel F.; Ridgeway, Greg; Mukherji, Arnab; Beighley, Christopher

    2006-01-01

    Each year, substance abuse treatment programs in the United States record approximately 150,000 admissions of youths under the age of 18. Nevertheless, little is known about the effectiveness of the types of community-based services typically available to youths and their families. Recognizing the need for better information on the effectiveness…

  8. Child protection medical service demonstration centers in approaching child abuse and neglect in Taiwan

    PubMed Central

    Chang, Yu-Ching; Huang, Jing-Long; Hsia, Shao-Hsuan; Lin, Kuang-Lin; Lee, En-Pei; Chou, I-Jun; Hsin, Yi-Chen; Lo, Fu-Song; Wu, Chang-Teng; Chiu, Cheng-Hsun; Wu, Han-Ping

    2016-01-01

    Abstract Child abuse includes all forms of physical and emotional ill treatment, sexual abuse, neglect, and exploitation that results in actual or potential harm to the child's health, development, or dignity. In Taiwan, the Child Protection Medical Service Demonstration Center (CPMSDC) was established to protect children from abuse and neglect. We further analyzed and compared the trends and clinical characteristics of cases reported by CPMSDC to evaluate the function of CPMSDC in approaching child abuse and neglect in Taiwan. We prospectively recorded children with reported child abuse and neglect in a CPMSDC in a tertiary medical center from 2014 to 2015. Furthermore, we analyzed and compared age, gender, scene, identifying settings, time of visits, injury type, injury severity, hospital admission, hospitalization duration, and outcomes based on the different types of abuse and the different settings in which the abuse or neglect were identified. Of 361 child abuse cases (mean age 4.8 ± 5.36 years), the incidence was highest in 1- to 6-year-old children (n = 198, 54.85%). Physical abuse and neglect were predominant in males, while sexual abuse was predominant in females (P < 0.001). Neglect was most common (n = 279, 75.85%), followed by physical (n = 56, 15.51%) and sexual abuse (n = 26, 7.2%). The most common identifying setting was the emergency department (n = 320, 88.64%), with neglect being most commonly reported. Head, neck, and facial injuries were more common in physically abused children than in neglected and sexual abused children (P < 0.005), leading to longer hospitalization (P = 0.042) and a higher Injury Severity Score (P = 0.043). There were more skin injuries in neglect (P < 0.001). The mortality rate was 2.49% (n = 9). The CPMSDC could enhance the ability, alertness, and inclination of professionals to identify suspected cases of child abuse, and to increase the rate of registry. Cases of physical

  9. Child protection medical service demonstration centers in approaching child abuse and neglect in Taiwan.

    PubMed

    Chang, Yu-Ching; Huang, Jing-Long; Hsia, Shao-Hsuan; Lin, Kuang-Lin; Lee, En-Pei; Chou, I-Jun; Hsin, Yi-Chen; Lo, Fu-Song; Wu, Chang-Teng; Chiu, Cheng-Hsun; Wu, Han-Ping

    2016-11-01

    Child abuse includes all forms of physical and emotional ill treatment, sexual abuse, neglect, and exploitation that results in actual or potential harm to the child's health, development, or dignity. In Taiwan, the Child Protection Medical Service Demonstration Center (CPMSDC) was established to protect children from abuse and neglect. We further analyzed and compared the trends and clinical characteristics of cases reported by CPMSDC to evaluate the function of CPMSDC in approaching child abuse and neglect in Taiwan. We prospectively recorded children with reported child abuse and neglect in a CPMSDC in a tertiary medical center from 2014 to 2015. Furthermore, we analyzed and compared age, gender, scene, identifying settings, time of visits, injury type, injury severity, hospital admission, hospitalization duration, and outcomes based on the different types of abuse and the different settings in which the abuse or neglect were identified. Of 361 child abuse cases (mean age 4.8 ± 5.36 years), the incidence was highest in 1- to 6-year-old children (n = 198, 54.85%). Physical abuse and neglect were predominant in males, while sexual abuse was predominant in females (P < 0.001). Neglect was most common (n = 279, 75.85%), followed by physical (n = 56, 15.51%) and sexual abuse (n = 26, 7.2%). The most common identifying setting was the emergency department (n = 320, 88.64%), with neglect being most commonly reported. Head, neck, and facial injuries were more common in physically abused children than in neglected and sexual abused children (P < 0.005), leading to longer hospitalization (P = 0.042) and a higher Injury Severity Score (P = 0.043). There were more skin injuries in neglect (P < 0.001). The mortality rate was 2.49% (n = 9). The CPMSDC could enhance the ability, alertness, and inclination of professionals to identify suspected cases of child abuse, and to increase the rate of registry. Cases of physical abuse

  10. Employing continuous quality improvement in community-based substance abuse programs.

    PubMed

    Chinman, Matthew; Hunter, Sarah B; Ebener, Patricia

    2012-01-01

    This article aims to describe continuous quality improvement (CQI) for substance abuse prevention and treatment programs in a community-based organization setting. CQI (e.g., plan-do-study-act cycles (PDSA)) applied in healthcare and industry was adapted for substance abuse prevention and treatment programs in a community setting. The authors assessed the resources needed, acceptability and CQI feasibility for ten programs by evaluating CQI training workshops with program staff and a series of three qualitative interviews over a nine-month implementation period with program participants. The CQI activities, PDSA cycle progress, effort, enthusiasm, benefits and challenges were examined. Results indicated that CQI was feasible and acceptable for community-based substance abuse prevention and treatment programs; however, some notable resource challenges remain. Future studies should examine CQI impact on service quality and intended program outcomes. The study was conducted on a small number of programs. It did not assess CQI impact on service quality and intended program outcomes. Practical implications- This project shows that it is feasible to adapt CQI techniques and processes for community-based programs substance abuse prevention and treatment programs. These techniques may help community-based program managers to improve service quality and achieve program outcomes. This is one of the first studies to adapt traditional CQI techniques for community-based settings delivering substance abuse prevention and treatment programs.

  11. Implementing solutions to barriers to on-site HIV testing in substance abuse treatment: a tale of three facilities.

    PubMed

    Hood, Kristina B; Robertson, Angela A; Baird-Thomas, Connie

    2015-04-01

    Due to the scarcity of resources for implementing rapid on-site HIV testing, many substance abuse treatment programs do not offer these services. This study sought to determine whether addressing previously identified implementation barriers to integrating on-site rapid HIV testing into the treatment admissions process would increase offer and acceptance rates. Results indicate that it is feasible to integrate rapid HIV testing into existing treatment programs for substance abusers when resources are provided. Addressing barriers such as providing start-up costs for HIV testing, staff training, addressing staffing needs to reduce competing job responsibilities, and helping treatment staff members overcome their concerns about clients' reactions to positive test results is paramount for the integration and maintenance of such programs. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Issues in the Treatment of Antisocial Adolescent Substance Abusers.

    ERIC Educational Resources Information Center

    McKay, James R.; Buka, Stephen L.

    1994-01-01

    Presents findings from research programs: first on substance abuse in juvenile offenders/adolescents with psychiatric/behavioral disorders focused on treatment issues (attributions for substance use, beliefs about effects of drugs, perceptions of family functioning); and second on psychiatric disorders in adolescent substance abuse patients…

  13. Therapeutic Progression in Abused Women Following a Drug-Addiction Treatment Program.

    PubMed

    Fernández-Montalvo, Javier; López-Goñi, José J; Arteaga, Alfonso; Cacho, Raúl; Azanza, Paula

    2015-06-30

    This study explored the prevalence of victims of abuse and the therapeutic progression among women who sought treatment for drug addiction. A sample of 180 addicted Spanish women was assessed. Information was collected on the patients' lifetime history of abuse (psychological, physical, and/or sexual), socio-demographic factors, consumption variables, and psychological symptoms. Of the total sample, 74.4% (n = 134) of the addicted women had been victims of abuse. Psychological abuse affected 66.1% (n = 119) of the patients, followed by physical abuse (51.7%; n = 93) and sexual abuse (31.7%; n = 57). Compared with patients who had not been abused, the addicted women with histories of victimization scored significantly higher on several European version of the Addiction Severity Index (EuropASI) and psychological variables. Specifically, physical abuse and sexual abuse were related to higher levels of severity of addiction. Regarding therapeutic progression, the highest rate of dropout was observed among victims of sexual abuse (63.5%; n = 33), followed by victims of physical abuse (48.9%; n = 23). Multivariate analysis showed that medical and family areas of the EuropASI, as well as violence problems and suicide ideation, were the main variables related to physical and/or sexual abuse. Moreover, women without abuse and with fewer family problems presented the higher probability of treatment completion. The implications of these results for further research and clinical practice are discussed. © The Author(s) 2015.

  14. Racial differences in treatment effect among men in a substance abuse and domestic violence program.

    PubMed

    Scott, Melanie C; Easton, Caroline J

    2010-11-01

    It is unclear whether racial differences in treatment effect exist for individuals in substance abuse and domestic violence programs. This study examined racial differences in treatment effect among substance dependent Caucasian and African-American male intimate partner violence (IPV) offenders court mandated to an integrated substance abuse and domestic violence treatment. From baseline to completion of treatment (week 12), 75 participants (39 Caucasian; 36 African-American) were assessed on demographics, substance use, legal characteristics, and use of violence (physical, verbal, and psychological). African-American men served more months incarcerated in their life than Caucasian men. Both groups showed decreases in their use of physical violence and alcohol abuse over treatment. Caucasian men also showed a decrease in their use of verbal abuse. At treatment completion, both groups showed a reduction in physical abuse and alcohol abuse. Caucasian men showed a reduction in their use of verbal abuse, but African-American men did not. Substance dependent African-American male IPV offenders may benefit from interventions that thoroughly target communication skills in addition to issues of substance abuse and IPV to reduce use of verbal abuse and improve treatment outcomes among African American men.

  15. Patterns of pre-treatment drug abuse, drug treatment history and characteristics of addicts in methadone maintenance treatment in Iran

    PubMed Central

    2012-01-01

    Background Opiates are the main drugs of abuse, and Methadone Maintenance Treatment (MMT) is the most widely administered drug addiction treatment program in Iran. Our study aimed to investigate patterns of pre-treatment drug abuse, addiction treatment history and characteristics of patients in MMT in Tehran. Methods We applied a stratified cluster random sampling technique and conducted a cross-sectional survey utilizing a standard patient characteristic and addiction history form with patients (n = 810) in MMT. The Chi-square test and t-test served for statistical analyses. Results A clear majority of the participants were men (96%), more than 60% of whom were between 25 and 44 years of age, educated (89% had more than elementary education), and employed (>70%). The most commonly reported main drugs of abuse prior to MMT entry were opium (69%) and crystalline heroin (24%). The patients’ lifetime drug experience included opium (92%), crystalline heroin (28%), cannabis (16%), amphetamines (15%), and other drugs (33%). Crystalline heroin abusers were younger than opium users, had begun abusing drugs earlier, and reported a shorter history of opiate addiction. Conclusion Opium and crystalline heroin were the main drugs of abuse. A high rate of addiction using more dangerous opiate drugs such as crystalline heroin calls for more preventive efforts, especially among young men. PMID:22676557

  16. Cultural Accommodation of Substance Abuse Treatment for Latino Adolescents

    PubMed Central

    Burrow-Sanchez, Jason; Martinez, Charles; Hops, Hyman; Wrona, Megan

    2011-01-01

    Collaborating with community stakeholders is an often suggested step when integrating cultural variables into psychological treatments for members of ethnic minority groups. However, there is a dearth of literature describing how to accomplish this process within the context of substance abuse treatment studies. This paper describes a qualitative study conducted through a series of focus groups with stakeholders in the Latino community. Data from focus groups were used by researchers to guide the integration of cultural variables into an empirically-supported substance abuse treatment for Latino adolescents currently being evaluated for efficacy. A model for culturally accommodating empirically-supported treatments for ethnic minority participants is also described. PMID:21888499

  17. Psychosocial Characteristics of Drug-Abusing Women. Services Research Monograph Series.

    ERIC Educational Resources Information Center

    Burt, Marvin R.; And Others

    In recent years considerable attention has been paid to the status of women as drug abusers and as clients in drug treatment programs. A study of drug abusers' characteristics found a significantly higher history of non-medical psychotherapeutic drug use for females than for males; however, males had a higher prevalence of illicit drug use.…

  18. Examining Treatment Climate Across Prison-Based Substance Abuse Treatment Groups.

    PubMed

    Kelly, Christopher E; Welsh, Wayne N

    2016-06-06

    With notable exceptions, few studies have looked critically at the role and effects of factors other than individual or programmatic differences that contribute to the climate within substance abuse treatment programs. De Leon's work on the therapeutic community, however, indicates that factors beyond the individual and program can contribute to the overall functioning of similarly situated communities. In this study, we introduce and examine the concept of the "treatment group," the level of aggregation between the individual who participates in treatment and the organization that provides it. The treatment group refers to the social context and dynamics that operate among treatment participants, and we sought to study differences in treatment climate across 12 prison-based treatment groups within a single prison. Using data from 604 participants who were assigned at random to one of the 12 groups, we analyzed differences on seven treatment climate indicators from one month and six months into the program across the treatment groups. No differences were found among the treatment groups at after one month; however, after 6 months, significant differences emerged across the groups on three treatment climate variables: program structure, counselor rapport, and counselor competence. This study is among the first of its kind to conceptualize and examine treatment climate across otherwise similar groups and find that differences emerge on several indicators of climate. As such, we argue that the treatment group may be important to consider in both the delivery and evaluation of substance abuse treatment.

  19. Neurocognitive Defects and Their Impact on Substance Abuse Treatment.

    ERIC Educational Resources Information Center

    Fals-Stewart, William

    1993-01-01

    Examined prevalence of cognitive deficits in substance abusers (n=108) referred by criminal justice system to complete treatment in drug-free therapeutic community. Findings revealed that substance abusers with neuropsychological deficits were more likely to be removed from program for failure to follow rules and ultimately stayed in residence…

  20. HPA axis response to psychological stress and treatment retention in residential substance abuse treatment: a prospective study.

    PubMed

    Daughters, Stacey B; Richards, Jessica M; Gorka, Stephanie M; Sinha, Rajita

    2009-12-01

    Substance abuse treatment programs are often characterized by high rates of premature treatment dropout, which increases the likelihood of relapse to drug use. Negative reinforcement models of addiction emphasize an individual's inability to tolerate stress as a key factor for understanding poor substance use treatment outcomes, and evidence indicates that dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis contributes to an individual's inability to respond adaptively to stress. The aim of the current study was to examine whether HPA axis response to stress is predictive of treatment retention among a sample of drug users in residential substance abuse treatment. Prospective study assessing treatment retention among 102 individuals enrolled in residential substance abuse treatment. Participants completed two computerized stress tasks, and HPA axis response to stress was measured via salivary cortisol at five time points from baseline (pre-stress) to 30 min post-stress exposure. The main outcome measures were treatment dropout (categorical) and total number of days in treatment (continuous). A significantly higher salivary cortisol response to stress was observed in treatment dropouts compared to treatment completers. Further, Cox proportional hazards survival analyses indicated that a higher peak cortisol response to stress was associated with a shorter number of days to treatment dropout. Results indicate that a higher salivary cortisol level in response to stress is associated with an inability to remain in substance abuse treatment. These findings are the first to document a biological marker of stress as a predictor of substance abuse treatment dropout, and support the development and implementation of treatments targeting this vulnerability.

  1. Parenting training for women in residential substance abuse treatment. Results of a demonstration project.

    PubMed

    Camp, J M; Finkelstein, N

    1997-01-01

    This paper presents findings on the impact of implementing a parenting component in two urban residential treatment programs in Massachusetts for pregnant and parenting chemically-dependent women. The parenting component consisted of multiple services for both women and their infants while they were in residential treatment as well as aftercare services after discharge from treatment. Findings presented focus on: (a) the characteristics of the 170 pregnant and parenting women who participated in the parenting component during its 48 months of implementation; (b) changes in the parenting skills and self-esteem of women who completed parenting training; (c) the quality of mother-child interaction; and (d) the participants' perceptions about the impact of the parenting training. Women in both programs made dramatic improvements in self-esteem and experienced significant gains in parenting knowledge and attitudes. The participants were also overwhelmingly positive about the impact of the parenting training on their lives. Study findings underline the importance of parenting services for pregnant and parenting women in residential substance abuse treatment.

  2. Assessment of AIDS Risk among Treatment Seeking Drug Abusers.

    ERIC Educational Resources Information Center

    Black, John L.; And Others

    Intravenous (IV) drug abusers are at risk for contracting transmittable diseases such as acquired immunodeficiency syndrome (AIDS) and hepatitis B. This study was conducted to investigate the prevalence of risk behaviors for acquiring and transmitting AIDS and hepatitis B among treatment-seeking drug abusers (N=168). Subjects participated in a…

  3. Substance-Abusing Parents in the Criminal Justice System: Does Substance Abuse Treatment Improve Their Children's Outcomes?

    ERIC Educational Resources Information Center

    Phillips, Susan D.; Gleeson, James P.; Waites-Garrett, Melissa

    2009-01-01

    The expansion of the criminal justice system over the last several decades helped to focus attention on children of incarcerated parents, many of whom have parents with substance abuse problems. Since the 1990's, a national grassroots campaign has been underway to make substance abuse treatment an alternative to incarceration for parents who…

  4. Racial Differences in Treatment Effect among Men in a Substance Abuse and Domestic Violence Program

    PubMed Central

    Scott, Melanie C.; Easton, Caroline J.

    2013-01-01

    Background It isunclear whether racial differences in treatment effect exist for individuals in substance abuse and domestic violence programs. Objectives This study examined racial differences in treatment effect among substance dependent Caucasian and African-American male intimate partner violence (IPV) offenders court mandated to an integrated substance abuse and domestic violence treatment. Methods From baseline to completion of treatment (week 12), 75 participants (39 Caucasian; 36 African-American) were assessed on demographics, substance use, legal characteristics, and use of violence (physical, verbal, and psychological). Results African-American men served more months incarcerated in their life than Caucasian men. Both groups showed decreases in their use of physical violence and alcohol abuse over treatment. Caucasian men also showed a decrease in their use of verbal abuse. Conclusions and Scientific Significance At treatment completion, both groups showed a reduction in physical abuse and alcohol abuse. Caucasian men showed a reduction in their use of verbal abuse, but African-American men did not. Substance dependent African-American male IPV offenders may benefit from interventions that thoroughly target communication skills in addition to issues of substance abuse and IPV to reduce use of verbal abuse and improve treatment outcomes among African American men. PMID:20936990

  5. Social Service Professionals' Perceptions of Nonoffending Caregivers in Child Sexual Abuse Cases

    ERIC Educational Resources Information Center

    Wolfteich, Paula M.; Cline, Monica L.

    2013-01-01

    This study was designed to assess social service workers' perceptions of nonoffending caregivers in cases of child sexual abuse. Attributions of blame were examined by administering questionnaires to staff at local social service agencies. It was hypothesized that social service workers who worked in the field longer, were male, or had less…

  6. Drug Abuse: The Crack Cocaine Epidemic Health Consequences and Treatment.

    DTIC Science & Technology

    1991-01-01

    addicts . Buackground Once considered to be nonaddictive, recent studies show that cocaine is one of the most potent drugs of abuse. Cocaine is a...responsibility for addiction prevention and treatment programs. The agencies we contacted include NIDA, the Alcohol, Drug Abuse, and Mental Health Administration...heroin addicts for Treating Crack are being used to treat many crack addicts . Meanwhile, drug treatment Addicts researchers are experimenting with new

  7. 75 FR 16487 - Center for Substance Abuse Treatment; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-01

    ... Center for Substance Abuse Treatment; Notice of Meeting Pursuant to Public Law 92-463, notice is hereby... Substance Abuse Treatment (CSAT) National Advisory Council on April 21, 2010. A portion of the meeting is... evaluation of grant applications. Therefore, this portion of the meeting will be closed to the public as...

  8. Program structure and counselor-client contact in outpatient substance abuse treatment.

    PubMed

    Knight, Danica K; Broome, Kirk M; Simpson, D Dwayne; Flynn, Patrick M

    2008-04-01

    To examine organizational structural attributes associated with counselor-client contact. Data were collected in 2004 and 2005 for a federally funded project, which simultaneously examines organizational structure, functioning, and resources among outpatient substance abuse treatment programs. The study uses a naturalistic design to investigate organizational structure measures-ownership, accreditation, and supplemental services-as predictors of time in counseling and case management, and caseload size, controlling for geographic differences. Directors at 116 outpatient drug-free treatment programs located in four regions across the U.S. (Great Lakes, Gulf Coast, Northwest, and Southeast) voluntarily completed a survey about program structure. Clients received more counseling hours in programs that were "intensive," publicly owned, accredited, and had a lower proportion of recently hired counselors. More case management hours were offered in "intensive," private-for-profit or publicly owned (versus private-nonprofit) programs, serving a lower proportion of dual-diagnosis clients, and providing more on-site supplemental services. Smaller caseloads were found in programs that were accredited and had a smaller average client census and a lower proportion of criminal justice referred clients. Organizational attributes are related to counselor-client contact and may have implications for staff turnover and service quality.

  9. Assessing Released Inmates for Substance-Abuse-Related Service Needs

    ERIC Educational Resources Information Center

    Belenko, Steven

    2006-01-01

    High rates of substance abuse and recidivism and limited in-prison and postrelease treatment access and transitional planning complicate community reintegration. Moreover, drug-related health and social problems are related to treatment outcomes. In the framework of risk-responsivity theory and structured, integrated reentry models, this article…

  10. Correlates of Sexual Abuse among Boys in Treatment for Chemical Dependency.

    ERIC Educational Resources Information Center

    Harrison, Patricia Ann; And Others

    1990-01-01

    Examined data from 1,227 boys in adolescent chemical dependency treatment centers to determine prevalence of history of child sexual abuse. Found only small proportion (6.6%) disclosed history of intra- or extra-familial sexual abuse. Abuse victims could be distinguished from counterparts by more serious psychopathology, behavior problems, and…

  11. Adolescent Substance Abuse Treatment: Evolving Policy at Federal, State and City Levels. Meeting Highlights and Background Briefing Report. Report of a Family Impact Seminar (Washington, D.C., November 17, 1989).

    ERIC Educational Resources Information Center

    Ooms, Theodora; Herendeen, Lisa

    This report contains highlights from a meeting on adolescent substance abuse treatment. Comments by these panelists are summarized: Elizabeth Rahdert, of the Division of Clinical Research, at the National Institute on Drug Abuse; Thomas Kirk, acting clinical director, Alcohol and Drug Abuse Services Administration, District of Columbia, Commission…

  12. The relationship between vulnerable attachment style, psychopathology, drug abuse, and retention in treatment among methadone maintenance treatment patients.

    PubMed

    Potik, David; Peles, Einat; Abramsohn, Yahli; Adelson, Miriam; Schreiber, Shaul

    2014-01-01

    The relationship between vulnerable attachment style, psychopathology, drug abuse, and retention in treatment among patients in methadone maintenance treatment (MMT) was examined by the Vulnerable Attachment Style Questionnaire (VASQ), the Symptom Checklist-90 (SCL-90), and drug abuse urine tests. After six years, retention in treatment and repeated urine test results were studied. Patients with vulnerable attachment style (a high VASQ score) had higher rates of drug abuse and higher psychopathology levels compared to patients with secure attachment style, especially on the interpersonal sensitivity, anxiety, hostility, phobic anxiety, and paranoid ideation scales. Drug abstinence at baseline was related to retention in treatment and to higher rates of drug abstinence after six years in MMT, whereas a vulnerable attachment style could not predict drug abstinence and retention in treatment. Clinical Implications concerning treatment of drug abusing populations and methodological issues concerning the VASQ's subscales are also discussed.

  13. Molecular approaches to treatments for cocaine abuse

    NASA Astrophysics Data System (ADS)

    Flippen-Anderson, Judith L.; George, Clifford; Deschamps, Jeffrey R.

    2003-02-01

    Cocaine is a potent stimulant of the central nervous system with severe addiction potential. Its abuse is a major problem worldwide. The exact mechanism of action of cocaine is still uncertain but it is known that its reinforcing and stimulant effects are related to its ability to inhibit the membrane bound dopamine transporter (DAT). This paper discusses efforts that are underway to identify ligands for possible use in the treatment of cocaine abuse. Much of this effort has been focussed on understanding cocaine interactions at DAT receptor sites.

  14. Are one-stop centres an appropriate model to deliver services to sexually abused children in urban Malawi?

    PubMed

    Mulambia, Yabwile; Miller, Aaron J; MacDonald, Geraldine; Kennedy, Neil

    2018-04-30

    The Republic of Malawi is creating a country-wide system of 28 One-Stop Centres (known as 'Chikwanekwanes' - 'everything under one roof') to provide medical, legal and psychosocial services for survivors of child maltreatment and adult intimate partner violence. No formal evaluation of the utility of such services has ever been undertaken. This study focused on the experiences of the families served at the country's first Chikwanekwane in the large, urban city of Blantyre. One hundred seven families were surveyed in their home three months after their initial evaluation for sexual abuse at the Blantyre One Stop Centre, and 25 families received a longer interview. The survey was designed to inquire what types of initial evaluation and follow-up services the children received from the medical, legal and social welfare services. All 107 received an initial medical exam and HIV testing, and 83% received a follow-up HIV test by 3 months; 80.2% were seen by a social welfare worker on the initial visit, and 29% had a home visit by 3 months; 84% were seen by a therapist at the initial visit, and 12% returned for further treatment; 95.3% had an initial police report and 27.1% ended in a criminal conviction for child sexual abuse. Most of the families were satisfied with the service they received, but a quarter of the families were not satisfied with the law enforcement response, and 2% were not happy with the medical assessment. Although a perception of corruption or negligence by police may discourage use of service, we believe that the One-Stop model is an appropriate means to deliver high quality care to survivors of abuse in Malawi.

  15. Acculturation and polysubstance abuse in Arab-American treatment clients.

    PubMed

    Arfken, Cynthia L; Kubiak, Sheryl P; Farrag, Mohamed

    2009-12-01

    Acculturation to U.S. culture by Latinos and Asian Americans has been associated with increased prevalence of substance abuse. However, little is known about the association between acculturation and substance use among Arab Americans, or more specifically, among Arab-American treatment clients. In 156 Arab-American male treatment clients, we found that higher levels of U.S. acculturation were positively associated with increased prevalence of polysubstance abuse. This first report on a large series of Arab-American clients also found considerable within-group variability. These results can be used to develop treatment plans and work-force training on the importance of U.S. acculturation and variability within Arab Americans.

  16. Addressing Trauma in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Giordano, Amanda L.; Prosek, Elizabeth A.; Stamman, Julia; Callahan, Molly M.; Loseu, Sahar; Bevly, Cynthia M.; Cross, Kaitlin; Woehler, Elliott S.; Calzada, Richard-Michael R.; Chadwell, Katie

    2016-01-01

    Trauma is prevalent among clients with substance abuse issues, yet addictions counselors' training in trauma approaches is limited. The purpose of the current article is to provide pertinent information regarding trauma treatment including the use of assessments, empirically supported clinical approaches, self-help groups and the risk of vicarious…

  17. Clinical outcomes of traumatized youth in adolescent substance abuse treatment: a longitudinal multisite study.

    PubMed

    Williams, Julie K; Smith, Douglas C; An, Hyonggin; Hall, James A

    2008-03-01

    The purpose of this study was to evaluate the effectiveness of outpatient substance abuse treatment for youth with high traumatic stress compared to youth without high traumatic stress in substance abuse treatment centers across the United States. The data for this study were gathered using a longitudinal survey design with purposive sampling from nine drug treatment delivery systems across the United States participating in the cooperative grant Strengthening Communities for Youth (SCY) awarded by SAMHSA's Center for Substance Abuse Treatment (CSAT) between September 2002 and June 2006. Follow-up assessments were conducted with the youth at three,six, and 12 months following intake. Traumatized youth responded to outpatient treatment in a similar pattern when compared to nontraumatized youth, although the traumatized youth had consistently higher scores on substance use frequency and substance problems scales than nontraumatized youth throughout the study. Current empirically validated treatments for adolescent substance abuse do not prepare the practitioner for trauma-informed practice or specifically address trauma-informed recovery. Based on our results, we advocate for the development and integration of trauma-informed practice within substance abuse treatment for adolescents to help them recover from trauma and substance abuse issues.

  18. Constructive conflict and staff consensus in substance abuse treatment.

    PubMed

    Melnick, Gerald; Wexler, Harry K; Chaple, Michael; Cleland, Charles M

    2009-03-01

    Previous studies demonstrated the relationship between consensus among both staff and clients with client engagement in treatment and between client consensus and 1-year treatment outcomes. The present article explores the correlates of staff consensus, defined as the level of agreement among staff as to the importance of treatment activities in their program, using a national sample of 80 residential substance abuse treatment programs. Constructive conflict resolution had the largest effect on consensus. Low client-to-staff ratios, staff education, and staff experience in substance abuse treatment were also significantly related to consensus. Frequency of training, an expected correlate of consensus, was negatively associated with consensus, whereas frequency of supervision was not a significant correlate. The implications of the findings for future research and program improvement are discussed.

  19. Study protocol: a stepped wedge cluster randomised controlled trial of a healthy lifestyle intervention for people attending residential substance abuse treatment.

    PubMed

    Kelly, Peter J; Baker, Amanda L; Deane, Frank P; Callister, Robin; Collins, Clare E; Oldmeadow, Christopher; Attia, John R; Townsend, Camilla J; Ingram, Isabella; Byrne, Gerard; Keane, Carol A

    2015-05-03

    Cardiovascular disease and cancer are leading causes of mortality for people with a history of alcohol or other substance use disorders. These chronic diseases share the same four primary behavioural risk factors i.e. excessive alcohol use, smoking, low intake of fruit and vegetables and physical inactivity. In addition to addressing problematic alcohol use, there is the potential for substance abuse treatment services to also address these other behaviours. Healthy Recovery is an 8-session group-based intervention that targets these multiple behavioural health risk factors and was developed specifically for people attending substance abuse treatment. This protocol describes a Cancer Institute NSW funded study that assesses the effectiveness of delivering Healthy Recovery for people who are attending residential alcohol and other substance abuse treatment. The study uses a stepped wedge randomised controlled design, where randomisation occurs at the service level. Participants will be recruited from residential rehabilitation programs provided by The Australian Salvation Army. All participants who (1) currently smoke tobacco and (2) are expected to be in the residential program for the duration of the 5-week intervention will be asked to participate in the study. Those participants residing at the facilities assigned to the treatment condition will complete Healthy Recovery. The intervention is manual guided and will be delivered over a 5-week period, with participants attending 8 group sessions. All participants will continue to complete The Salvation Army residential program, a predominantly 12-step based, modified therapeutic community. Participants in the control condition will complete treatment as usual. Research staff blind to treatment allocation will complete the primary and secondary outcome assessments at baseline and then at weeks 8, 20 and 32 weeks post intervention. This study will provide comprehensive data on the effect of delivering a healthy

  20. An Overview of Outpatient Treatment of Adolescent Substance Abuse

    ERIC Educational Resources Information Center

    Galanter, Marc; Glickman, Linda; Singer, David

    2007-01-01

    This paper reviews the literature on ambulatory substance abuse treatment for adolescents, including brief intervention, Twelve-Step-based outpatient treatment, family-based treatment, cognitive behavioral therapy, and pharmacologic treatment. An overview of socially and culturally specific strategies is also included. The diversity of settings…

  1. The Impact of Child, Family, and Child Protective Services Factors on Reports of Child Sexual Abuse Recurrence

    ERIC Educational Resources Information Center

    Sinanan, Allison N.

    2011-01-01

    This study identified selected child factors (e.g., age, gender, race/ethnicity, disabilities, prior victimization, and relationship to perpetrator of abuse), family risk factors (e.g., substance abuse, domestic violence, inadequate housing, and financial problems), and services provided by child protective services that likely increased reports…

  2. A discrete choice model of drug abuse treatment location.

    PubMed Central

    Goodman, A C; Nishiura, E; Hankin, J R

    1998-01-01

    OBJECTIVE: To identify short-term drug abuse treatment location risk factors for ten large, self-insured firms starting January 1, 1989 and ending December 31, 1991. DATA SOURCES/STUDY SETTING: Study population selected from a large database of health insurance claims for all treatment events starting January 1, 1989 and ending December 31, 1991. STUDY DESIGN: A nested binomial logit method is used to estimate firm-specific patterns of treatment location. The differences in treatment location patterns among firms are then decomposed into firm effects (holding explanatory variables constant among firms) and variable effects (holding firm-specific parameters constant). PRINCIPAL FINDINGS: Probability of inpatient drug treatment is directly related to the type of drug diagnosis. The most important factors are diagnoses of drug dependence (versus drug abuse) and/or a cocaine dependence. Firm-specific factors also make a substantive difference. Controlling for patient risk factors, firm-specific probabilities of inpatient treatment vary by as much as 87 percent. Controlling for practices of firms and their insurance carriers, differing patient risk profiles cause probabilities of inpatient treatment to vary by as much as 69 percent among firms. Use of the outpatient setting increased over the three-year period. CONCLUSIONS: There are two plausible explanations for the findings. First, people beginning treatment later in the three-year period had less severe conditions than earlier cases and therefore had less need of inpatient treatment. Second, drug abuse treatment experienced the same trend toward the increased use of outpatient care that characterized treatment for other illnesses in the 1980s and early 1990s. PMID:9566181

  3. Comparison of drug treatment histories of single and multiple drug abusers in detox.

    PubMed

    Greberman, S B; Jasinski, D

    2001-01-01

    This study was undertaken to determine differences in previous treatment patterns in individuals currently using different numbers of substances. Medical records of 1198 inpatient detoxification (detox) admissions were analyzed. Numbers of past admissions to completed detox, methadone, or other types of drug abuse treatment were totaled and ranked to determine most frequent type. Within gender, treatment histories of single and multiple drug abusers usually do not differ. The one exception is male multiple drug abusers ages 26-30, who show increased admissions. Possible explanations are that men do not seek treatment before developing medical complications of addiction or until external factors influence admission. There were differences in treatment histories between genders in multiple drug abusers only. Before age 30, women reported increased treatment of certain types. Possible explanations are that treatment priority is given to women who are, or may be, pregnant. Also, younger men may not enter or complete treatment. Previous treatment history may influence many behaviors. The results of this study delineate several valuable indicators for assessing past history.

  4. Medical marijuana use among adolescents in substance abuse treatment.

    PubMed

    Salomonsen-Sautel, Stacy; Sakai, Joseph T; Thurstone, Christian; Corley, Robin; Hopfer, Christian

    2012-07-01

    To assess the prevalence and frequency of medical marijuana diversion and use among adolescents in substance abuse treatment and to identify factors related to their medical marijuana use. This study calculated the prevalence and frequency of diverted medical marijuana use among adolescents (n = 164), ages 14-18 years (mean age = 16.09, SD = 1.12), in substance abuse treatment in the Denver metropolitan area. Bivariate and multivariate analyses were completed to determine factors related to adolescents' use of medical marijuana. Approximately 74% of the adolescents had used someone else's medical marijuana, and they reported using diverted medical marijuana a median of 50 times. After adjusting for gender and race/ethnicity, adolescents who used medical marijuana had an earlier age of regular marijuana use, more marijuana abuse and dependence symptoms, and more conduct disorder symptoms compared with those who did not use medical marijuana. Medical marijuana use among adolescent patients in substance abuse treatment is very common, implying substantial diversion from registered users. These results support the need for policy changes that protect against diversion of medical marijuana and reduce adolescent access to diverted medical marijuana. Future studies should examine patterns of medical marijuana diversion and use in general population adolescents. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  5. The Client Satisfaction Questionnaire-8: Psychometric properties in a cross-sectional survey of people attending residential substance abuse treatment.

    PubMed

    Kelly, Peter J; Kyngdon, Felicity; Ingram, Isabella; Deane, Frank P; Baker, Amanda L; Osborne, Briony A

    2018-01-01

    The Client Satisfaction Questionnaire (CSQ-8) is one of a limited number of standardised satisfaction measures that have been used widely across mental health services. This study examined the CSQ-8 as a measure of general satisfaction within residential substance abuse treatment. It compared the CSQ-8 with another established measure of client satisfaction that was developed for substance abuse treatment settings (Treatment Perceptions Questionnaire, TPQ). It also sought to examine the relationship between the CSQ-8 and commonly used process measures. Cross-sectional data was collected from across 14 Australian residential medium-to-long term alcohol and other drug treatment facilities (N = 1378). Demographic, substance abuse and mental health characteristics were collected, as well as process measures of craving, general functioning, self-perceptions, recovery and symptom distress. A confirmatory factory analysis established that the CSQ-8 retains a single factor. The scale was strongly correlated with the TPQ, suggesting high concurrent validity. However, while the TPQ was normally distributed, the CSQ-8 was highly negatively skewed. Significant associations were found between the CSQ-8 and cross-sectional process measures. Results suggest that that CSQ-8 is an appropriate measure to be used in residential substance abuse treatment settings. However, because of the high levels of negative skew, it is likely that the TPQ is more accurate in capturing clients' dissatisfaction than the CSQ-8. Future research should include longitudinal studies of satisfaction in order to examine how changes in satisfaction may be related to client characteristics, outcome measures, dropout or re-engagement in treatment. [Kelly PJ, Kyngdon F, Ingram I, Deane FP, Baker AL, Osborne BA. The Client Satisfaction Questionnaire-8: Psychometric properties in a cross-sectional survey of people attending residential substance abuse treatment. Drug Alcohol Rev 2018;37:79-86]. © 2017

  6. A Post-Hurricane Katrina Examination of Substance Abuse Treatment Discharges With Co-Occurring Psychiatric and Substance Use Disorders.

    PubMed

    Shuler, Monique; Suzuki, Sumihiro; Podesta, Arwen; Qualls-Hampton, Raquel; Wallington, Sherrie Flynt

    2017-01-01

    There is increasing literature supporting the adverse effects of disasters on substance use and psychiatric disorders. The co-occurrence of psychiatric disorders with substance use intensifies the challenge of treatment delivery. Thus the aim of this study was to examine the prevalence of substance use, treatment characteristics, and demographics of discharges from substance abuse treatment in New Orleans, post-Hurricane Katrina. Trends associated with discharges that have a co-occurring psychiatric and substance use disorder (COD) were also assessed. The secondary aim of this study was to examine the association of successful substance abuse treatment completion among those with a COD post-Hurricane Katrina. Substance abuse treatment discharge data (N = 16,507) from New Orleans, Louisiana, for years 2006 through 2011 were obtained from the Treatment Episode Data Set-Discharge. Multiple logistic regression analysis was employed to examine the association of discharges with a COD and completion of substance abuse treatment. Demographic, psychiatric, and treatment characteristics of discharges in 2006 were compared to characteristics in 2011. Trends of characteristics were also assessed through the study period. Roughly a third (35.2%) of all discharges in New Orleans from 2006 to 2011 had a COD. After controlling for race, employment, treatment service setting at discharge, primary substance problem, and the discharge's principal source of referral, discharges with a COD were 29% less likely to complete treatment as compared to those with no COD (AOR = 0.71, 95% CI [0.56, 0.90], p = .004). Treatment completion among discharges with a COD has significantly declined from 36.8% in 2006 to 18.7% in 2011 (p < .0001). Notable significant trends in homelessness, criminality, and heroin use were identified among discharges with a COD. Substance abuse treatment undergoes various changes in the event of a natural disaster. These changes may increase challenges for successful

  7. The Substance Abuse Treatment Workforce of South Africa

    ERIC Educational Resources Information Center

    Sodano, Ruthlyn; Watson, Donnie W.; Rataemane, Solomon; Rataemane, Lusanda; Ntlhe, Nomvuyo; Rawson, Richard

    2010-01-01

    The purpose of this paper is to describe characteristics of substance abuse treatment counselors in the Republic of South Africa, including demographics, education, training, and job duties. Counselors recruited from 24 treatment centers completed a survey after signing informed consent. Counselors were primarily female (75%), racially diverse…

  8. Intrafamilial Child Sexual Abuse Treatment: Prosecution Following Expulsion.

    ERIC Educational Resources Information Center

    Fridell, Lorie A.

    1991-01-01

    This study of 13 cases assessed the extent to which prosecution of child sexual abuse was successfully resumed against defendants terminated from a treatment program for noncompliance in Sacramento, California. Results indicated that convictions were obtained against persons initially diverted to treatment and that sentences received were…

  9. Racial and Ethnic Differences in Substance Abuse Service Needs, Utilization, and Outcomes in California

    PubMed Central

    Niv, Noosha; Pham, Rhoda; Hser, Yih-Ing

    2010-01-01

    Objective This study examined differences in service needs and treatment utilization, retention, and outcomes between African-American, Hispanic, and white substance abusers in community-based treatment programs. Methods Data were collected from 2,401 African Americans, 3,222 Hispanics, and 7,980 whites who were admitted to 43 drug treatment programs across California from 2000 to 2001. The Addiction Severity Index (ASI) was administered at intake to assess clients’ problem severity in a number of domains (alcohol use, drug use, employment, family and social relationships, legal, medical, and psychological), and treatment retention and arrest data were obtained from administrative records. A subsample was followed up at three months to assess service utilization (N=2,145) and again at nine months to readminister the ASI (N=2,566). Results All three groups had similar severity levels of drug and legal problems upon treatment entry. Upon entry to treatment, white clients had the highest severity levels of alcohol, family, and psychiatric problems and African Americans had the highest severity levels of employment problems compared with the other two groups. Treatment retention did not differ between the three groups, but whites received a greater number of alcohol treatment services than did African Americans or Hispanics, and African Americans received a greater number of employment services than did Hispanic and white clients. All three groups showed significant improvement in all outcome domains except for medical outcomes. At the nine-month follow-up, whites had worse outcomes in the alcohol domain compared with the other two groups, and whites had worse outcomes in the legal domain compared with Hispanics. Compared with whites, African Americans were significantly less likely to be charged with driving under the influence in the year after treatment admission. Conclusions All three groups improved after treatment, although benefits from treatment can be

  10. Mental health treatment need among pregnant and postpartum women/girls entering substance abuse treatment.

    PubMed

    Coleman-Cowger, Victoria H

    2012-06-01

    Substance use during pregnancy is widely acknowledged as a major public health concern with detrimental effects on both mother and unborn child. Mental health issues often co-occur with substance use and may trigger continued use during pregnancy or relapse to use postpartum, though little is known about the extent of these issues in pregnant and postpartum women entering substance abuse treatment. The purpose of this study is: (a) to examine self-reported mental health in a population of women and girls who were pregnant in the past year and are entering substance abuse treatment, and (b) to determine whether disparity exists in mental health treatment received across groups by race and age if a treatment need is present. Secondary data analysis was conducted with Global Appraisal of Individual Needs (GAIN) data from 502 female adolescents and adults who reported having been pregnant in the past year and who completed the GAIN upon entry into substance abuse treatment. Participants were compared on demographic, diagnostic, and problem severity variables by race and age. Results indicate that mental health treatment need is high among the whole pregnant and postpartum sample, but African American and Hispanic women and girls are receiving less mental health treatment than other groups despite having a need for it. No mental health treatment acquisition disparity was found by age.

  11. Dissemination activities: a critical new role for substance abuse treatment organizations.

    PubMed

    Fields, Dail; Blum, Terry C; Roman, Paul M

    2014-10-01

    The Affordable Care Act calls for integration of substance abuse treatment into medical care via medical homes and continuing specialty care. For this integration to occur in the substance abuse treatment field, substantial sharing and dissemination of information by treatment providers is required. This study explored the determinants of organizational activities directed at disseminating evidence-based practices (EBPs) undertaken by 193 community treatment programs who are members of the National Institute on Drug Abuse (NIDA) Clinical Trials Network. Using factor analysis, the research identified two generic categories reflecting different motivations for dissemination activities and explored both treatment center leadership and organizational characteristics as determinants of these different types of dissemination activities. Organizational characteristics predicting treatment center dissemination activities included size, previous involvement in research protocols, linkages with other providers, and having non-profit status. The treatment center leader's membership in professional organizations was also a significant determinant. Organization variables account for a larger portion of the variance in treatment center dissemination activities. The results suggest that the willingness of treatment providers to help disseminate EBPs within the industry may be heavily influenced through shared network connections with other treatment organizations.

  12. Dissemination Activities: A Critical New Role for Substance Abuse Treatment Organizations

    PubMed Central

    Blum, Terry C.; Roman, Paul M.

    2014-01-01

    The Affordable Care Act calls for integration of substance abuse treatment into medical care via medical homes and continuing specialty care. For this integration to occur in the substance abuse treatment field, substantial sharing and dissemination of information by treatment providers is required. This study explored the determinants of organizational activities directed at disseminating evidence-based practices (EBP) undertaken by 193 community treatment programs who are members of the National Institute on Drug Abuse (NIDA) Clinical Trials Network. Using factor analysis, the research identified two generic categories reflecting different motivations for dissemination activities, and explored both treatment center leadership and organizational characteristics as determinants of these different types of dissemination activities. Organizational characteristics predicting treatment center dissemination activities included size, previous involvement in research protocols, linkages with other providers, and having non-profit status. The treatment center leader's membership in professional organizations was also a significant determinant. Organization variables account for a larger portion of the variance in treatment center dissemination activities. The results suggest that the willingness of treatment providers to help disseminate EBPs within the industry may be heavily influenced through shared network connections with other treatment organizations. PMID:24722825

  13. The Response to Conjugal Violence in Substance Abuse Treatment Settings.

    ERIC Educational Resources Information Center

    Brown, Thomas G.; Caplan, Thomas; Seraganian, Peter; Werk, Annette

    The linkage between conjugal violence and substance abuse is well established. The evidence suggests that little coordination exists among the therapeutic communities positioned to treat co-existing problems. A survey was conducted in Quebec with professionals representing 57 substance abuse treatment centers, 38 of which were public. Questions…

  14. Brief screening for co-occurring disorders among women entering substance abuse treatment.

    PubMed

    Lincoln, Alisa K; Liebschutz, Jane M; Chernoff, Miriam; Nguyen, Dana; Amaro, Hortensia

    2006-09-07

    Despite the importance of identifying co-occurring psychiatric disorders in substance abuse treatment programs, there are few appropriate and validated instruments available to substance abuse treatment staff to conduct brief screen for these conditions. This paper describes the development, implementation and validation of a brief screening instrument for mental health diagnoses and trauma among a diverse sample of Black, Hispanic and White women in substance abuse treatment. With input from clinicians and consumers, we adapted longer existing validated instruments into a 14 question screen covering demographics, mental health symptoms and physical and sexual violence exposure. All women entering treatment (methadone, residential and out-patient) at five treatment sites were screened at intake (N = 374). Eighty nine percent reported a history of interpersonal violence, and 70% reported a history of sexual assault. Eighty-eight percent reported mental health symptoms in the last 30 days. The screening questions administered to 88 female clients were validated against in-depth psychiatric diagnostic assessments by trained mental health clinicians. We estimated measures of predictive validity, including sensitivity, specificity and predictive values positive and negative. Screening items were examined multiple ways to assess utility. The screen is a useful and valid proxy for PTSD but not for other mental illness. Substance abuse treatment programs should incorporate violence exposure questions into clinical use as a matter of policy. More work is needed to develop brief screening tools measures for front-line treatment staff to accurately assess other mental health needs of women entering substance abuse treatment.

  15. Characteristics of an Outpatient Treatment Sample by Primary Substance of Abuse

    PubMed Central

    Campbell, Aimee N. C.; Nunes, Edward V.; McClure, Erin A.; Hu, Mei-Chen; Turrigiano, Eva; Goldman, Bruce; Stabile, Patricia Quinn

    2013-01-01

    Objective The current study examines sociodemographic and clinical characteristics, as a function of primary substance of abuse, among clients approached, screened, and assessed for eligibility in a 10-site effectiveness trial of a web-based psychosocial intervention for substance use disorders. Consistent with the design of effectiveness trials, eligibility criteria were broad and exclusion criteria minimal; thus, the recruited sample may be viewed as relatively representative of patients seeking treatment throughout the United States. Methods Chi-square tests for categorical variables and F-tests for continuous variables were used to analyze demographic, substance use, physical and mental health, and sexual risk data collected at screening and baseline; pairwise comparisons between primary substance subgroups for baseline data were conducted if the test statistic p-value was ≤ .01. Results Few participants expressed disinterest in the study at screening due to the computer-assisted intervention. A diverse sample of substance users completed baseline and were enrolled: 22.9% marijuana; 21.7% opiates; 20.9% alcohol; 20.5% cocaine; and 13.9% stimulants. Marijuana users demonstrated the greatest differences across primary substances: they were younger, less likely to be married or attend 12-step meetings, and more likely to be in treatment as a result of criminal justice involvement. All patients, even marijuana users, reported comparable rates of co-occurring mental health disorders and sexual risk, as well as substantial rates of polysubstance use disorders. Conclusion Primary substance of abuse may be a less important indicator of overall severity compared to co-occurring disorders and other factors common across treatment seekers, further demonstrating the need for integrated treatment services and care, as well as comprehensive pre-treatment assessment. PMID:24089040

  16. The role of the EAP in the identification and treatment of substance abuse.

    PubMed

    Kramer, R M

    1998-12-01

    Employee Assistance Programs (EAPs) are cost-effective strategies for employers to contain the substantial direct and indirect costs of substance abuse in the workplace. EAPs offer prevention, early detection, assessment of referral, and after-care programs to help stem the enormous costs of substance abuse in the workplace. Most effective employer substance abuse programs integrate drug-testing and EAP services to ensure a well coordinated, cost-effective program.

  17. Sexual abuse in male children and adolescents: indicators, effects, and treatments.

    PubMed

    Black, C A; DeBlassie, R R

    1993-01-01

    It is believed by many that the sexual abuse of children and adolescents is primarily perpetrated against females. This article presents a review of the literature on the incidence, indicators, effects, and treatment of sexual abuse in males.

  18. The Juvenile Justice Behavioral Health Services Cascade: A new framework for measuring unmet substance use treatment services needs among adolescent offenders.

    PubMed

    Belenko, Steven; Knight, Danica; Wasserman, Gail A; Dennis, Michael L; Wiley, Tisha; Taxman, Faye S; Oser, Carrie; Dembo, Richard; Robertson, Angela A; Sales, Jessica

    2017-03-01

    Substance use and substance use disorders are highly prevalent among youth under juvenile justice (JJ) supervision, and related to delinquency, psychopathology, social problems, risky sex and sexually transmitted infections, and health problems. However, numerous gaps exist in the identification of behavioral health (BH) problems and in the subsequent referral, initiation and retention in treatment for youth in community justice settings. This reflects both organizational and systems factors, including coordination between justice and BH agencies. This paper presents a new framework, the Juvenile Justice Behavioral Health Services Cascade ("Cascade"), for measuring unmet substance use treatment needs to illustrate how the cascade approach can be useful in understanding service delivery issues and identifying strategies to improve treatment engagement and outcomes for youth under community JJ supervision. We discuss the organizational and systems barriers for linking delinquent youth to BH services, and explain how the Cascade can help understand and address these barriers. We provide a detailed description of the sequential steps and measures of the Cascade, and then offer an example of its application from the Juvenile Justice - Translational Research on Interventions for Adolescents in the Legal System project (JJ-TRIALS), a multi-site research cooperative funded by the National Institute on Drug Abuse. As illustrated with substance abuse treatment, the Cascade has potential for informing and guiding efforts to improve behavioral health service linkages for adolescent offenders, developing and testing interventions and policies to improve interagency and cross-systems coordination, and informing the development of measures and interventions for improving the implementation of treatment in complex multisystem service settings. Clinical Trials Registration number - NCT02672150. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. The Juvenile Justice Behavioral Health Services Cascade: A New Framework for Measuring Unmet Substance Use Treatment Services Needs among Adolescent Offenders

    PubMed Central

    Knight, Danica; Wasserman, Gail A.; Dennis, Michael L.; Wiley, Tisha; Taxman, Faye S.; Oser, Carrie; Dembo, Richard; Robertson, Angela A.; Sales, Jessica

    2017-01-01

    Overview Substance use and substance use disorders are highly prevalent among youth under juvenile justice (JJ) supervision, and related to delinquency, psychopathology, social problems, risky sex and sexually transmitted infections, and health problems. However, numerous gaps exist in the identification of behavioral health (BH) problems and in the subsequent referral, initiation and retention in treatment for youth in community justice settings. This reflects both organizational and systems factors, including coordination between justice and BH agencies. Methods and Results This paper presents a new framework, the Juvenile Justice Behavioral Health Services Cascade (“Cascade”), for measuring unmet substance use treatment needs to illustrate how the cascade approach can be useful in understanding service delivery issues and identifying strategies to improve treatment engagement and outcomes for youth under community JJ supervision. We discuss the organizational and systems barriers for linking delinquent youth to BH services, and explain how the Cascade can help understand and address these barriers. We provide a detailed description of the sequential steps and measures of the Cascade, and then offer an example of its application from the Juvenile Justice – Translational Research on Interventions for Adolescents in the Legal System project (JJ-TRIALS), a multi-site research cooperative funded by the National Institute on Drug Abuse. Conclusion As illustrated with substance abuse treatment, the Cascade has potential for informing and guiding efforts to improve behavioral health service linkages for adolescent offenders, developing and testing interventions and policies to improve interagency and cross-systems coordination, and informing the development of measures and interventions for improving the implementation of treatment in complex multisystem service settings. PMID:28132705

  20. Substance abuse intensive outpatient treatment: does program graduation matter?

    PubMed

    Wallace, Amy E; Weeks, William B

    2004-07-01

    Program graduation, even after controlling for length of stay, may predict for improved outcomes in some substance abuse treatment settings. We investigated the role of program graduation by comparing social outcomes and inpatient utilization the years before and after treatment among graduates and dropouts of a Veterans Administration substance abuse intensive outpatient program. At enrollment, graduates and dropouts were similar in all spheres measured. Patients who completed the treatment program used significantly fewer psychiatric inpatient bed days of care the year after they completed the program, both in comparison to their own prior use and in comparison to program dropouts. Graduates were more likely to be abstinent and less likely to fully relapse or be incarcerated at 6-month followup. Further research is needed to discern optimal treatment length-that which maximizes both length of stay and completion rates, while optimizing use of limited treatment resources.

  1. Factors that predict adolescent motivation for substance abuse treatment.

    PubMed

    Battjes, Robert J; Gordon, Michael S; O'Grady, Kevin E; Kinlock, Timothy W; Carswell, Melissa A

    2003-04-01

    Many adolescent substance abusers enter treatment because of external pressures and thus lack motivation to change their behavior and engage in treatment. Because an understanding of adolescent motivation may contribute to improved treatment, an investigation of factors that predict motivation was undertaken with youth admitted to an adolescent outpatient substance abuse treatment program (N=196). At admission, these subjects received a comprehensive biopsychosocial assessment. Using multiple regression analysis, factors considered to potentially predict motivation were assessed. Of the factors examined, those that involved experiencing various negative consequences of substance use emerged as important predictors of motivation, whereas severity of substance use did not. Diminished awareness of negative consequences of use was consonant with lower motivation, suggesting the importance of interventions to help youth recognize negative consequences of their substance use. Interventions to enhance motivation are likely to become more important as the juvenile justice system increasingly refers troubled youth to treatment.

  2. Using Administrative Data for Longitudinal Substance Abuse Research

    PubMed Central

    Evans, Elizabeth; Grella, Christine E.; Murphy, Debra A.; Hser, Yih-Ing

    2008-01-01

    The utilization of administrative data in substance abuse research has become more widespread than ever. This selective review synthesizes recent extant research from 31 articles to consider what has been learned from using administrative data to conduct longitudinal substance abuse research in four overlapping areas: (1) service access and utilization, (2) underrepresented populations, (3) treatment outcomes, and (4) cost analysis. Despite several notable limitations, administrative data contribute valuable information, particularly in the investigation of service system interactions and outcomes among substance abusers as they unfold and influence each other over the long term. This critical assessment of the advantages and disadvantages of using existing administrative data within a longitudinal framework should stimulate innovative thinking regarding future applications of administrative data for longitudinal substance abuse research purposes. PMID:18679805

  3. Characteristics and problems of 600 adolescent cannabis abusers in outpatient treatment.

    PubMed

    Tims, Frank M; Dennis, Michael L; Hamilton, Nancy; J Buchan, Betty; Diamond, Guy; Funk, Rod; Brantley, Laura B

    2002-12-01

    Risk factors among adolescent substance abusers have been shown to correlate with substance use severity. Characteristics related to severity, such as demographic and family factors, peer influences, psychiatric co-morbidity and HIV risk behaviors, are examined for a sample of adolescent cannabis users entering treatment. These data are from a clinical trial study utilizing blocked random assignment of clients to one of five treatment conditions. The study targeted adolescents entering outpatient treatment for primarily cannabis abuse or dependence. Treatment and research facilities in four metropolitan areas of the US were used to recruit study participants. Treatment was delivered in outpatient drug-free settings. Participants were 600 clients, ages 12-18, admitted to outpatient substance abuse treatment programs for cannabis problems, 96% with DSM-IV diagnoses of substance abuse or dependence, with the remaining 4% having at least one symptom of dependence plus significant problems indicating need for treatment. The Global Appraisal of Individual Needs (GAIN) was used to collect the information presented in this paper. The GAIN incorporates DSM-IV criteria for substance use disorders, conduct disorder and attention deficit hyperactivity disorder, as well as dimensional (scale) measures for physical and mental health. All participants reported at least one symptom of substance use disorders, and 46% met the DSM-IV criteria for substance dependence, while 50% met criteria for a diagnosis of abuse. Only 20% of the participants perceived any need for help with problems associated with their drug or alcohol use. Clients participating in the study typically presented multiple problems at treatment entry, most often including conduct disorder, attention deficit hyperactivity disorder (ADHD), internal (mental) distress, and physical health distress. The co-occurrence of conduct disorder and ADHD was found in 30% of the sample. Clients meeting criteria for substance

  4. The impact of illicit drug use and substance abuse treatment on adherence to HAART

    PubMed Central

    HICKS, P. L.; MULVEY, K. P.; CHANDER, G.; FLEISHMAN, J. A.; JOSEPHS, J. S.; KORTHUIS, P. T.; HELLINGER, J.; GAIST, P.; GEBO, K. A.

    2009-01-01

    High levels of adherence to highly active antiretroviral therapy (HAART) are essential for virologic suppression and longer survival in patients with HIV. We examined the effects of substance abuse treatment, current versus former substance use, and hazardous/binge drinking on adherence to HAART. During 2003, 659 HIV patients on HAART in primary care were interviewed. Adherence was defined as ≥95% adherence to all antiretroviral medications. Current substance users used illicit drugs and/or hazardous/binge drinking within the past six months, while former users had not used substances for at least six months. Logistic regression analyses of adherence to HAART included demographic, clinical and substance abuse variables. Sixty-seven percent of the sample reported 95% adherence or greater. However, current users (60%) were significantly less likely to be adherent than former (68%) or never users (77%). In multivariate analysis, former users in substance abuse treatment were as adherent to HAART as never users (Adjusted Odds Ratio (AOR) 0.82; p>0.5). In contrast, former users who had not received recent substance abuse treatment were significantly less adherent than never users (AOR=0.61; p=0.05). Current substance users were significantly less adherent than never users, regardless of substance abuse treatment (p<0.01). Substance abuse treatment interacts with current versus former drug use status to affect adherence to HAART. Substance abuse treatment may improve HAART adherence for former substance users. PMID:18058397

  5. Substance abuse interface with intimate partner violence: what treatment programs need to know.

    PubMed

    Brackley, Margaret H; Williams, Gail B; Wei, Christina C

    2010-12-01

    This article provides suggestions for skill development for substance abuse (SA) treatment agencies and providers for implementing Treatment Improvement Protocol number 25: Substance Abuse Treatment and Domestic Violence. Methods for detecting, screening, intervening, and referring victims and perpetrators of intimate partner violence enrolled in SA treatment are presented. Evidence-based brief intervention is presented. A 2-minute screen for domestic violence as well as danger assessment for lethality of abuse and the Conflict Tactics Scales 2 are reviewed. A survey of interventions aimed at establishing trust, brief intervention from best practice, guidelines for safety planning, compliance strategies for SA treatment, and community resource development are presented. Copyright © 2010 Elsevier Inc. All rights reserved.

  6. Racial/Ethnic Differences in Social Vulnerability among Women with Co-Occurring Mental Health and Substance Abuse Disorders: Implications for Treatment Services

    ERIC Educational Resources Information Center

    Amaro, Hortensia; Larson, Mary Jo; Gampel, Joanne; Richardson, Erin; Savage, Andrea; Wagler, Debra

    2005-01-01

    Little attention has been given to racial/ethnic differences in studies of co-occurring disorders among women. In this article, we present findings from analyses conducted on the influence of racial/ethnic differences on the demographic and clinical profiles of 2,534 women in the Substance Abuse and Mental Health Services Administration-sponsored…

  7. Hospitalization of adolescents for psychiatric and substance abuse treatment. Legal and ethical issues.

    PubMed

    Schwartz, I M

    1989-11-01

    It has been estimated that as many as 12%-15% of the nations 63 million children are in need of mental health treatment. We have a responsibility to do everything we can to see to it that these children receive the services they need. Unfortunately, there is mounting evidence that a significant proportion of our health care resources are being misspent on the unnecessary and inappropriate hospitalization of children and youths in psychiatric and substance abuse treatment programs. More alarming is the evidence of poor quality programs, abusive practices, and greed. The intense competition to capture a "share of the market" and turn a profit or keep a nonprofit hospital from closing its doors is contributing to unprofessional and unethical advertising and public relations practices. In the end these practices will reflect poorly on the broader mental health and health care community. Hopefully, the stakeholders in the system will recognize these problems and assume a leadership role in turning the situation around. If not, we can expect intervention from forces outside the system (e.g., courts, elected public officials, public interest groups, the business community, and child advocates).

  8. Continuous quality improvement in substance abuse treatment facilities: How much does it cost?

    PubMed

    Hunt, Priscillia; Hunter, Sarah B; Levan, Deborah

    2017-06-01

    Continuous quality improvement (CQI) has grown in the U.S. since the 1970s, yet little is known about the costs to implement CQI in substance abuse treatment facilities. This paper is part of a larger group randomized control trial in a large urban county evaluating the impact of Plan-Study-Do-Act (PDSA)-CQI designed for community service organizations (Hunter, Ober, Paddock, Hunt, & Levan, 2014). Operated by one umbrella organization, each of the eight facilities of the study, four residential and four outpatient substance abuse treatment facilities, selected their own CQI Actions, including administrative- and clinical care-related Actions. Using an activity-based costing approach, we collected labor and supplies and equipment costs directly attributable to CQI Actions over a 12-month trial period. Our study finds implementation of CQI and meeting costs of this trial per facility were approximately $2000 to $10,500 per year ($4500 on average), or $10 to $60 per admitted client. We provide a description of the sources of variation in these costs, including differing intensity of the CQI Actions selected, which should help decision makers plan use of PDSA-CQI. Copyright © 2017. Published by Elsevier Inc.

  9. Counselor Active Rehabilitation Service and the Reduction of Hopelessness in Individuals with Substance Abuse Disorders

    ERIC Educational Resources Information Center

    Ferdinandi, Andrew D.; Bethea, James S.

    2006-01-01

    The purpose of this quantitative study was to investigate the effect of Counselor Active Rehabilitation Service (CARS), compared to standard rehabilitation counseling in reducing feelings of hopelessness in individuals with substance abuse disorders. This study involved 50 inner city participants with substance abuse disorders. As determined using…

  10. Adolescent Abuse.

    ERIC Educational Resources Information Center

    Foreman, Susan; Seligman, Linda

    1983-01-01

    Discusses legal and developmental aspects of adolescent abuse, as distinguished from child abuse. The role of the school counselor in identifying and counseling abused adolescents and their families is discussed and several forms of intervention and support services are described. (JAC)

  11. "It Gave Me My Life Back": An Evaluation of a Specialist Legal Domestic Abuse Service.

    PubMed

    Lea, Susan J; Callaghan, Lynne

    2016-05-01

    Community-based advocacy services are important in enabling victims to escape domestic abuse and rebuild their lives. This study evaluated a domestic abuse service. Two phases of research were conducted following case-file analysis (n = 86): surveys (n = 22) and interviews (n = 12) with victims, and interviews with key individuals (n = 12) based in related statutory and community organizations. The findings revealed the holistic model of legal, practical, mental health-related, and advocacy components resulted in a range of benefits to victims and enhanced interagency partnership working. Core elements of a successful needs-led, victim-centered service could be distilled. © The Author(s) 2015.

  12. Enhanced Case Management versus Substance Abuse Treatment Alone among Substance Abusers with Depression

    ERIC Educational Resources Information Center

    Striley, Catherine W.; Nattala, Prasanthi; Ben Abdallah, Arbi; Dennis, Michael L.; Cottler, Linda B.

    2013-01-01

    This pilot study evaluated the effectiveness of enhanced case management for substance abusers with comorbid major depression, which was an integrated approach to care. One hundred and 20 participants admitted to drug treatment who also met Computerized Diagnostic Interview Schedule criteria for major depression at baseline were randomized to…

  13. Substance Abuse Treatment Stage and Personal Networks of Women in Substance Abuse Treatment

    PubMed Central

    Tracy, Elizabeth M.; Kim, HyunSoo; Brown, Suzanne; Min, Meeyoung O.; Jun, Min Kyoung; McCarty, Christopher

    2012-01-01

    This study examines the relationship among 4 treatment stages (i.e., engagement, persuasion, active treatment, relapse prevention) and the composition, social support, and structural characteristics of personal networks. The study sample includes 242 women diagnosed with substance dependence who were interviewed within their first month of intensive outpatient treatment. Using EgoNet software, the women reported on their 25 alter personal networks and the characteristics of each alter. With one exception, few differences were found in the network compositions at different stages of substance abuse treatment. The exception was the network composition of women in the active treatment stage, which included more network members from treatment programs or 12-Step meetings. Although neither the type nor amount of social support differed across treatment stages, reciprocity differed between women in active treatment and those in the engagement stage. Networks of women in active treatment were less connected, as indicated by a higher number of components, whereas networks of women in the persuasion stage had a higher degree of centralization, as indicated by networks dominated by people with the most ties. Overall, we find social network structural variables to relate to the stage of treatment, whereas network composition, type of social support, and sociodemographic variables (with a few exceptions) do not relate to treatment stage. Results suggest that social context, particularly how social contacts are arranged around clients, should be incorporated into treatment programs, regardless of demographic background. PMID:22639705

  14. Long-term correlates of childhood abuse among adults with severe mental illness: adult victimization, substance abuse, and HIV sexual risk behavior.

    PubMed

    Meade, Christina S; Kershaw, Trace S; Hansen, Nathan B; Sikkema, Kathleen J

    2009-04-01

    The prevalence of childhood sexual and physical abuse among persons with severe mental illness (SMI) is disproportionately high. Adults with SMI also engage in high rates of HIV risk behaviors. This study examined the association between childhood abuse and adult victimization, substance abuse, and lifetime HIV sexual risk in a sample of 152 adults with SMI receiving community mental health services. Structured interviews assessed psychiatric, psychosocial, and behavioral risk factors. Seventy percent reported childhood physical and/or sexual abuse, and 32% reported both types of abuse. Participants with childhood abuse were more likely to report adult victimization and greater HIV risk. A structural equation model found that childhood abuse was directly and indirectly associated with HIV risk through drug abuse and adult vicitimization. Integrated treatment approaches that address interpersonal violence and substance abuse may be necessary for HIV risk reduction in this population.

  15. Elder Abuse Identification in the Prehospital Setting: An Examination of State Emergency Medical Services Protocols.

    PubMed

    Namboodri, Brooke L; Rosen, Tony; Dayaa, Joseph A; Bischof, Jason J; Ramadan, Nadeem; Patel, Mehul D; Grover, Joseph; Brice, Jane H; Platts-Mills, Timothy F

    2018-03-22

    To describe statewide emergency medical service (EMS) protocols relating to identification, management, and reporting of elder abuse in the prehospital setting. Cross-sectional analysis. Statewide EMS protocols in the United States. Publicly available statewide EMS protocols identified from published literature, http://EMSprotocols.org, and each state's public health website. Protocols were reviewed to determine whether elder abuse was mentioned, elder abuse was defined, potential indicators of elder abuse were listed, management of older adults experiencing abuse was described, and instructions regarding reporting were provided. EMS protocols for child abuse were reviewed in the same manner for the purpose of comparison. Of the 35 publicly available statewide EMS protocols, only 14 (40.0%) mention elder abuse. Of protocols that mention elder abuse, 6 (42.9%) define elder abuse, 10 (71.4%) describe indicators of elder abuse, 8 (57.1%) provide instruction regarding management, and 12 (85.7%) provide instruction regarding reporting. Almost twice as many states met each of these metrics for child abuse. Statewide EMS protocols for elder abuse vary in regard to identification, management, and reporting, with the majority of states having no content on this subject. Expansion and standardization of protocols may increase the identification of elder abuse. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  16. Partner violence and substance abuse are intertwined: women's perceptions of violence-substance connections.

    PubMed

    Macy, Rebecca J; Renz, Connie; Pelino, Emily

    2013-07-01

    Research shows that co-occurring partner violence and substance abuse are problems for many women. However, less is known about women's varied experiences with partner violence and substance abuse. This exploratory, qualitative study investigates these two issues among a sample of 15 women in substance abuse treatment who experienced partner violence. Overall, findings show participants' experience of violence-substance connections varied in important ways; complicating factors exacerbate both problems; and domestic violence services and substance abuse treatments should account for these variations and complications. We discuss directions for providers, researchers, and policymakers concerned with partner violence or substance abuse.

  17. Management practices in substance abuse treatment programs.

    PubMed

    McConnell, K John; Hoffman, Kim A; Quanbeck, Andrew; McCarty, Dennis

    2009-07-01

    Efforts to understand how to improve the delivery of substance abuse treatment have led to a recent call for studies on the "business of addiction treatment." This study adapts an innovative survey tool to collect baseline management practice data from 147 addiction treatment programs enrolled in the Network for the Improvement of Addiction Treatment 200 project. Measures of "good" management practice were strongly associated with days to treatment admission. Management practice scores were weakly associated with revenues per employee but were not correlated with operating margins. Better management practices were more prevalent among programs with a higher number of competitors in their catchment area.

  18. Predicting incentives to change among adolescents with substance abuse disorder.

    PubMed

    Breda, Carolyn; Heflinger, Craig Anne

    2004-05-01

    While interest in understanding the incentives to change among individuals with substance abuse disorders is growing, little is known about incentives among adolescents with substance abuse disorders who are participating in formal services. The present research assesses the degree and nature of motivation and treatment readiness among adolescents admitted to substance abuse services, and whether such factors vary across significant subgroups of youth based on their social, legal, or clinical profiles. Data are based on interviews with 249 youth between 12 and 18 years of age who have been admitted to either inpatient, residential, or outpatient substance abuse treatment. Measures are adapted from an instrument developed to assess multiple domains of motivation to change (e.g., intrinsic and extrinsic motivation, treatment readiness). Results suggest that the incentive to change among adolescents with substance-abusing behavior is modest at best, regardless of dimension. Nonetheless, ethnicity, type of substance use, and psychopathology significantly predict incentives to change, though the predictors depend on which dimension is considered. The most robust predictor of incentives is the severity of negative consequences associated with youth's substance use--the greater the severity, the greater the incentives. Findings underscore the need to examine the utility and dimensionality of incentive for treatment planning, while at the same time, they identify factors that treatment planners can consider as they seek ways to enhance incentives and help adolescents with substance use disorders attain positive outcomes.

  19. Research on Rural Residence and Access to Drug Abuse Services: Where Are We and where Do We Go?

    ERIC Educational Resources Information Center

    Borders, Tyrone F.; Booth, Brenda M.

    2007-01-01

    Context: Illicit drug use is common in rural areas, but very little research has investigated rural populations' access to drug abuse services. Purpose: To describe the current state of the scientific literature on access to drug abuse services in rural areas and suggest directions for future research. Methods: We performed a literature review of…

  20. Perceived Discrimination in Healthcare and Mental Health/Substance Abuse Treatment Among Blacks, Latinos, and Whites

    PubMed Central

    Mays, Vickie M.; Jones, Audrey; Delany-Brumsey, Ayesha; Coles, Courtney; Cochran, Susan D.

    2016-01-01

    Background Experiences of discrimination in healthcare settings may contribute to disparities in mental health outcomes for Blacks and Latinos. We investigate whether perceived discrimination in mental health/substance abuse visits contributes to participants’ ratings of treatment helpfulness and stopped treatment. Research Methods We used data from three waves of the California Quality of Life Survey, a statewide population-based telephone survey assessing mental health/substance disorders and their treatment. In a sample of 1,099 adults (age 18–72) who indicated prior year mental health/substance abuse visits, we examined: experiences of discrimination that occurred during healthcare and mental health/substance abuse visits, ratings of treatment helpfulness, and reports of stopping treatment early. Results Fifteen percent of California adults reported discrimination during a healthcare visit and 4% specifically during mental health/substance abuse visits. Latinos, the uninsured, and those with past-year mental disorders were twice as likely as others to report healthcare discrimination (Adjusted Odds Ratio [AORs]=2.08, 2.77 and 2.51). Uninsured patients were seven times more likely to report discrimination in mental health/substance abuse visits (AOR=7.27, p<.01). The most commonly reported reasons for healthcare discrimination were race/ethnicity for Blacks (52%) and Latinos (31%), and insurance status for Whites (40%). Experiences of discrimination in mental health/substance abuse visits were associated with less helpful treatment ratings for Latinos (AOR=0.09, p< .05) and Whites (AOR=0.25, p< .01), and early treatment termination for Blacks (AOR=13.38, p< .05). Conclusions Experiences of discrimination are associated with negative mental health/substance abuse treatment experiences and stopped treatment, and could be a factor in mental health outcomes. PMID:27753743

  1. Employment services utilization and outcomes among substance abusing offenders participating in California's proposition 36 drug treatment initiative.

    PubMed

    Evans, Elizabeth; Hser, Yih-Ing; Huang, David

    2010-10-01

    California drug treatment programs may use funds to address barriers to work faced by Proposition 36 offenders, most of whom are not working at treatment entry, but employment services utilization and related behavioral outcomes have never been studied. This study examined primary data collected on 1,453 offenders by 30 programs during 2004 to explore the characteristics, employment services utilization, and outcomes of those who did and did not receive employment services while in drug treatment. One-year outcomes were mostly similar across groups, however, increases in the proportion of offenders employed, receiving income from employment and family or friends, and being paid for work were significantly greater among the received-employment-services group, and a greater proportion of this group also completed drug treatment. Employment services utilization was less likely for persons recruited from outpatient settings and more likely with greater severity of family/social problems and desire for services. Odds of employment one-year post-treatment entry were higher for those of Hispanic race/ethnicity (vs. White) and for those with treatment completion/longer retention but lower for those who were older, lived in specific counties, had greater employment problem severity at intake, and received other income-related services. Strategies for improving employment services utilization and outcomes among Proposition 36 offenders are discussed.

  2. Perception of Helpfulness among Participants in a Prison-Based Residential Substance Abuse Treatment Program

    ERIC Educational Resources Information Center

    Raney, Valerie K.; Magaletta, Philip; Hubbert, Timothy A.

    2005-01-01

    The purpose of the current study was to determine the extent to which an early prison release incentive impacted inmates' perceptions of substance abuse treatment helpfulness, overall satisfaction and focus on treatment issues. Three groups of inmates participating in their first, third or sixth month of residential drug abuse treatment were…

  3. Recognition and treatment of psychological disorders during military service in the UK armed forces: a study of war pensioners.

    PubMed

    Brewin, Chris R; Andrews, Bernice; Hejdenberg, Jennie

    2012-12-01

    Little is known about the detection and treatment of psychological disorders arising during military service. We investigated whether personnel who developed disorders while serving in the UK armed forces came to the attention of medical services for these problems, received corresponding diagnoses, and were treated. For this retrospective record-based study 132 veterans in receipt of a war pension for psychological or physical problems received a lifetime diagnostic interview. Those with onsets of PTSD, depression, or alcohol abuse while in service were compared with those who never developed any condition or only developed it after discharge. Their medical records were inspected for contemporaneous contacts, diagnoses, and treatment. PTSD and depression, but not alcohol abuse, were independently associated with mental health contacts while in service. The median time from PTSD onset to first contact was 1 month. Under half of personnel meeting criteria for these disorders received a corresponding diagnosis, and alcohol abuse was more likely to be recognised in the context of comorbid PTSD. PTSD was as well recognised in earlier as in later years covered by the study. Most personnel with disorders received treatment, and those treated were more likely to be medically downgraded or discharged. War pensioners are more likely than not to have had their psychological problems acknowledged and treated while in service. The fact that these problems are still largely present 10 years later raises questions over the continuity of care associated with the transition to civilian life.

  4. Trends in acute mental health care: comparing psychiatric and substance abuse treatment programs.

    PubMed

    Timko, Christine; Lesar, Michelle; Calvi, Noël J; Moos, Rudolf H

    2003-01-01

    This study compared psychiatric and substance abuse acute care programs, within both inpatient and residential modalities of care, on organization and staffing, clinical management practices and policies, and services and activities. A total of 412 (95% of those eligible) Department of Veterans Affairs' programs were surveyed nationwide. Some 40% to 50% of patients in psychiatric and substance abuse programs, in both inpatient and residential venues of care, had dual diagnoses. Even though psychiatric programs had a sicker patient population, they provided fewer services, including basic components of integrated programs, than substance abuse programs did. Findings also showed that there is a strong emphasis on the use of clinical practice guidelines, performance monitoring, and obtaining client satisfaction and outcome data in mental health programs. The author's suggest how psychiatric programs might better meet the needs of acutely ill and dually diagnosed patients (e.g., by incorporating former patients as role models and mutual help groups, as substance abuse programs do; and by having policies that balance patient choice with program demand).

  5. Treatment Effects for Common Outcomes of Child Sexual Abuse: A Current Meta-Analysis

    PubMed Central

    Trask, Emily V.; Walsh, Kate; DiLillo, David

    2010-01-01

    The present meta-analysis examined the effects of psychosocial treatments at reducing deleterious outcomes of sexual abuse. The meta-analysis included a total of 35 published and unpublished studies written in English, focusing on youth under the age of 18, and evaluating the effectiveness of treatments for the most common negative outcomes of sexual abuse: PTSD symptoms, externalizing problems, and internalizing problems. Results revealed medium effect sizes for PTSD symptoms, externalizing problems, and internalizing problems following treatment for sexual abuse. This study also examined the potential moderating effects of treatment (e.g., modality, duration, inclusion of caregiver) and participant (e.g., age, gender, ethnicity) characteristics. Results indicated that longer interventions were associated with greater treatment gains while group and individual treatments were equally effective. These findings shed new light on treatment effectiveness and provide useful information regarding the conditions under which treatment may be most effective. Future directions for research in this area are discussed. PMID:21603060

  6. Resources for Linkage of Primary Health Care and Substance Abuse Services.

    ERIC Educational Resources Information Center

    Edmunds, Margo

    1993-01-01

    Contends that substance abusing clients benefit from comprehensive and coordinated approach to their medical and psychosocial problems. Suggests range of strategies that have been used to enhance communication among practitioners and agencies and organizations with whom they interact. Describes strategies related to coordination of services;…

  7. Dimensions of Publicness and Performance in Substance Abuse Treatment Organizations

    ERIC Educational Resources Information Center

    Heinrich, Carolyn J.; Fournier, Elizabeth

    2004-01-01

    Changes in funding, clientele, and treatment practices of public and privately owned substance abuse treatment programs, compelled in part by increased cost containment pressures, have prompted researchers' investigations of the implications of organizational form for treatment programs. These studies primarily probe associations between ownership…

  8. Improving consistency and quality of service delivery: implications for the addiction treatment field.

    PubMed

    Knott, Anne Marie; Corredoira, Rafael; Kimberly, John

    2008-09-01

    Addiction treatment providers face serious problems in delivering consistent, high-quality services over time. Among those providers with multiple treatment sites, there is also intersite variability. This is a serious problem in the addiction field, likely to be made worse as new technologies are introduced and/or as there is industry consolidation (Corredoira, R., Kimberly, J. (2006) Industry evolution through consolidation: Implications for addiction treatment. Journal of Substance Abuse Treatment 31, 255-265.). Although serious, these problems in managing and monitoring to assure consistent service quality have been faced by many other industries. Here, we review evidence from research in other industries regarding three different forms of management (vertical integration, franchising, and licensing) across a chain of individual service providers. We show how each management form affects the level, consistency, and improvement of service delivery over time. In addition, we discuss how such performance advantages affect customer demand as well as regulatory endorsement of the consolidated firm and its approach.

  9. Screening Homeless Youth for Histories of Abuse: Prevalence, Enduring Effects, and Interest in Treatment

    ERIC Educational Resources Information Center

    Keeshin, Brooks R.; Campbell, Kristine

    2011-01-01

    Objectives: To identify the incidence of self-reported physical and sexual child abuse among homeless youth, the self-perceived effects of past abuse, and current interest in treatment for past abuse among homeless youth with histories of abuse. Methods: Homeless and street-involved persons aged 18-23 filled out a questionnaire and participated in…

  10. From benzos to berries: treatment offered at an Aboriginal youth solvent abuse treatment centre relays the importance of culture.

    PubMed

    Dell, Colleen Anne; Seguin, Maureen; Hopkins, Carol; Tempier, Raymond; Mehl-Madrona, Lewis; Dell, Debra; Duncan, Randy; Mosier, Karen

    2011-02-01

    First Nations and Inuit youth who abuse solvents are one of the most highly stigmatized substance-abusing groups in Canada. Drawing on a residential treatment response that is grounded in a culture-based model of resiliency, this article discusses the cultural implications for psychiatry's individualized approach to treating mental disorders. A systematic review of articles published in The Canadian Journal of Psychiatry during the past decade, augmented with a review of Canadian and international literature, revealed a gap in understanding and practice between Western psychiatric disorder-based and Aboriginal culture-based approaches to treatment and healing from substance abuse and mental disorders. Differing conceptualizations of mental health and substance abuse are discussed from Western psychiatric and Aboriginal worldviews, with a focus on connection to self, community, and political context. Applying an Aboriginal method of knowledge translation-storytelling-experiences from front-line workers in a youth solvent abuse treatment centre relay the difficulties with applying Western responses to Aboriginal healing. This lends to a discussion of how psychiatry can capitalize on the growing debate regarding the role of culture in the treatment of Aboriginal youth who abuse solvents. There is significant need for culturally competent psychiatric research specific to diagnosing and treating First Nations and Inuit youth who abuse substances, including solvents. Such understanding for front-line psychiatrists is necessary to improve practice. A health promotion perspective may be a valuable beginning point for attaining this understanding, as it situates psychiatry's approach to treating mental disorders within the etiology for Aboriginal Peoples.

  11. Availability and capacity of substance abuse programs in correctional settings: A classification and regression tree analysis.

    PubMed

    Taxman, Faye S; Kitsantas, Panagiota

    2009-08-01

    OBJECTIVE TO BE ADDRESSED: The purpose of this study was to investigate the structural and organizational factors that contribute to the availability and increased capacity for substance abuse treatment programs in correctional settings. We used classification and regression tree statistical procedures to identify how multi-level data can explain the variability in availability and capacity of substance abuse treatment programs in jails and probation/parole offices. The data for this study combined the National Criminal Justice Treatment Practices (NCJTP) Survey and the 2000 Census. The NCJTP survey was a nationally representative sample of correctional administrators for jails and probation/parole agencies. The sample size included 295 substance abuse treatment programs that were classified according to the intensity of their services: high, medium, and low. The independent variables included jurisdictional-level structural variables, attributes of the correctional administrators, and program and service delivery characteristics of the correctional agency. The two most important variables in predicting the availability of all three types of services were stronger working relationships with other organizations and the adoption of a standardized substance abuse screening tool by correctional agencies. For high and medium intensive programs, the capacity increased when an organizational learning strategy was used by administrators and the organization used a substance abuse screening tool. Implications on advancing treatment practices in correctional settings are discussed, including further work to test theories on how to better understand access to intensive treatment services. This study presents the first phase of understanding capacity-related issues regarding treatment programs offered in correctional settings.

  12. Enforced abstinence from tobacco during in-patient dual-diagnosis treatment improves substance abuse treatment outcomes in smokers.

    PubMed

    Stuyt, Elizabeth B

    2015-04-01

    Although the prevalence of tobacco use in those in substance abuse treatment is known to be quite high, most treatment programs do not address tobacco. The purpose of this study was to determine substance abuse recovery rates a year after treatment in a fully integrated, 90-day inpatient, dual diagnosis treatment program where patients are required to quit tobacco use in addition to drug and alcohol use for the duration of their 3 month stay. Tobacco is treated in the same way as other drugs and alcohol. One hundred fifty-four patients enrolled in a yearlong follow-up after treatment study consisting of monthly phone contact to assess recovery from substance abuse. One hundred forty (n=140) patients completed the year follow-up. At the time of entry into the program 120 (86%) were using tobacco daily. At the end of the year this decreased to 102 (73%). Patients who were using tobacco were more likely to relapse to other drugs or alcohol (p = .01). Patients who actively attempted to abstain from tobacco after treatment were significantly more likely to remain continuously abstinent throughout the year (p = .03). This study demonstrates that tobacco use is correlated with relapse and addressing tobacco in treatment as seriously as and in the same fashion as other drugs, improves outcomes. When provided with a tobacco free treatment environment for 90 days, patients with substance abuse and mental illness can and do make the decision to quit tobacco and stay quit, aiding their ability to remain sober. © American Academy of Addiction Psychiatry.

  13. Residential Treatment for Sexually Abusive Youth: An Assessment of Treatment Outcomes

    ERIC Educational Resources Information Center

    Jones, Christopher D.; Chancey, Roy; Lowe, Laura A.; Risler, Edwin A.

    2010-01-01

    Objective: This research study assesses the effectiveness of participation in a multimodal/holistic residential treatment program on changing deviant sexual interests and functional impairment among sexually abusive youth. Method: A one-group pretest posttest design was utilized to examine pretest (intake) and posttest (discharge) scores for 58…

  14. Spouse Abuse, Child Abuse, and Substance Abuse Among Army Facilities: Co-Occurrence, Correlations and Service Delivery Issues

    DTIC Science & Technology

    2006-03-01

    refer spouse abuse or child abuse offenders with identified alcohol or other drug involvement to the on-base counseling center for a substance...abuse assessment. The military’s response to combat substance abuse involves a combination of education, prevention, random testing for illicit drug ...data from three Army sources: the Army Central Registry (ACR), the Drug and Alcohol Management Information System (DAMIS), and Army personnel data

  15. Cultural issues in an Outpatient Program for stimulant abusers.

    PubMed

    Pérez-Arce, P; Carr, K D; Sorensen, J L

    1993-01-01

    Cocaine abuse has created widespread problems, especially in poor urban ethnic minority communities. This article discusses the cultural issues in delivering a cocaine treatment program to a predominantly minority patient population. The Stimulant Treatment Outpatient Program (STOP) of San Francisco General Hospital's Substance Abuse Services was established in 1990 as a public service clinic. Many program elements apply equally well to various cultural groups, including individual and group counseling, limited time in treatment, and crisis intervention. Culturally linked clinical issues include provision of a supportive infrastructure, role models in leadership positions, understanding the cultural influences in patients' lives, and establishing communication links with Cultural themes are discussed as they apply to treating African-Americans, Latinos, Asian-Americans, Native Americans, and clients of different genders. Programmatic outcome indicators, including program attrition, suggest that different cultural groups benefit differentially from the treatment.

  16. A plan analysis of pedophile sexual abusers' motivations for treatment: a qualitative pilot study.

    PubMed

    Drapeau, Martin; Körner, Annett; Granger, Luc; Brunet, Louis; Caspar, Franz

    2005-06-01

    Many authors have suggested adapting treatment programs to the specific needs of sexual abusers. However, little research has been conducted to understand what these patients seek in therapy or what elements play a key role in keeping them in treatment. In this pilot study, fifteen (N=15) pedophile sexual abusers from La Macaza clinic for sexual abusers were interviewed. Plan analysis was used to investigate the most prevalent components involved in staying in or leaving therapy. Results suggest that many components involved in the plans leading to doing and to avoiding treatment were similar. Differences were found in regards to the outcome of confrontations with the therapists, a tendency to isolate and overcomply, guilt related to the abuse, a need for a stable environment, and a need to be accepted. These results are discussed along with possible ways to improve the patients' involvement in treatment.

  17. Evidence-Based Practices, Attitudes, and Beliefs in Substance Abuse Treatment Programs Serving American Indians and Alaska Natives: A Qualitative Study

    PubMed Central

    Larios, Sandra E.; Wright, Serena; Jernstrom, Amanda; Lebron, Dorothy; Sorensen, James L.

    2012-01-01

    Substance abuse disproportionately impacts American Indian/Alaska Native (AI/AN) communities in the United States. For the increasing numbers of AI/AN individuals who enter and receive treatment for their alcohol or other drug problem it is imperative that the service they receive be effective. This study used qualitative methodology to examine attitudes toward evidence-based practices, also known as evidence-based treatments (EBTs) in minority-serving substance abuse treatment programs in the San Francisco Bay area. Twenty-two interviews were conducted in the study, of which seven were with program directors and substance abuse counselors at two urban AI/AN focused sites. These clinics were more likely than other minority-focused programs to have experience with research and knowledge about adapting EBTs. Only in the AI/AN specific sites did an issue arise concerning visibility, that is, undercounting AI/AN people in national and state databases. Similar to other minority-focused programs, these clinics described mistrust, fear of exploitation from the research community, and negative attitudes towards EBTs. The underutilization of EBTs in substance abuse programs is prevalent and detrimental to the health of patients who would benefit from their use. Future research should explore how to use this research involvement and experience with adaptation to increase the adoption of EBTs in AI/AN serving clinics. PMID:22400469

  18. 49 CFR 40.289 - Are employers required to provide SAP and treatment services to employees?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 1 2012-10-01 2012-10-01 false Are employers required to provide SAP and treatment services to employees? 40.289 Section 40.289 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Substance Abuse...

  19. 49 CFR 40.289 - Are employers required to provide SAP and treatment services to employees?

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 1 2014-10-01 2014-10-01 false Are employers required to provide SAP and treatment services to employees? 40.289 Section 40.289 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Substance Abuse...

  20. 49 CFR 40.289 - Are employers required to provide SAP and treatment services to employees?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 1 2011-10-01 2011-10-01 false Are employers required to provide SAP and treatment services to employees? 40.289 Section 40.289 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Substance Abuse...

  1. 49 CFR 40.289 - Are employers required to provide SAP and treatment services to employees?

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 1 2013-10-01 2013-10-01 false Are employers required to provide SAP and treatment services to employees? 40.289 Section 40.289 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Substance Abuse...

  2. 49 CFR 40.289 - Are employers required to provide SAP and treatment services to employees?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Are employers required to provide SAP and treatment services to employees? 40.289 Section 40.289 Transportation Office of the Secretary of Transportation PROCEDURES FOR TRANSPORTATION WORKPLACE DRUG AND ALCOHOL TESTING PROGRAMS Substance Abuse...

  3. Utilization of communication technology by patients enrolled in substance abuse treatment

    PubMed Central

    McClure, Erin A.; Acquavita, Shauna; Harding, Emily; Stitzer, Maxine

    2012-01-01

    Background Technology-based applications represent a promising method for providing efficacious, widely available interventions to substance abuse treatment patients. However, limited access to communication technology (i.e., mobile phones, computers, internet, and e-mail) could significantly impact the feasibility of these efforts, and little is known regarding technology utilization in substance abusing populations. Methods A survey was conducted to characterize utilization of communication technology in 266 urban, substance abuse treatment patients enrolled at eight drug-free, psychosocial or opioid-replacement therapy clinics. Results Survey participants averaged 41 years of age and 57% had a yearly household income of less than $15,000. The vast majority reported access to a mobile phone (91%), and to SMS text messaging (79%). Keeping a consistent mobile phone number and yearly mobile contract was higher for White participants, and also for those with higher education, and enrolled in drug-free, psychosocial treatment. Internet, e-mail, and computer use was much lower (39–45%), with younger age, higher education and income predicting greater use. No such differences existed for the use of mobile phones however. Conclusions Concern regarding the digital divide for marginalized populations appears to be disappearing with respect to mobile phones, but still exists for computer, internet, and e-mail access and use. Results suggest that mobile phone and texting applications may be feasibly applied for use in program-client interactions in substance abuse treatment. Careful consideration should be given to frequent phone number changes, access to technology, and motivation to engage with communication technology for treatment purposes. PMID:23107600

  4. Utilization of communication technology by patients enrolled in substance abuse treatment.

    PubMed

    McClure, Erin A; Acquavita, Shauna P; Harding, Emily; Stitzer, Maxine L

    2013-04-01

    Technology-based applications represent a promising method for providing efficacious, widely available interventions to substance abuse treatment patients. However, limited access to communication technology (i.e., mobile phones, computers, internet, and e-mail) could significantly impact the feasibility of these efforts, and little is known regarding technology utilization in substance abusing populations. A survey was conducted to characterize utilization of communication technology in 266 urban, substance abuse treatment patients enrolled at eight drug-free, psychosocial or opioid-replacement therapy clinics. Survey participants averaged 41 years of age and 57% had a yearly household income of less than $15,000. The vast majority reported access to a mobile phone (91%), and to SMS text messaging (79%). Keeping a consistent mobile phone number and yearly mobile contract was higher for White participants, and also for those with higher education, and enrolled in drug-free, psychosocial treatment. Internet, e-mail, and computer use was much lower (39-45%), with younger age, higher education and income predicting greater use. No such differences existed for the use of mobile phones however. Concern regarding the digital divide for marginalized populations appears to be disappearing with respect to mobile phones, but still exists for computer, internet, and e-mail access and use. Results suggest that mobile phone and texting applications may be feasibly applied for use in program-client interactions in substance abuse treatment. Careful consideration should be given to frequent phone number changes, access to technology, and motivation to engage with communication technology for treatment purposes. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  5. Understanding the neurobiology, assessment, and treatment of substances of abuse and dependence: a guide for the critical care nurse.

    PubMed

    Genung, Vanessa

    2012-03-01

    therapies. 8. An individual's treatment and services plan must be assessed continually and modified as necessary to ensure it meets his or her changing needs. 9. Many drug-addicted individuals also have other mental disorders that need treatment. 10. Medically assisted detoxification in the first stage of addiction treatment and by itself does little to change long-term drug abuse. 11. Treatment does not need to be voluntary to be effective. 12. Drug use during treatment must be monitored continuously, because lapses during treatment do occur. 13. Treatment programs should assess patients for the presence of HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases, as well as provide targeted risk-reduction counseling to help patients modify or change behaviors that place them at risk of contracting or spreading infectious diseases. To truly impact this disease, there needs to be improvement in the identification of risk factors and early identification and early intervention with children and adolescents. The future of neuroscience is in objective brain scans and genetic testing. Out of these approaches can come more objective measures of addiction and dependence using brain scans and genetic testing. These measures would potentially allow for the development of vaccines for specific drugs of abuse and dependence, as well as increasingly selective and effective pharmacologic approaches for treatment and a new consensus on standard of care for substance dependence.

  6. Impact of Physical and Sexual Abuse on Treatment Response in the Treatment of Resistant Depression in Adolescent Study (TORDIA)

    ERIC Educational Resources Information Center

    Shamseddeen, Wael; Asarnow, Joan Rosenbaum; Clarke, Gregory; Vitiello, Benedetto; Wagner, Karen Dineen; Birmaher, Boris; Keller, Martin B.; Emslie, Graham; Iyengar, Satish; Ryan, Neal D.; McCracken, James T.; Porta, Giovanna; Mayes, Taryn; Brent, David A.

    2011-01-01

    Objective: We previously reported that a history of abuse was associated with a poorer response to combination treatment in the Treatment of Resistant Depression in Adolescents study (TORDIA). We now report on the nature and correlates of abuse that might explain these findings. Method: Youth who did not benefit from an adequate selective…

  7. The long-term impacts of group treatment for partner abuse.

    PubMed

    Mcgregor, Marla; Tutty, Leslie M; Babins-Wagner, Robbie; Gill, Marlyn

    2002-01-01

    This paper evaluates Responsible Choices for Men, a 14-week therapy group for abusive men based on feminist perspectives using narrative methods. Pre-test and post-test information was available for 76 program completers measuring physical and non-physical abuse, self-esteem, perceived stress, family relations, depression, assertiveness, and sex-role beliefs. The men significantly improved on all variables. A further focus was following up with 22 group members, contacted 5 to 28 months post treatment and asked to complete the same measures. The results indicated not only maintenance of the post-group changes, but continued improvement. Clinical implications and recommendations for group programming with abusive men are presented.

  8. History of reported sexual or physical abuse among long-term heroin users and their response to substitution treatment.

    PubMed

    Oviedo-Joekes, Eugenia; Marchand, Kirsten; Guh, Daphne; Marsh, David C; Brissette, Suzanne; Krausz, Michael; Anis, Aslam; Schechter, Martin T

    2011-01-01

    Opioid-dependent individuals with a history of abuse have exhibited worse mental and physical health compared to those without such a history; however, the evidence regarding the influence of abuse histories on addiction treatment outcomes are conflicting. In the present study, we identified history of physical or sexual abuse at treatment initiation in relation to drug use and health among long-term opioid-dependent individuals and we determined the relationship of abuse histories with treatment outcomes following substitution treatment. We analyzed data from a randomized controlled trial that compared the effectiveness of opioid-agonists in the treatment of chronic opioid dependence. The North American Opiate Medication Initiative (NAOMI) was conducted in Vancouver and Montreal (Canada) and provided oral methadone, injectable diacetylmorphine or injectable hydromorphone, the last two on a double blind basis, over 12 months. A total of 112 (44.6%) participants reported a history of physical or sexual abuse at baseline. Participants with an abuse history reported a significantly higher number of chronic medical problems, suicide attempts, and previous drug treatments and had poorer psychiatric, family and social relations, and quality of life status compared to those without abuse histories. No differences in current and past substance use were found between those with and without abuse histories. Following 12 months of treatment, the participants with abuse histories improved to a similar degree as those without a history of abuse in all of the European Addiction Severity Index sub-scales, with the exception of medical status. The findings suggest that individuals with abuse histories were able to achieve similar outcomes as those without abuse histories following treatment despite having poorer scores in physical and mental health, social status and quality of life at treatment initiation. These findings suggest that the substitution treatments as provided in

  9. Can MDMA play a role in the treatment of substance abuse?

    PubMed

    Jerome, Lisa; Schuster, Shira; Yazar-Klosinski, B Berra

    2013-03-01

    A wider array of treatments are needed for people with substance abuse disorders. Some psychedelic compounds have been assessed as potential substance abuse treatments with promising results. MDMA may also help treat substance abuse based on shared features with psychedelic compounds and recent reports indicating that MDMAassisted psychotherapy can reduce symptoms of PTSD. Narrative reports and data from early investigations found that some people reduced or eliminated their substance use after receiving MDMA, especially in a therapeutic setting. MDMA is a potent monoamine releaser with sympathomimetic effects that may indirectly activate 5-HT2A receptors. It increases interpersonal closeness and prosocial feelings, potentially through oxytocin release. Findings suggest that ecstasy, material represented as containing MDMA, is associated with deleterious long-term effects after heavy lifetime use, including fewer serotonin transporter sites and impaired verbal memory. Animal and human studies demonstrate moderate abuse liability for MDMA, and this effect may be of most concern to those treating substance abuse disorders. However, subjects who received MDMA-assisted psychotherapy in two recent clinical studies were not motivated to seek out ecstasy, and tested negative in random drug tests during follow-up in one study. MDMA could either directly treat neuropharmacological abnormalities associated with addiction, or it could indirectly assist with the therapeutic process or reduce symptoms of comorbid psychiatric conditions, providing a greater opportunity to address problematic substance use. Studies directly testing MDMA-assisted psychotherapy in people with active substance abuse disorder may be warranted.

  10. Abuse and Young Children with Disabilities: A Review of the Literature

    ERIC Educational Resources Information Center

    Corr, Catherine; Santos, Rosa Milagros

    2017-01-01

    Legislation in the United States, such as the Child Abuse Prevention and Treatment Act and the Individuals With Disabilities Education Improvement Act, mandates service system collaboration to meet the complex needs of young children with disabilities who have experienced abuse. This literature review examines extant literature related to young…

  11. Improving access to geriatric mental health services: a randomized trial comparing treatment engagement with integrated versus enhanced referral care for depression, anxiety, and at-risk alcohol use.

    PubMed

    Bartels, Stephen J; Coakley, Eugenie H; Zubritsky, Cynthia; Ware, James H; Miles, Keith M; Areán, Patricia A; Chen, Hongtu; Oslin, David W; Llorente, Maria D; Costantino, Giuseppe; Quijano, Louise; McIntyre, Jack S; Linkins, Karen W; Oxman, Thomas E; Maxwell, James; Levkoff, Sue E

    2004-08-01

    The authors sought to determine whether integrated mental health services or enhanced referral to specialty mental health clinics results in greater engagement in mental health/substance abuse services by older primary care patients. This multisite randomized trial included 10 sites consisting of primary care and specialty mental health/substance abuse clinics. Primary care patients 65 years old or older (N=24,930) were screened. The final study group consisted of 2,022 patients (mean age=73.5 years; 26% female; 48% ethnic minority) with depression (N=1,390), anxiety (N=70), at-risk alcohol use (N=414), or dual diagnosis (N=148) who were randomly assigned to integrated care (mental health and substance abuse providers co-located in primary care; N=999) or enhanced referral to specialty mental health/substance abuse clinics (i.e., facilitated scheduling, transportation, payment; N=1,023). Seventy-one percent of patients engaged in treatment in the integrated model compared with 49% in the enhanced referral model. Integrated care was associated with more mental health and substance abuse visits per patient (mean=3.04) relative to enhanced referral (mean=1.91). Overall, greater engagement was predicted by integrated care and higher mental distress. For depression, greater engagement was predicted by integrated care and more severe depression. For at-risk alcohol users, greater engagement was predicted by integrated care and more severe problem drinking. For all conditions, greater engagement was associated with closer proximity of mental health/substance abuse services to primary care. Older primary care patients are more likely to accept collaborative mental health treatment within primary care than in mental health/substance abuse clinics. These results suggest that integrated service arrangements improve access to mental health and substance abuse services for older adults who underuse these services.

  12. Nonmedical prescription drug users in private vs. public substance abuse treatment: a cross sectional comparison of demographic and HIV risk behavior profiles.

    PubMed

    O'Grady, Catherine L; Surratt, Hilary L; Kurtz, Steven P; Levi-Minzi, Maria A

    2014-02-04

    Little is known regarding the demographic and behavioral characteristics of nonmedical prescription drug users (NMPDUs) entering substance abuse treatment settings, and information on the HIV-related risk profiles of NMPDUs is especially lacking. Participation in substance abuse treatment provides a critical opportunity for HIV prevention and intervention, but successful initiatives will require services appropriately tailored for the needs of NMPDUs. This paper compares the HIV risk profiles of NMPDUs in public (n = 246) and private (n = 249) treatment facilities. Participants included in the analysis reported five or more recent episodes of nonmedical prescription drug use, a prior HIV negative test result, and current enrollment in a substance abuse treatment facility. A standardized questionnaire was administered by trained interviewers with questions about demographics, HIV risk, and substance use. Private treatment clients were more likely to be non-Hispanic White, younger, and opioid and heroin users. Injection drug use was higher among private treatment clients, whereas public clients reported higher likelihood of trading or selling sex. Public treatment clients reported higher rates of HIV testing and availability at their treatment facilities compared to private clients. Findings suggest differing demographics, substance use patterns, profiles of HIV risk and access to HIV testing between the two treatment samples. Population tailored HIV interventions, and increased access to HIV testing in both public and private substance treatment centers, appear to be warranted.

  13. Mental Health, Substance Abuse, and Suicide Among Homeless Adults.

    PubMed

    Lee, Kyoung Hag; Jun, Jung Sim; Kim, Yi Jin; Roh, Soonhee; Moon, Sung Seek; Bukonda, Ngoyi; Hines, Lisa

    2017-01-01

    This study explored the role of mental health and substance abuse problems on the suicidal ideation and suicide attempts of 156 homeless adults. The logistic regression results indicated that homeless adults with anxiety were significantly more likely than those without anxiety to have both suicidal ideation and suicide attempts. Also, homeless adults with drug abuse were significantly more likely than those without drug abuse to have suicidal ideation. The study suggests that to reduce the suicide of the homeless, case managers need to screen mental health and substance abuse issues and to provide appropriate treatment services at homeless shelters.

  14. Selection and utilization of assessment instruments in substance abuse treatment trials: the National Drug Abuse Treatment Clinical Trials Network experience.

    PubMed

    Rosa, Carmen; Ghitza, Udi; Tai, Betty

    2012-07-17

    Based on recommendations from a US Institute of Medicine report, the National Institute on Drug Abuse established the National Drug Abuse Treatment Clinical Trials Network (CTN) in 1999, to accelerate the translation of science-based addiction treatment research into community-based practice, and to improve the quality of addiction treatment, using science as the vehicle. One of the CTN's primary tasks is to serve as a platform to forge bi-directional communications and collaborations between providers and scientists, to enhance the relevance of research, which generates empirical results that impact practice. Among many obstacles in moving research into real-world settings, this commentary mainly describes challenges and iterative experiences in regard to how the CTN develops its research protocols, with focus on how the CTN study teams select and utilize assessment instruments, which can reasonably balance the interests of both research scientists and practicing providers when applied in CTN trials. This commentary also discusses the process by which the CTN further selects a core set of common assessment instruments that may be applied across all trials, to allow easier cross-study analyses of comparable data.

  15. Combating Violence against Children: Jordanian Pre-Service Early Childhood Teachers' Perceptions towards Child Abuse and Neglect

    ERIC Educational Resources Information Center

    Fayez, Merfat; Takash, Hanan Mahmoud; Al-Zboon, Eman Khleif

    2014-01-01

    Early childhood teachers play major roles in defying child abuse and neglect and alleviating its detrimental effects on young children. Therefore, this study aimed at exploring how Jordanian pre-service early childhood teachers define and perceive violence against children and their role in child abuse detection and prevention. Furthermore, the…

  16. Pre-Service Special Education Teachers' Professionalism and Preparation in Terms of Child Sexual Abuse

    ERIC Educational Resources Information Center

    Al-Zboon, Eman; Ahmad, Jamal

    2016-01-01

    This study aimed at examining Jordanian pre-service special education teachers' professionalism and preparation on the topic of child sexual abuse (CSA). Qualitative research data from interviews with 20 pre-service special education teachers were analysed using thematic analysis. The results showed that these participants generally hold avoiding…

  17. Targeted Expansion Project for Outreach and Treatment for Substance Abuse and HIV Risk Behaviors in Asian and Pacific Islander Communities

    ERIC Educational Resources Information Center

    Nemoto, Tooru; Iwamoto, Mariko; Kamitani, Emiko; Morris, Anne; Sakata, Maria

    2011-01-01

    Access to culturally competent HIV/AIDS and substance abuse treatment and prevention services is limited for Asian and Pacific Islanders (APIs). Based on the intake data for a community outreach project in the San Francisco Bay Area (N = 1,349), HIV risk behaviors were described among the targeted API risk groups. The self-reported HIV prevalence…

  18. Perceived Discrimination in Health Care and Mental Health/Substance Abuse Treatment Among Blacks, Latinos, and Whites.

    PubMed

    Mays, Vickie M; Jones, Audrey L; Delany-Brumsey, Ayesha; Coles, Courtney; Cochran, Susan D

    2017-02-01

    Experiences of discrimination in health care settings may contribute to disparities in mental health outcomes for blacks and Latinos. We investigate whether perceived discrimination in mental health/substance abuse visits contributes to participants' ratings of treatment helpfulness and stopped treatment. We used data from 3 waves of the California Quality of Life Survey, a statewide population-based telephone survey assessing mental health/substance disorders and their treatment. In a sample of 1099 adults (age 18-72) who indicated prior year mental health/substance abuse visits, we examined: experiences of discrimination that occurred during health care and mental health/substance abuse visits, ratings of treatment helpfulness, and reports of stopping treatment early. Fifteen percent of California adults reported discrimination during a health care visit and 4% specifically during mental health/substance abuse visits. Latinos, the uninsured, and those with past year mental disorders were twice as likely as others to report health care discrimination [adjusted odds ratio (AORs)=2.08, 2.77, and 2.51]. Uninsured patients were 7 times more likely to report discrimination in mental health/substance abuse visits (AOR=7.27, P<0.01). The most commonly reported reasons for health care discrimination were race/ethnicity for blacks (52%) and Latinos (31%), and insurance status for whites (40%). Experiences of discrimination in mental health/substance abuse visits were associated with less helpful treatment ratings for Latinos (AOR=0.09, P<0.05) and whites (AOR=0.25, P<0.01), and early treatment termination for blacks (AOR=13.38, P<0.05). Experiences of discrimination are associated with negative mental health/substance abuse treatment experiences and stopped treatment, and could be a factor in mental health outcomes.

  19. Tobacco-related mortality among persons with mental health and substance abuse problems.

    PubMed

    Bandiera, Frank C; Anteneh, Berhanu; Le, Thao; Delucchi, Kevin; Guydish, Joseph

    2015-01-01

    The rate of cigarette smoking is greater among persons with mental health and/or substance abuse problems. There are few population-based datasets with which to study tobacco mortality in these vulnerable groups. The Oregon Health Authority identified persons who received publicly-funded mental health or substance abuse services from January 1996 through December 2005. These cases were then matched to Oregon Vital Statistics records for all deaths (N= 148,761) in the period 1999-2005. The rate of tobacco-related death rates was higher among persons with substance abuse problems only (53.6%) and those with both substance abuse and mental health problems (46.8%), as compared to the general population (30.7%). The rate of tobacco-related deaths among persons with mental health problems (30%) was similar to that in the general population. Persons receiving substance abuse treatment alone, or receiving both substance abuse and mental health treatment, were more likely to die and more likely to die prematurely of tobacco-related causes as compared to the general population. Persons receiving mental health services alone were not more likely to die of tobacco-related causes, but tobacco-related deaths occurred earlier in this population.

  20. The Use of Adventure Programming in Traditional Substance Abuse Treatment Programs: An Exploratory Investigation.

    ERIC Educational Resources Information Center

    Moraes, Ricardo

    As a valuable addition to substance abuse treatment, adventure programming can have positive impacts on clients' self-efficacy, social behavior, and problem solving. A study explored the extent to which traditional substance abuse treatment programs use adventure programming, the level of adventure training and experience among substance abuse…

  1. Adolescent Substance Abuse Treatment: Organizational Change and Quality of Care

    ERIC Educational Resources Information Center

    Rieckmann, Traci; Fussell, Holly; Doyle, Kevin; Ford, Jay; Riley, Katherine J.; Henderson, Stuart

    2011-01-01

    Substance abuse treatment agencies serving youth face unique barriers to providing quality care. Interviews with 17 adolescent programs found that family engagement, community involvement, and gender and diversity issues affected treatment delivery. Programs report organizational change efforts with implications for future process improvement…

  2. The adoption of medications in substance abuse treatment: associations with organizational characteristics and technology clusters.

    PubMed

    Knudsen, Hannah K; Ducharme, Lori J; Roman, Paul M

    2007-03-16

    Despite growing interest in closing the "research to practice gap", there are few data on the availability of medications in American substance abuse treatment settings. Recent research suggests that organizational characteristics may be associated with medication availability. It is unclear if the availability of medications can be conceptualized in terms of "technology clusters", where the availability of a medication is positively associated with the likelihood that other medications are also offered. Using data from 403 privately funded and 363 publicly funded specialty substance abuse treatment centers in the US, this research models the availability of agonist medications, naltrexone, disulfiram, and SSRIs. Bivariate logistic regression models indicated considerable variation in adoption across publicly funded non-profit, government-owned, privately funded non-profit, and for-profit treatment centers. Some of these differences were attenuated by organizational characteristics, such as accreditation, the presence of staff physicians, and the availability of detoxification services. There was some evidence that naltrexone, disulfiram, and SSRIs represent a group of less intensely regulated medications that is distinct from more intensely regulated medications. These types of medications were associated with somewhat different correlates. Future research should continue to investigate the similarities and differences in the predictors of medication availability across national contexts.

  3. [Five years of ROM in substance abuse treatment centres in the Netherlands].

    PubMed

    Oudejans, S C C; Schippers, G M; Spits, M E; Stollenga, M; van den Brink, W

    2012-01-01

    Three substance abuse treatment centres set up a benchmarking project for routine outcome management (ROM) of structured cognitive behavioral treatments for outpatients with a substance use disorder. To present the results of five years benchmarking. All patients were included at intake and the follow-up assessment was performed by a call-center nine months later. Twice a year aggregated data were fed back to management and treatment teams. Since 2005, clinical outcome data, including substance abuse data, have been collected for more than half of all 15.786 treated patients. At follow-up, nine months after intake, 23% was abstinent, 28% reported moderate substance use and 49% reported excessive substance use. The Dutch centres for the treatment of substance abuse were successful in setting up ROM projects to monitor and compare the development and the effects of outpatient addiction treatments. The clinical results are acceptable and correspond to the results of the American project called match. It is not yet clear whether the biannual feedback of aggregated outcomes to management and treatment teams has contributed to the creation of learning organisations, but it has provided transparency and has made it possible for teams to learn from the outcomes.

  4. Adoption of Evidence-Based Practices Among Substance Abuse Treatment Providers*

    PubMed Central

    Haug, Nancy A.; Shopshire, Michael; Tajima, Barbara; Gruber, Valerie; Guydish, Joseph

    2009-01-01

    This research was conducted at a Substance Abuse Forum designed to address local community needs by focusing on Evidence-Based Practices (EBPs) in addiction treatment. The purpose of the study was to assess substance abuse treatment professionals’ readiness to adopt EBPs, experience with EBPs, and attitudes toward EBPs, as well as agency support for EBPs. A total of 119 addiction treatment providers completed pre-test measures, and 82% completed a post-test. Eighty-three percent of participants reported using some EBPs in the past year, and 75% reported currently using EBPs. Participants who were currently licensed or certified in addictions had less negative attitudes toward EBPs than those without credentials. While respondents reported agency support for EBPs, most expressed interest in further training. This study underscores the movement toward EBPs in addiction treatment and the need for effective dissemination and training in this area. PMID:18724657

  5. PREVENTION AND OUTCOMES FOR VICTIMS OF CHILDHOOD SEXUAL ABUSE

    PubMed Central

    Ulibarri, Monica D.; Ulloa, Emilio C.; Salazar, Marissa

    2015-01-01

    This study examined self-reported sexually abusive experiences in childhood and adulthood as correlates of current drug use, alcohol abuse, and depression and posttraumatic stress disorder (PTSD) symptoms. Participants were 204 Latina women 18–34 years old. Results indicated significant relationships between history of sexual abuse (regardless of age of occurrence), depression symptoms, PTSD symptoms, alcohol abuse, and drug use. When examined separately, childhood sexual abuse was associated with symptoms of depression, PTSD, and substance use but not alcohol abuse behaviors. Experiencing sexual abuse in adulthood was associated with symptoms of depression, alcohol abuse behaviors, and substance use but not PTSD symptoms. Structural equation modeling showed that substance use partially mediated the relationship between sexual abuse and mental health outcomes. These findings suggest mental health and substance use services should incorporate treatment for trauma, which may be the root of comorbid mental health and substance use issues. PMID:25635897

  6. Utilization of Medical Treatments and Adherence to Antiretroviral Therapy among HIV-Positive Adults with Histories of Childhood Sexual Abuse

    PubMed Central

    Hansen, Nathan B.; Kochman, Arlene; Sikkema, Kathleen J.

    2009-01-01

    Abstract HIV is a chronic, life-threatening illness that necessitates regular and consistent medical care. Childhood sexual abuse (CSA) is a common experience among HIV-positive adults and may interfere with treatment utilization. This study examined rates and correlates of treatment utilization among HIV-positive adults with CSA enrolled in a coping intervention trial in New York City. The baseline assessment included measures of treatment utilization, mental health, substance abuse, and other psychosocial factors. In 2002–2004, participants (50% female, 69% African-American, M = 42.3 ± 6.8 years old) were recruited. Nearly all (99%) received HIV medical care. However, 20% had no outpatient visits and 24% sought emergency services in the past 4 months. Among 184 participants receiving antiretroviral therapy (ART), 22% were less than 90% adherent in the past week. In a multivariable logistic regression model, no outpatient treatment was associated with African American race (AOR = 3.46 [1.42–8.40]), poor social support (AOR = 1.59 [1.03–2.45]), and abstinence from illicit drug use (AOR = 0.37 [0.16–0.85]). Emergency service utilization was associated with HIV symptoms (AOR = 2.30 [1.22–4.35]), binge drinking (AOR=2.92 (1.18–7.24)), and illicit drug use (AOR = 1.98 [1.02–3.85]). Poor medication adherence was associated with trauma symptoms (AOR = 2.64 [1.07–6.75]) and poor social support (AOR = 1.82 [1.09–2.97]). In sum, while participants had access to HIV medical care, a sizable minority did not adhere to recommended guidelines and thus may not be benefiting optimally from treatment. Interventions targeting HIV-positive adults with CSA histories may need to address trauma symptoms, substance abuse, and poor social support that interfere with medical treatment utilization and adherence. PMID:19260772

  7. Meeting the substance abuse treatment needs of lesbian, bisexual and transgender women: implications from research to practice

    PubMed Central

    Stevens, Sally

    2012-01-01

    Research on the incidence, etiology and substance abuse treatment needs of lesbian, bisexual and transgender (LBT) women is limited. Most research indicates higher levels of alcohol and drug abuse among these populations compared to their heterosexual counterparts, with recent research indicating that substance abuse is a particular concern for transgender individuals and an increasing problem among younger LBT individuals. Risk factors and reasons for substance abuse among sexual minority women are similar to those of heterosexual women, yet are substantially complicated by issues of family rejection and lack of social support, stigma and minority stress, as well as abuse and harassment. Historically, substance abuse prevention, early intervention, and clinical treatment programs were designed to meet the needs of the sexual majority population with relatively few programs designed to incorporate the specific needs of sexual minorities. This article reviews findings from previous studies and utilizes new data collected from community-based and residential substance abuse treatment programs to (1) examine issues relevant to LBT women and substance use, and (2) make recommendations for tailoring substance abuse treatment programs to meet the needs of these populations. PMID:24474874

  8. 49 CFR Appendix A to Part 604 - Listing of Human Service Federal Financial Assistance Programs

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Programs Health Resources and Services Administration Department of Health and Human Services. 34 Substance Abuse Prevention and Treatment Block Grant Substance Abuse and Mental Health Services Administration Department of Health and Human Services. 35 Prevention and Texas Block Grant Substance Abuse and Mental...

  9. 49 CFR Appendix A to Part 604 - Listing of Human Service Federal Financial Assistance Programs

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Programs Health Resources and Services Administration Department of Health and Human Services. 34 Substance Abuse Prevention and Treatment Block Grant Substance Abuse and Mental Health Services Administration Department of Health and Human Services. 35 Prevention and Texas Block Grant Substance Abuse and Mental...

  10. Traumatic experiences and re-victimization of female inmates undergoing treatment for substance abuse.

    PubMed

    Mejía, Bertha; Zea, Paloma; Romero, Martha; Saldívar, Gabriela

    2015-02-09

    In the past decade, several studies have focused on the treatment needs of female inmates with substance abuse problems. An important finding has been that these women are more likely to report histories of sexual, physical, and emotional abuse-at rates varying from 77% to 90%. The trauma resulting from this kind of abuse is a key contributing factor in behavioral problems in adolescence and subsequent delinquency, substance abuse, and criminality in adulthood. This was a retrospective clinical study. A convenience sample of 112 women who entered the program's treatment groups consecutively for one year form part of the study. Information on traumatic events was obtained using some questions from the Initial Trauma Review. It explores whether the participant experienced physical abuse, sexual abuse, disasters, automobile accidents, or witnessed violence under the age of 18. It also examines experiences as an adult, including sexual and physical abuse, attacks by others who are not intimate partners, and abuse by authorities. Revictimization in sexual abuse was found in 78.1% of participants. Significant differences were identified between women who had experienced a traumatic sexual event from a person five years their senior before the age of 18 and then suffered from sexual violence as an adult, and women who had never undergone either of these events (x(2) = 11.3, df 112/1, p = <.001). In physical abuse, the figure was 82.17%. Differences were observed between women who were revictimized through physical abuse before and after the age of 18 (x(2) = 5.91, df 112/1, p = <.01), and those who had not experienced any kind of revictimization. Significant differences were found between women who had suffered a traumatic sexual event as a child and subsequently physical violence from their parents, and women who had not undergone either of these events (x(2) = 3.48, df 112/1, p = <.05). Investment in treatment in these areas during the prison

  11. A Distance Education Model for Training Substance Abuse Treatment Providers in Cognitive-Behavioral Therapy

    ERIC Educational Resources Information Center

    Watson, Donnie W.; Rawson, Richard R.; Rataemane, Solomon; Shafer, Michael S.; Obert, Jeanne; Bisesi, Lorrie; Tanamly, Susie

    2003-01-01

    This paper presents a rationale for the use of a distance education approach in the clinical training of community substance abuse treatment providers. Developing and testing new approaches to the clinical training and supervision of providers is important in the substance abuse treatment field where new information is always available. A…

  12. Predictors of Relapse for American Indian Women after Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Chong, Jenny; Lopez, Darlene

    2008-01-01

    The objective of this study was to describe the predictors of substance use relapse of American Indian (AI) women up to one year following substance abuse treatment. Relapse is defined as any use of alcohol or drugs in the past 30 days at the follow-up points. Data were collected from AI women in a 45-day residential substance abuse treatment…

  13. A Study of Clinical Supervision Techniques and Training in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    West, Paul L.; Hamm, Terri

    2012-01-01

    Data from 57 clinical supervisors in licensed substance abuse treatment programs indicate that 28% had completed formal graduate course work in clinical supervision and 33% were professionally licensed or certified. Findings raise concerns about the scope and quality of clinical supervision available to substance abuse counselors. (Contains 3…

  14. Substance Abuse Treatment for Persons With Co-Occurring Disorders. Treatment Improvement Protocol (TIP) Series 42

    ERIC Educational Resources Information Center

    Sacks, Stanley; Ries, Richard K.

    2005-01-01

    This Treatment Improvement Protocol (TIP) provides guidelines for counselors and others working in the field of co-occurring substance use and mental disorders. TIPs are best-practice guidelines for the treatment of substance use disorders that make the latest research in substance abuse treatment available to counselors and educators. The content…

  15. Behavioral Health Services Utilization among Older Adults Identified within a State Abuse Hotline Database

    ERIC Educational Resources Information Center

    Schonfeld, Lawrence; Larsen, Rebecca G.; Stiles, Paul G.

    2006-01-01

    Purpose: This study examined the extent to which older adults identified in a statewide abuse hotline registry utilized behavioral health services. This is important as mental health issues have been identified as a high priority for filling gaps in services for victims of mistreatment. Design and Methods: We compared Medicaid and Medicare claims…

  16. Talking about friends, drugs, and change: meanings of friendship in substance abusers' change talk.

    PubMed

    Sarpavaara, Harri

    2014-05-01

    This article explores the meanings of substance-abusing clients attach to friendships during motivational treatment sessions in Probation Service. Sessions (98) were videotaped in 12 probation service offices in Finland in 2007 to 2009. By using semiotic framework, this qualitative study examines client's change talk utterance about friendships as a symbolic sign. The findings indicate that the friendships play an important role in the substance-abusing clients' motivation to change and in their treatment outcome. The study suggests that the personal meanings of clients' utterances in motivational treatment sessions could be seen as potential predictors of their future behavior.

  17. Supporting the need for an integrated system of care for youth with co-occurring traumatic stress and substance abuse problems.

    PubMed

    Suarez, Liza M; Belcher, Harolyn M E; Briggs, Ernestine C; Titus, Janet C

    2012-06-01

    Adolescents are at high risk for violence exposure and initiation of drug use. Co-occurring substance use and trauma exposure are associated with increased risk of mental health disorders, school underachievement, and involvement with multiple systems of care. Coordination and integration of systems of care are of utmost importance for these vulnerable youth. This study delineates the negative sequelae and increased service utilization patterns of adolescents with a history of trauma, substance abuse, and co-occurring trauma and substance abuse to support the need for integrated mental health and substance abuse services for youth. Data from two national sources, the National Child Traumatic Stress Network and Center for Substance Abuse Treatment demonstrate the increased clinical severity (measured by reports of emotional and behavioral problems), dysfunction, and service utilization patterns for youth with co-occurring trauma exposure and substance abuse. We conclude with recommendations for an integrated system of care that includes trauma-informed mental health treatment and substance abuse services aimed at reducing the morbidity and relapse probability of this high-risk group.

  18. Spanish language proficiency among providers and Latino clients' engagement in substance abuse treatment.

    PubMed

    Guerrero, Erick G; Khachikian, Tenie; Kim, Tina; Kong, Yinfei; Vega, William A

    2013-12-01

    Quality of care, such as provision of services in Spanish, is a common factor believed to improve treatment engagement among Spanish-speaking Latinos in health care. However, there is little evidence that Spanish language proficiency among providers increases treatment access and retention in publicly funded substance abuse treatment. We analyzed client and program data collected in 2010-2011 from publicly funded treatment programs in Los Angeles County, California. An analytic sample of 1903 Latino clients nested within 40 treatment programs located in minority communities was analyzed using multilevel negative binomial regressions on days to initiate and spent in treatment. As hypothesized, Spanish language proficiency was negatively associated with client wait time and positively associated with retention in treatment, after controlling for individual and program characteristics. The path analysis models showed that Spanish language proficiency played a mediating role between professional accreditation and client wait time and retention. These preliminary findings provide an evidentiary base for the role of providers' Spanish language proficiency and Latino engagement in treatment for a population at high risk of treatment dropout. Implications related to health care reform legislation, which seeks to enhance linguistically competent care, are discussed. © 2013.

  19. Oxford House: Deaf-Affirmative Support for Substance Abuse Recovery

    ERIC Educational Resources Information Center

    Alvarez, Josefina; Adebanjo, Aderonke M.; Davidson, Michelle K.; Jason, Leonard A.; Davis, Margaret I.

    2006-01-01

    Deaf individuals seeking substance abuse recovery are less likely to have access to treatment and aftercare services because of a lack of culturally and linguistically specific programs and insufficient information about existing services. Previous research indicates that Oxford House, a network of resident-run recovery homes, serves a diverse…

  20. Service providers' reactions to intimate partner violence as a function of victim sexual orientation and type of abuse.

    PubMed

    Basow, Susan A; Thompson, Janelle

    2012-05-01

    In this online vignette study, a national sample of domestic violence shelter service providers (N = 282) completed a 10-item questionnaire about a woman experiencing intimate partner violence (IPV). Scenarios varied in terms of couple sexual orientation (heterosexual or lesbian) and type of abuse (physical or nonphysical). Results indicate that although participants did not overtly discriminate against a woman in a lesbian relationship, they were less likely to perceive her as a victim, and their acceptance of a lesbian as a client was more dependent on their comfort with her than was the case for a woman in a heterosexual relationship. Type of abuse, as expected, had a main effect on many questions, with physical abuse taken more seriously than nonphysical abuse. Scores on the Attitudes Toward Lesbians subscale (Herek) were unrelated to responses. Implications for service providers are discussed.

  1. Adverse events in an integrated trauma-focused intervention for women in community substance abuse treatment.

    PubMed

    Killeen, Therese; Hien, Denise; Campbell, Aimee; Brown, Chanda; Hansen, Cheri; Jiang, Huiping; Kristman-Valente, Allison; Neuenfeldt, Christine; Rocz-de la Luz, Nicci; Sampson, Royce; Suarez-Morales, Lourdes; Wells, Elizabeth; Brigham, Greg; Nunes, Edward

    2008-10-01

    A substantial number of women who enter substance abuse treatment have a history of trauma and meet criteria for posttraumatic stress disorder (PTSD). Fear regarding the extent to which PTSD treatment can evoke negative consequences remains a research question. This study explored adverse events related to the implementation of an integrated treatment for women with trauma and substance use disorder (Seeking Safety) compared with a nontrauma-focused intervention (Women's Health Education). Three hundred fifty-three women enrolled in community substance abuse treatment were randomized to 1 of the 2 study groups and monitored weekly for adverse events. There were no differences between the two intervention groups in the number of women reporting study-related adverse events (28 [9.6%] for the Seeking Safety group and 21[7.2%] for the Women's Health Education group). Implementing PTSD treatment in substance abuse treatment programs appears to be safe, with minimal impact on intervention-related adverse psychiatric and substance abuse symptoms. More research is needed on the efficacy of such interventions to improve outcomes of PTSD and substance use.

  2. Differences by Gender in Predictors of Motivation Among Substance Abuse Treatment Participants.

    PubMed

    Taylor, Liana R; Caudy, Michael; Blasko, Brandy L; Taxman, Faye S

    2017-03-21

    Substance-involved females tend to have different clinical profiles than men (Adams, Leukefeld, & Peden, 2008 ); yet they do not appear to have worse treatment outcomes (Green, 2006 ; Hser, Huang, Teruya, & Anglin, 2003 ). As motivation for treatment is considered essential in the substance abuse treatment context (Cahill, Adinoff, Hosig, Muller, & Pulliam, 2003 ; Longshore & Teruya, 2006 ), it is possible that higher motivation among females could potentially counteract the negative effect of more risk factors. The purpose of the current study was to examine if females differ from males in their motivation for treatment using the Texas Christian University Motivation Form scales: desire for help, problem recognition, treatment readiness, pressure for treatment, and treatment needs; and whether factors predicting motivation for treatment differed between male and female participants of substance abuse treatment. The sample included 2,989 substance-involved males and 982 substance-involved females who were referred to substance abuse treatment through a case management program. Linear regression models predicting each motivation scale were analyzed, followed by gender-specific models. Overall, the results did not demonstrate a significant gender difference in the motivation scales. However, among male participants, the findings did show that Hispanic significantly predicted desire for help and alcohol as a primary drug of choice predicted treatment readiness. Findings suggest that motivation for treatment may be a gender-neutral construct, and that there is a need to better understand sociodemographic predictors of motivation.

  3. Substance abuse treatment cost offsets vary with gender, age, and abstinence likelihood.

    PubMed

    Zywiak, W H; Hoffmann, N G; Stout, R L; Hagberg, S; Floyd, A S; DeHart, S S

    1999-01-01

    The cost-offset effect has been promoted as a way for substance abuse treatment to pay for itself by generating reductions in health care utilization in other areas. Clients (n = 5,434) that were abstinent for 24 months following substance abuse treatment had lower posttreatment utilization than clients that had relapsed. An examination of cost offsets revealed a complex interplay between gender, age, and type of utilization (medical versus psychiatric). Cost offsets were especially pronounced for women over 40 years old.

  4. Social Support: A Mixed Blessing for Women in Substance Abuse Treatment

    PubMed Central

    Tracy, Elizabeth M.; Munson, Michelle R.; Peterson, Lance T.; Floersch, Jerry E.

    2010-01-01

    Using a personal social network framework, this qualitative study sought to understand how women in substance abuse treatment describe their network members' supportive and unsupportive behaviors related to recovery. Eighty-six women were interviewed from residential and outpatient substance abuse treatment programs. Positive and negative aspects of women's social networks were assessed via open-ended questions. Analysis was guided by grounded theory techniques using three coders. The findings extend classic social support concepts such as emotional, tangible, and informational support. Practice implications are presented in light of the potential roles network members may play in substance use and recovery. PMID:20953326

  5. Perceptions of a Prison-Based Substance Abuse Treatment Program among Some Staff and Participants

    ERIC Educational Resources Information Center

    Goodrum, Sarah; Staton, Michele; Leukefeld, Carl; Webster, J. Matthew; Purvis, Richard T.

    2003-01-01

    Almost 90% of all State and Federal prisons in the U.S. offer some form of substance abuse counseling, and one in eight prisoners have participated in a substance abuse treatment program while incarcerated. Evidence indicates that these programs can be successful in stopping prisoners' substance abuse. While some data are available about the…

  6. Use of evidence-based treatments in substance abuse treatment programs serving American Indian and Alaska Native communities.

    PubMed

    Novins, Douglas K; Croy, Calvin D; Moore, Laurie A; Rieckmann, Traci

    2016-04-01

    Research and health surveillance activities continue to document the substantial disparities in the impacts of substance abuse on the health of American Indian and Alaska Native (AI/AN) people. While Evidence-Based Treatments (EBTs) hold substantial promise for improving treatment for AI/ANs with substance use problems (as they do for non-AI/ANs), anecdotal reports suggest that their use is limited. In this study, we examine the awareness of, attitudes toward, and use of EBTs in substance abuse treatment programs serving AI/AN communities. Data are drawn from the first national survey of tribal substance abuse treatment programs. Clinicians or clinical administrators from 192 programs completed the survey. Participants were queried about their awareness of, attitudes toward, and use of 9 psychosocial and 3 medication EBTs. Cognitive Behavioral Therapy (82.2%), Motivational Interviewing (68.6%), and Relapse Prevention Therapy (66.8%) were the most commonly implemented psychosocial EBTs; medications for psychiatric comorbidity was the most commonly implemented medication treatment (43.2%). Greater EBT knowledge and use were associated with both program (e.g., funding) and staff (e.g., educational attainment) characteristics. Only two of the commonly implemented psychosocial EBTs (Motivational Interviewing and Relapse Prevention Therapy) were endorsed as culturally appropriate by a majority of programs that had implemented them (55.9% and 58.1%, respectively). EBT knowledge and use is higher in substance abuse treatment programs serving AI/AN communities than has been previously estimated. However, many users of these EBTs continue to have concerns about their cultural appropriateness, which likely limits their further dissemination. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. 45 CFR 96.129 - Revolving funds for establishment of homes in which recovering substance abusers may reside.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... which recovering substance abusers may reside. 96.129 Section 96.129 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.129 Revolving funds for establishment of homes in which recovering substance abusers may...

  8. 45 CFR 96.129 - Revolving funds for establishment of homes in which recovering substance abusers may reside.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... which recovering substance abusers may reside. 96.129 Section 96.129 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.129 Revolving funds for establishment of homes in which recovering substance abusers may...

  9. 45 CFR 96.129 - Revolving funds for establishment of homes in which recovering substance abusers may reside.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... which recovering substance abusers may reside. 96.129 Section 96.129 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.129 Revolving funds for establishment of homes in which recovering substance abusers may...

  10. 45 CFR 96.129 - Revolving funds for establishment of homes in which recovering substance abusers may reside.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... which recovering substance abusers may reside. 96.129 Section 96.129 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.129 Revolving funds for establishment of homes in which recovering substance abusers may...

  11. 45 CFR 96.129 - Revolving funds for establishment of homes in which recovering substance abusers may reside.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... which recovering substance abusers may reside. 96.129 Section 96.129 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.129 Revolving funds for establishment of homes in which recovering substance abusers may...

  12. Brain Potentials Measured During a Go/NoGo Task Predict Completion of Substance Abuse Treatment

    PubMed Central

    Steele, Vaughn R.; Fink, Brandi C.; Maurer, J. Michael; Arbabshirani, Mohammad R.; Wilber, Charles H.; Jaffe, Adam J.; Sidz, Anna; Pearlson, Godfrey D.; Calhoun, Vince D.; Clark, Vincent P.; Kiehl, Kent A.

    2014-01-01

    Background US nationwide estimates indicate 50–80% of prisoners have a history of substance abuse or dependence. Tailoring substance abuse treatment to specific needs of incarcerated individuals could improve effectiveness of treating substance dependence and preventing drug abuse relapse. The purpose of the present study was to test the hypothesis that pre-treatment neural measures of a Go/NoGo task would predict which individuals would or would not complete a 12-week cognitive behavioral substance abuse treatment program. Methods Adult incarcerated participants (N=89; Females=55) who volunteered for substance abuse treatment performed a response inhibition (Go/NoGo) task while event-related potentials (ERP) were recorded. Stimulus- and response-locked ERPs were compared between individuals who completed (N=68; Females=45) and discontinued (N=21; Females=10) treatment. Results As predicted, stimulus-locked P2, response-locked error-related negativity (ERN/Ne), and response-locked error positivity (Pe), measured with windowed time-domain and principal component analysis, differed between groups. Using logistic regression and support-vector machine (i.e., pattern classifiers) models, P2 and Pe predicted treatment completion above and beyond other measures (i.e., N2, P300, ERN/Ne, age, sex, IQ, impulsivity, and self-reported depression, anxiety, motivation for change, and years of drug abuse). Conclusions We conclude individuals who discontinue treatment exhibited deficiencies in sensory gating, as indexed by smaller P2, error-monitoring, as indexed by smaller ERN/Ne, and adjusting response strategy post-error, as indexed by larger Pe. However, the combination of P2 and Pe reliably predicted 83.33% of individuals who discontinued treatment. These results may help in the development of individualized therapies, which could lead to more favorable, long-term outcomes. PMID:24238783

  13. Progress and Compliance in Alcohol Abuse Treatment*

    PubMed Central

    Lien, Hsien-Ming; Lu, Mingshan; Ma, Ching-To Albert; McGuire, Thomas G.

    2009-01-01

    Improving patient compliance with physicians’ treatment or prescription recommendations is an important goal in medical practice. We examine the relationship between treatment progress and patient compliance. We hypothesize that patients balance expected benefits and costs during a treatment episode when deciding on compliance; a patient is more likely to comply if doing so results in an expected gain in health benefit. We use a unique data set of outpatient alcohol abuse treatment to identify a relationship between treatment progress and compliance. Treatment progress is measured by the clinician’s comments after each attended visit. Compliance is measured by a client attending a scheduled appointment, and continuing with treatment. We find that a patient who is making progress is less likely to drop out of treatment. We find no evidence that treatment progress raises the likelihood of a patient attending the next scheduled visit. Our results are robust to unobserved patient heterogeneity. PMID:20031241

  14. Gender differences in treatment retention among individuals with co-occurring substance abuse and mental health disorders.

    PubMed

    Choi, Sam; Adams, Susie M; Morse, Siobhan A; MacMaster, Sam

    2015-04-01

    A significant number of individuals with co-occurring substance abuse and mental health disorders do not engage, stay, and/or complete residential treatment. Although prior research indicates that women and men differ in their substance abuse treatment experiences, our knowledge of individuals with co-occurring substance abuse and mental health disorders as well as those attending private residential treatment is limited. The purpose of this study is to examine gender differences on treatment retention for individuals with co-occurring substance abuse and mental health disorders who participate in private residential treatment. The participants were 1,317 individuals (539 women and 778 men) with co-occurring substance abuse and mental health disorders receiving treatment at three private residential treatment centers. Bivariate analyses, life tables, and Cox regression (survival analyses) were utilized to examine gender effects on treatment retention, and identify factors that predict treatment retention for men and women. This study found that women with co-occurring disorders were more likely to stay longer in treatment when compared to men. The findings indicate the factors influencing length of stay differ for each gender, and include: type of substance used prior to admission; Addiction Severity Index Composite scores; and Readiness to Change/URICA scores. Age at admission was a factor for men only. CONCLUSIONS/IMPORTANCE: These findings can be incorporated to develop and initiate program interventions to minimize early attrition and increase overall retention in private residential treatment for individuals with co-occurring substance use and mental health disorders.

  15. 78 FR 21616 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-11

    ... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Alcoholism Initial Review Group Clinical, Treatment and Health Services Research Review... on Alcohol Abuse & Alcoholism, National Institutes of Health, 5635 Fishers Lane, Rm. 2019, Rockville...

  16. Benefits and costs of substance abuse treatment programs for state prison inmates: results from a lifetime simulation model.

    PubMed

    Zarkin, Gary A; Cowell, Alexander J; Hicks, Katherine A; Mills, Michael J; Belenko, Steven; Dunlap, Laura J; Houser, Kimberly A; Keyes, Vince

    2012-06-01

    Reflecting drug use patterns and criminal justice policies throughout the 1990s and 2000s, prisons hold a disproportionate number of society's drug abusers. Approximately 50% of state prisoners meet the criteria for a diagnosis of drug abuse or dependence, but only 10% receive medically based drug treatment. Because of the link between substance abuse and crime, treating substance abusing and dependent state prisoners while incarcerated has the potential to yield substantial economic benefits. In this paper, we simulate the lifetime costs and benefits of improving prison-based substance abuse treatment and post-release aftercare for a cohort of state prisoners. Our model captures the dynamics of substance abuse as a chronic disease; estimates the benefits of substance abuse treatment over individuals' lifetimes; and tracks the costs of crime and criminal justice costs related to policing, adjudication, and incarceration. We estimate net societal benefits and cost savings to the criminal justice system of the current treatment system and five policy scenarios. We find that four of the five policy scenarios provide positive net societal benefits and cost savings to the criminal justice system relative to the current treatment system. Our study demonstrates the societal gains to improving the drug treatment system for state prisoners. Copyright © 2011 John Wiley & Sons, Ltd.

  17. BENEFITS AND COSTS OF SUBSTANCE ABUSE TREATMENT PROGRAMS FOR STATE PRISON INMATES: RESULTS FROM A LIFETIME SIMULATION MODEL

    PubMed Central

    ZARKIN, GARY A.; COWELL, ALEXANDER J.; HICKS, KATHERINE A.; MILLS, MICHAEL J.; BELENKO, STEVEN; DUNLAP, LAURA J.; HOUSER, KIMBERLY A.; KEYES, VINCE

    2011-01-01

    SUMMARY Reflecting drug use patterns and criminal justice policies throughout the 1990s and 2000s, prisons hold a disproportionate number of society’s drug abusers. Approximately 50% of state prisoners meet the criteria for a diagnosis of drug abuse or dependence, but only 10% receive medically based drug treatment. Because of the link between substance abuse and crime, treating substance abusing and dependent state prisoners while incarcerated has the potential to yield substantial economic benefits. In this paper, we simulate the lifetime costs and benefits of improving prison-based substance abuse treatment and post-release aftercare for a cohort of state prisoners. Our model captures the dynamics of substance abuse as a chronic disease; estimates the benefits of substance abuse treatment over individuals’ lifetimes; and tracks the costs of crime and criminal justice costs related to policing, adjudication, and incarceration. We estimate net societal benefits and cost savings to the criminal justice system of the current treatment system and five policy scenarios. We find that four of the five policy scenarios provide positive net societal benefits and cost savings to the criminal justice system relative to the current treatment system. Our study demonstrates the societal gains to improving the drug treatment system for state prisoners. PMID:21506193

  18. Examining the nexus between domestic violence and animal abuse in a national sample of service providers.

    PubMed

    Krienert, Jessie L; Walsh, Jeffrey A; Matthews, Kevin; McConkey, Kelly

    2012-01-01

    Companion animals play a complex role in families impacted by violence. An outlet of emotional support for victims, the family pet often becomes a target for physical abuse. Results from a comprehensive e-survey of domestic violence shelters nationwide (N = 767) highlight both improvements and existing gaps in service provision for domestic violence victims and their pets. Quantitative and qualitative data noted frequently encountered obstacles to successful shelter seeking by abuse victims with companion animals including a lack of availability, funding, space, and reliable programming. Although results indicate an overall improvement in organizational awareness, fewer than half of surveyed shelters include intake questions about animals. Continued awareness and an expansion of services is needed to create viable safety planning strategies and reliable alternatives for women with companion animals in order to improve the likelihood that abuse victims will seek escape and refuge for themselves, their children, and their pets.

  19. Substance Abuse Treatment and Domestic Violence. Treatment Improvement Protocol (TIP) Series 25.

    ERIC Educational Resources Information Center

    Cook, Paddy; Gartner, Constance Grant; Markl, Lise; Henderson, Randi; Brooks, Margaret K.; Wesson, Donald; Dogoloff, Mary Lou; Vitzthum, Virginia; Hayes, Elizabeth

    The major goal of this TIP, on the best practice guidelines to improve the treatment of substance abuse, is to provide clinicians, educators, and paraprofessionals with the latest findings concerning domestic violence. The information is intended to educate providers about the needs and behaviors of batterers and survivors, and how to tailor…

  20. Encopresis and Sexual Abuse in a Sample of Boys in Residential Treatment.

    ERIC Educational Resources Information Center

    Morrow, Jan; And Others

    1997-01-01

    This study of 23 boys (ages 6 to 14) in a residential psychiatric treatment program found nine of the boys were encopretic (27 times the incidence of encopresis in the general population of boys 10-12). Seven of the nine boys had histories of sexual abuse by males, suggesting that encopresis may be a marker of sexual abuse. (DB)

  1. Substance Abuse among the Deaf Population: An Overview of Current Strategies, Programs and Barriers to Recovery.

    ERIC Educational Resources Information Center

    Lane, Katherine E.

    1989-01-01

    The paper analyzes the problem of alcohol and drug abuse among the deaf population focusing on: precipitating factors leading to substance abuse; barriers to recovery; and descriptions of several treatment centers, programs, and services. (JDD)

  2. Predicting substance-abuse treatment providers' communication with clients about medication assisted treatment: a test of the theories of reasoned action and planned behavior.

    PubMed

    Roberto, Anthony J; Shafer, Michael S; Marmo, Jennifer

    2014-01-01

    The purpose of this investigation is to determine if the theory of reasoned action (TRA) and theory of planned behavior (TPB) can retrospectively predict whether substance-abuse treatment providers encourage their clients to use medicated-assisted treatment (MAT) as part of their treatment plan. Two-hundred and ten substance-abuse treatment providers completed a survey measuring attitudes, subjective norms, perceived behavioral control, intentions, and behavior. Results indicate that substance-abuse treatment providers have very positive attitudes, neutral subjective norms, somewhat positive perceived behavioral control, somewhat positive intentions toward recommending MAT as part of their clients' treatment plan, and were somewhat likely to engage in the actual behavior. Further, the data fit both the TRA and TPB, but with the TPB model having better fit and predictive power for this target audience and behavior. The theoretical and practical implications for the developing messages for substance-abuse treatment providers and other health-care professionals who provide treatment to patients with substance use disorders are discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Brain potentials measured during a Go/NoGo task predict completion of substance abuse treatment.

    PubMed

    Steele, Vaughn R; Fink, Brandi C; Maurer, J Michael; Arbabshirani, Mohammad R; Wilber, Charles H; Jaffe, Adam J; Sidz, Anna; Pearlson, Godfrey D; Calhoun, Vince D; Clark, Vincent P; Kiehl, Kent A

    2014-07-01

    U.S. nationwide estimates indicate that 50% to 80% of prisoners have a history of substance abuse or dependence. Tailoring substance abuse treatment to specific needs of incarcerated individuals could improve effectiveness of treating substance dependence and preventing drug abuse relapse. We tested whether pretreatment neural measures of a response inhibition (Go/NoGo) task would predict which individuals would or would not complete a 12-week cognitive behavioral substance abuse treatment program. Adult incarcerated participants (n = 89; women n = 55) who volunteered for substance abuse treatment performed a Go/NoGo task while event-related potentials (ERPs) were recorded. Stimulus- and response-locked ERPs were compared between participants who completed (n = 68; women = 45) and discontinued (n = 21; women = 10) treatment. As predicted, stimulus-locked P2, response-locked error-related negativity (ERN/Ne), and response-locked error positivity (Pe), measured with windowed time-domain and principal component analysis, differed between groups. Using logistic regression and support-vector machine (i.e., pattern classifiers) models, P2 and Pe predicted treatment completion above and beyond other measures (i.e., N2, P300, ERN/Ne, age, sex, IQ, impulsivity, depression, anxiety, motivation for change, and years of drug abuse). Participants who discontinued treatment exhibited deficiencies in sensory gating, as indexed by smaller P2; error-monitoring, as indexed by smaller ERN/Ne; and adjusting response strategy posterror, as indexed by larger Pe. The combination of P2 and Pe reliably predicted 83.33% of individuals who discontinued treatment. These results may help in the development of individualized therapies, which could lead to more favorable, long-term outcomes. © 2013 Society of Biological Psychiatry Published by Society of Biological Psychiatry All rights reserved.

  4. Client Experiences with Shelter and Community Care Services in the Netherlands: Quality of Services for Homeless People, Homeless Youth, and Abused Women

    ERIC Educational Resources Information Center

    Asmoredjo, Jolanda; Beijersbergen, Mariëlle D.; Wolf, Judith R. L. M.

    2017-01-01

    Purpose: To gain insight into client experiences with shelter or community care services for homeless people, homeless youth, and abused women and identify priority improvement areas. Methods: Seven hundred and forty-four clients rated their experiences and 116 clients rated the services' importance. Results: Clients had most positive experiences…

  5. Effectiveness of Different Models of Case Management for Substance-Abusing Populations

    PubMed Central

    Vanderplasschen, Wouter; Wolf, Judith; Rapp, Richard C.; Broekaert, Eric

    2007-01-01

    Case management has been implemented in substance abuse treatment to improve (cost-) effectiveness, but controversy exists about its potential to realize this objective. A systematic and comprehensive review of peer-reviewed articles (n = 48) published between 1993 and 2003 is presented, focusing on the effects of different models of case management among various substance-abusing populations. Results show that several studies have reported positive effects, but only some randomized and controlled trials have demonstrated the effectiveness of case management compared with other interventions. Longitudinal effects of this intervention remain unclear. Although no compelling evidence was found for the effectiveness of case management, some evidence is available about the (differential) effectiveness of intensive case management and assertive community treatment for homeless and dually-diagnosed substance abusers. Strengths-based and generalist case management have proven to be relatively effective for substance abusers in general. Most positive effects concern reduced use of inpatient services and increased utilization of community-based services, prolonged treatment retention, improved quality of life, and high client satisfaction. Outcomes concerning drug use and psychosocial functioning are less consistent, but seem to be mediated by retention in treatment and case management. Further research is required to learn more about the extent of the effects of this intervention, how long these are sustained and what specific elements cause particular outcomes. PMID:17523588

  6. Experiences Associated with Intervening with Homeless, Substance-Abusing Mothers: The Importance of Success

    ERIC Educational Resources Information Center

    Slesnick, Natasha; Glassman, Michael; Katafiasz, Heather; Collins, Jennifer C.

    2012-01-01

    This article documents the experiences of providing housing and supportive services, or ecologically based treatment, to shelter-recruited, substance-abusing homeless women with young children in their care. Among clients, observed experiences related to housing, substance abuse, and health and mental health care are discussed. Among therapists,…

  7. Treatment barriers identified by substance abusers assessed at a centralized intake unit.

    PubMed

    Rapp, Richard C; Xu, Jiangmin; Carr, Carey A; Lane, D Tim; Wang, Jichuan; Carlson, Robert

    2006-04-01

    The 59-item Barriers to Treatment Inventory (BTI) was administered to 312 substance abusers at a centralized intake unit following assessment but before treatment entry to assess their views on barriers to treatment. Factor analysis identified 25 items in 7 well-defined latent constructs: Absence of Problem, Negative Social Support, Fear of Treatment, Privacy Concerns, Time Conflict, Poor Treatment Availability, and Admission Difficulty. The factorial structure of the barriers is consistent with the findings of other studies that asked substance abusers about barriers to treatment and is conceptually compatible with Andersen's model of health care utilization. Factors were moderately to highly correlated, suggesting that they interact with one another. Selected characteristics were generally not predictive of barrier factors. Overall, results indicate that the BTI has good content validity and is a reliable instrument for assessing barriers to drug treatment. The potential utility of the BTI in assessment settings is discussed.

  8. Exploring the nature of the relationship between child sexual abuse and substance use among women.

    PubMed

    Jarvis, T J; Copeland, J; Walton, L

    1998-06-01

    This study investigated whether child abuse (CSA) was associated with earlier substance use and greater severity of substance dependence and what aspects of CSA might predict substance abuse. The study compared (a) drug and alcohol treatment clients with and without a history of CSA and (b) CSA survivors outside drug and alcohol treatment who did or did not have current substance abuse. Semi-structured interviews took place at participants' homes, treatment agencies or the research centre. Volunteer participants included 100 women recruited from drug and alcohol treatment programmes and 80 CSA survivors recruited through CSA counseling services and medial advertising. The results focus on data from the Opiate Treatment Index, Severity of Alcohol Dependence Questionnaire, Substance Dependence Scale, Self-Esteem Inventory and self-reported histories of CSA. There were no differences between CSA survivors and other drug and alcohol treatment clients in their severity of dependence. Women with a history of CSA more frequently identified stimulants as their main problem drug and reported an earlier age of first intoxication and earlier use of inhalants. Among abused CSA survivors outside drug and alcohol treatment, women with current substance abuse had typically been abused during adolescence by someone outside the family, whereas those without current substance abuse were typically abused by family members before adolescence. The results suggest that adolescence is a crucial time for the influence of CSA experiences on substance abuse.

  9. A methodological pilot: parenting among women in substance abuse treatment.

    PubMed

    Lewin, Linda; Farkas, Kathleen; Niazi, Maryam

    2014-01-01

    Mothers who abuse substances are likely to have insecure emotional attachment with their children, placing their children at risk for social-emotional and psychiatric conditions. Sobriety does not inevitably improve parenting. We tested recruitment methods, audiovisual (AV) recording procedures, the protocol for identifying child abuse risk, the coding of mother-child interactions, and retention of the sample for repeated measures as the first phase in examining mother-child relational quality of women in substance abuse treatment. This innovative study involved AV recordings to capture the in-vivo mother-child interactional behaviors that were later coded and analyzed for mean scores on the 64-item Parent-Child Relational Quality Assessment. Repeated measurement was planned during treatment and two months after discharge from treatment. The pilot involved a small sample (n = 11) of mother-child (<6 years) dyads. Highest and lowest ratings of interaction behaviors were identified. Mothers showed less enthusiasm and creativity but matched their child's emotional state. The children showed appropriate motor skill items and attachment behaviors. The dyad coding showed less mutual enjoyment between the mother and child. Eight of the participants could not be located for the second measurement despite multiple contact methods. AV recordings capture rich, descriptive information that can be coded for interactional quality analysis. Repeated measurement with this cohort was not feasible, thus needing to assess for additional/more frequent contacts to maintain the sample.

  10. Protective Services for Abused and Neglected Children and Their Families. A Guide for State and Local Department of Public Social Services on the Delivery of Protective Services.

    ERIC Educational Resources Information Center

    Community Research Applications, Inc., New York, NY.

    Provided is a guide to assist state and local agencies in improving the administration and management of services to abused and neglected children and their families. Protective services at the state level are covered in the first section, including such topics as organization; initiating and reacting to proposed state legislation; developing…

  11. 77 FR 52337 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-29

    ... Alcohol Abuse and Alcoholism; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory... and Alcoholism Initial Review Group Clinical, Treatment and Health Services Research Review... Abuse & Alcoholism, National Institutes of Health, 5635 Fishers Lane, Rm. 2019, Rockville, MD 20852, 301...

  12. Brain potentials predict substance abuse treatment completion in a prison sample.

    PubMed

    Fink, Brandi C; Steele, Vaughn R; Maurer, Michael J; Fede, Samantha J; Calhoun, Vince D; Kiehl, Kent A

    2016-08-01

    National estimates suggest that up to 80% of prison inmates meet diagnostic criteria for a substance use disorder. Because more substance abuse treatment while incarcerated is associated with better post-release outcomes, including a reduced risk of accidental overdose death, the stakes are high in developing novel predictors of substance abuse treatment completion in inmate populations. Using electroencephalography (EEG), this study investigated stimulus-locked ERP components elicited by distractor stimuli in three tasks (VO-Distinct, VO-Repeated, Go/NoGo) as a predictor of treatment discontinuation in a sample of male and female prison inmates. We predicted that those who discontinued treatment early would exhibit a less positive P3a amplitude elicited by distractor stimuli. Our predictions regarding ERP components were partially supported. Those who discontinued treatment early exhibited a less positive P3a amplitude and a less positive PC4 in the VO-D task. In the VO-R task, however, those who discontinued treatment early exhibited a more negative N200 amplitude rather than the hypothesized less positive P3a amplitude. The discontinuation group also displayed less positive PC4 amplitude. Surprisingly, there were no time-domain or principle component differences among the groups in the Go/NoGo task. Support Vector Machine (SVM) models of the three tasks accurately classified individuals who discontinued treatment with the best model accurately classifying 75% of inmates. PCA techniques were more sensitive in differentiating groups than the classic time-domain windowed approach. Our pattern of findings are consistent with the context-updating theory of P300 and may help identify subtypes of ultrahigh-risk substance abusers who need specialized treatment programs.

  13. Implementing a Statewide Screening, Brief Intervention, and Referral to Treatment (SBIRT) Service in Rural Health Settings: New Mexico SBIRT

    ERIC Educational Resources Information Center

    Gonzales, Arturo; Westerberg, Verner S.; Peterson, Thomas R.; Moseley, Ana; Gryczynski, Jan; Mitchell, Shannon Gwin; Buff, Gary; Schwartz, Robert P.

    2012-01-01

    This is a report on the New Mexico Screening, Brief Intervention, and Referral to Treatment (SBIRT) project conducted over 5 years as part of a national initiative launched by the Substance Abuse and Mental Health Services Administration with the aim of increasing integration of substance use services and medical care. Throughout the state, 53,238…

  14. A gender-specific approach to improving substance abuse treatment for women: The Healthy Steps to Freedom program.

    PubMed

    Lindsay, Anne R; Warren, Cortney S; Velasquez, Sara C; Lu, Minggen

    2012-07-01

    Given that women increasingly report using drugs to lose weight, substance abuse treatment programs must include body image, weight, eating pathology, and health knowledge as core intervention targets. This study tested the efficacy of a supplemental health and body image curriculum designed for women in substance abuse treatment who report weight concerns called Healthy Steps to Freedom (HSF). Data from 124 adult women recruited from substance abuse treatment facilities in southern Nevada completed measures of drug use, body dissatisfaction, eating pathology, thin-ideal internalization, and health knowledge/behaviors before and after participation in the 12-week HSF program. Results revealed that thin-ideal internalization, body dissatisfaction, and eating disorder symptoms significantly decreased after HSF program participation, whereas health-related behaviors (e.g., increased healthy food consumption) and knowledge (e.g., understanding of basic nutrition, exercise) increased. These results suggest that the inclusion of the HSF program in substance abuse treatment improves weight-related issues in substance-abusing women. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Indigenous traditional knowledge and substance abuse treatment outcomes: the problem of efficacy evaluation.

    PubMed

    Gone, Joseph P

    2012-09-01

    In the field of substance abuse treatment, American Indian and Alaska Native (AI/AN) communities have routinely incorporated ceremonial practices as one important component in the promotion of recovery and healing. The beneficial effects of such practices are frequently described as plainly apparent by community-based advocates, providers, and professionals alike. In the present era of evidence-based substance abuse intervention, however, indigenous integration of such practices raises questions pertaining to the systematic evaluation of treatment efficacy. The focus of this article is outcome evaluation. Although intervention outcome researchers recognize the randomized controlled trial as the "gold standard" against which claims of treatment efficacy are measured, AI/AN efficacy assertions grounded in indigenous traditional knowledge (ITK) reflect different concerns that have emerged in non-Western historical contexts. The interface between scientific and indigenous "ways of knowing" is explored here relative to efficacy claims about substance abuse treatment. Distinguishing features of both scientific knowing and ITK are summarized and compared. ITK has been described as personal and experiential, reflecting the primacy of autonomous individual knowing. In contrast, intervention scientists are skeptical of personal inference as a basis for efficacy evaluation. The evident divergence between these epistemic paradigms can result in potentially contradictory claims. Proper appraisal of the status and relevance of ITK for determining treatment efficacy requires further exploration of these marginalized approaches to knowledge. Intervention scientists who work in AI/AN communities should remain open to the legitimacy and role of ITKs in investigations of substance abuse treatment.

  16. 42 CFR Appendix to Part 54a - Model Notice of Individuals Receiving Substance Abuse Services

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Model Notice of Individuals Receiving Substance Abuse Services Appendix to Part 54a Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... against you on the basis of religion, a religious belief, a refusal to hold a religious belief, or a...

  17. 42 CFR Appendix to Part 54a - Model Notice of Individuals Receiving Substance Abuse Services

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Model Notice of Individuals Receiving Substance Abuse Services Appendix to Part 54a Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... against you on the basis of religion, a religious belief, a refusal to hold a religious belief, or a...

  18. 42 CFR Appendix to Part 54a - Model Notice of Individuals Receiving Substance Abuse Services

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Model Notice of Individuals Receiving Substance Abuse Services Appendix to Part 54a Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... against you on the basis of religion, a religious belief, a refusal to hold a religious belief, or a...

  19. 42 CFR Appendix to Part 54a - Model Notice of Individuals Receiving Substance Abuse Services

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Model Notice of Individuals Receiving Substance Abuse Services Appendix to Part 54a Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... against you on the basis of religion, a religious belief, a refusal to hold a religious belief, or a...

  20. 42 CFR Appendix to Part 54a - Model Notice of Individuals Receiving Substance Abuse Services

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Model Notice of Individuals Receiving Substance Abuse Services Appendix to Part 54a Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... against you on the basis of religion, a religious belief, a refusal to hold a religious belief, or a...

  1. 38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... other community-based treatment facilities, when considered to be medically advantageous and cost... dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. 17... rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or abuse...

  2. Brain mu-opioid receptor binding predicts treatment outcome in cocaine-abusing outpatients

    PubMed Central

    Ghitza, Udi E.; Preston, Kenzie L.; Epstein, David H.; Kuwabara, Hiroto; Endres, Christopher J.; Bencherif, Badreddine; Boyd, Susan J.; Copersino, Marc L.; Frost, J. James; Gorelick, David A.

    2010-01-01

    Background Cocaine users not seeking treatment have increased regional brain mu-opioid receptor (mOR) binding that correlates with cocaine craving and tendency to relapse. In cocaine-abusing outpatients in treatment, the relationship of mOR binding and treatment outcome is unknown. Methods We determined whether regional brain mOR binding before treatment correlates with outcome and compared it to standard clinical predictors of outcome. Twenty-five individuals seeking outpatient treatment for cocaine abuse or dependence (DSM-IV) received up to 12 weeks of cognitive-behavioral therapy and cocaine-abstinence reinforcement whereby each cocaine-free urine was reinforced with vouchers redeemable for goods. Regional brain mOR binding was measured before treatment using positron emission tomography (PET) with [11C] carfentanil (a selective mOR agonist). Main outcome measures were: 1) overall percentage of urines positive for cocaine during first month of treatment, 2) longest duration (weeks) of abstinence from cocaine during treatment, all verified by urine toxicology. Results Elevated mOR binding in the medial frontal and middle frontal gyri before treatment correlated with greater cocaine use during treatment. Elevated mOR binding in the anterior cingulate, medial frontal, middle frontal, middle temporal, and sub-lobar insular gyri correlated with shorter duration of cocaine abstinence during treatment. Regional mOR binding contributed significant predictive power for treatment outcome beyond that of standard clinical variables such as baseline drug and alcohol use. Conclusions Elevated mOR binding in brain regions associated with reward sensitivity is a significant independent predictor of treatment outcome in cocaine-abusing outpatients, suggesting a key role for the brain endogenous opioid system in cocaine addiction. PMID:20579973

  3. Abuse and neglect of American Indian children: findings from a survey of federal providers.

    PubMed

    Piasecki, J M; Manson, S M; Biernoff, M P; Hiat, A B; Taylor, S S; Bechtold, D W

    1989-01-01

    Child abuse and neglect is of growing concern in many American Indian and Alaska Native communities. The present paper represents one attempt to add to the existing, albeit sparse, knowledge base concerning the abuse and neglect of American Indian children. It reports the results of a survey of federal human service providers in which the subject of child abuse and neglect in Indian communities figured prominently. The study took place at several locations in Arizona and New Mexico. Data were obtained using the key-informant method from 55 federal service providers who identified 1,155 children, from birth to 21 years for inclusion in the survey. Children were included if they were currently in mental health treatment, if they were in need of mental health treatment, or if they were known to have been abused or neglected. Particular emphasis was given in the data collection to abuse- and neglect-related factors such as living arrangements, familial disruption, psychiatric symptoms, substance abuse, and school adjustment. The patterns evident in this sample closely resemble those trends identified among abused and/or neglected children in the general population. Sixty-seven percent of the sample was described as neglected or abused. The presence of abuse and/or neglect was strongly related to severe levels of chaos in the family. Children who were described as both abused and neglected had more psychiatric symptoms, greater frequency of having run away or been expelled, and greater frequency of drug use.

  4. An Effective Web Presence for Substance Abuse Treatment Facilities.

    PubMed

    Link, Thomas W; Hefner, Jennifer L; Ford, Eric W; Huerta, Timothy R

    2016-01-01

    Website development for health care has only been prevalent in the last two and a half decades. The first websites were electronic versions of brochures providing hardly any interaction with the consumer or potential consumer. The percentage of consumers that use the internet during the decision-making process for health care providers continues to rise. As a result, the websites of health care providers are becoming more of a representation of the facility and creating an organizational image rather than a brochure-like informational page. The purpose of this study was to analyze substance abuse treatment center's websites in the State of California with the goal of informing the management of substance abuse centers regarding an effective and inexpensive means to closing the marketing gaps in the industry. This brief research report presents the results of employing an automated web-crawler to assess website quality along five dimensions: accessibility, content, marketing, technology, and usability score. The sample mean scores for all dimensions were between 4 and 6 on a 10-point scale. On average larger facilities had higher quality websites. The low mean scores on these dimensions indicate that that substance abuse centers have significant room for improvement of their website's. Efficiently spending marketing funds to increase the effectiveness of a treatment center's website can be a low cost way for even small facilities to increase market competitiveness.

  5. 75 FR 42451 - National Institute on Alcohol Abuse and Alcoholism; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-21

    ... Alcohol Abuse and Alcoholism; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Alcohol Abuse and Alcoholism Initial Review Group, Clinical Treatment and Health Services Research Review... Alcoholism, National Institutes of Health, 5635 Fishers Lane, Room 2019, Rockville, MD 20852, 301-443-4032...

  6. Substance Abuse Prevention, Assessment, and Treatment for Lesbian, Gay, Bisexual, and Transgender Youth.

    PubMed

    Aromin, Romulo Alcalde

    2016-12-01

    Knowing how to manage substance abuse in all youth is an important aspect of pediatric care, including providing clinically appropriate anticipatory guidance, monitoring, assessment, and treatment. Although most lesbian, gay, bisexual, and transgender (LGBT) youth do not abuse substances, as a group they experience unique challenges in self-identity development that put them at an increased risk for substance abuse. This article addresses prevention and management of substance use in LGBT youth relevant to pediatrics and allied professions as an aspect of their overall health care. It reviews basic information about substance abuse in youth and special considerations for LGBT youth. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Interventions to address parenting and parental substance abuse: conceptual and methodological considerations.

    PubMed

    Neger, Emily N; Prinz, Ronald J

    2015-07-01

    Parental substance abuse is a serious problem affecting the well-being of children and families. The co-occurrence of parental substance abuse and problematic parenting is recognized as a major public health concern. This review focuses on 21 outcome studies that tested dual treatment of substance abuse and parenting. A summary of theoretical conceptualizations of the connections between substance abuse and parenting provides a backdrop for the review. Outcomes of the dual treatment studies were generally positive with respect to reduction of parental substance use and improvement of parenting. Research in this area varied in methodological rigor and needs to overcome challenges regarding design issues, sampling frame, and complexities inherent in such a high-risk population. This area of work can be strengthened by randomized controlled trials, use of mixed-methods outcome measures, consideration of parent involvement with child protective services, involvement of significant others in treatment, provision of concrete supports for treatment attendance and facilitative public policies. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Interventions to Address Parenting and Parental Substance Abuse: Conceptual and Methodological Considerations

    PubMed Central

    Neger, Emily N.; Prinz, Ronald J.

    2015-01-01

    Parental substance abuse is a serious problem affecting the well-being of children and families. The co-occurrence of parental substance abuse and problematic parenting is recognized as a major public health concern. This review focuses on 21 outcome studies that tested dual treatment of substance abuse and parenting. A summary of theoretical conceptualizations of the connections between substance abuse and parenting provides a backdrop for the review. Outcomes of the dual treatment studies were generally positive with respect to reduction of parental substance use and improvement of parenting. Research in this area varied in methodological rigor and needs to overcome challenges regarding design issues, sampling frame, and complexities inherent in such a high-risk population. This area of work can be strengthened by randomized controlled trials, use of mixed-methods outcome measures, consideration of parent involvement with child protective services, involvement of significant others in treatment, provision of concrete supports for treatment attendance and facilitative public policies. PMID:25939033

  9. Abuse of Medications Employed for the Treatment of ADHD: Results From a Large-Scale Community Survey

    PubMed Central

    Bright, George M.

    2008-01-01

    Objective The objective is to assess abuse of prescription and illicit stimulants among individuals being treated for attention-deficit/hyperactivity disorder (ADHD). Methods A survey was distributed to patients enrolled in an ADHD treatment center. It included questions designed to gain information about demographics; ADHD treatment history; illicit drug use; and misuse of prescribed stimulant medications, including type of stimulant medication most frequently misused or abused, and how the stimulant was prepared and administered. Results A total of 545 subjects (89.2% with ADHD) were included in the survey. Results indicated that 14.3% of respondents abused prescription stimulants. Of these, 79.8% abused short-acting agents; 17.2% abused long-acting stimulants; 2.0% abused both short- and long-acting agents; and 1.0% abused other agents. The specific medications abused most often were mixed amphetamine salts (Adderall; 40.0%), mixed amphetamine salts extended release (Adderall XR; 14.2%), and methylphenidate (Ritalin; 15.0%), and the most common manner of stimulant abuse was crushing pills and snorting (75.0%). Survey results also showed that 39.1% of respondents used nonprescription stimulants, most often cocaine (62.2%), methamphetamine (4.8%), and both cocaine and amphetamine (31.1%). Choice of illicit drug was based on rapidity of high onset (43.5%), ease of acquisition (40.7%), ease of use (10.2%), and cost (5.5%). Conclusions The risks for abuse of prescription and illicit stimulants are elevated among individuals being treated in an ADHD clinic. Prescription agents used most often are those with pharmacologic and pharmacokinetic characteristics that provide a rapid high. This suggests that long-acting stimulant preparations that have been developed for the treatment of ADHD may have lower abuse potential than short-acting formulations. PMID:18596945

  10. Barriers to accessing substance abuse treatment in Mexico: national comparative analysis by migration status.

    PubMed

    Guerrero, Erick G; Villatoro, Jorge Ameth; Kong, Yinfei; Fleiz, Clara; Vega, William A; Strathdee, Steffanie A; Medina-Mora, Maria Elena

    2014-07-30

    We examined Mexican migrants' perceived barriers to entering substance abuse treatment and potential differences by gender. This study analyzed a subset of household data collected in Mexico in 2011 via the Encuesta Nacional de Adicciones (National Survey of Addictions). A sample of 1,143 individuals who reported using illicit drugs was analyzed using multivariate negative binomial models to determine direct and moderated relationships of gender, migrant status, and drug dependence with perceived barriers to accessing treatment. Significant findings included disparities in drug dependence by migrant status. Compared with non-migrant men, women who have traveled to the United States was associated with fewer (1.3) barriers to access treatment. Fewer barriers to access care were associated with individuals residing in other regions of the country, compared to those living in Mexico City. Drug dependence, gender, migration status and regional location are factors associated with access to needed treatment. Implications for health care policy to develop treatment services infrastructure and for future research are discussed in the context of ongoing drug policy reform in Mexico.

  11. Barriers to accessing substance abuse treatment in Mexico: national comparative analysis by migration status

    PubMed Central

    2014-01-01

    Background We examined Mexican migrants’ perceived barriers to entering substance abuse treatment and potential differences by gender. Methods This study analyzed a subset of household data collected in Mexico in 2011 via the Encuesta Nacional de Adicciones (National Survey of Addictions). A sample of 1,143 individuals who reported using illicit drugs was analyzed using multivariate negative binomial models to determine direct and moderated relationships of gender, migrant status, and drug dependence with perceived barriers to accessing treatment. Results Significant findings included disparities in drug dependence by migrant status. Compared with non-migrant men, women who have traveled to the United States was associated with fewer (1.3) barriers to access treatment. Fewer barriers to access care were associated with individuals residing in other regions of the country, compared to those living in Mexico City. Conclusions Drug dependence, gender, migration status and regional location are factors associated with access to needed treatment. Implications for health care policy to develop treatment services infrastructure and for future research are discussed in the context of ongoing drug policy reform in Mexico. PMID:25074067

  12. [Current situation on new psychoactive substances abuse among methadone maintenance treatment patients in China].

    PubMed

    Cheng, Z; Dai, M M; Cao, X B

    2018-04-10

    Methadone maintenance treatment (MMT) greatly contributed to the successful outcomes of prevention and control on both AIDS and drug abuse in China. However, the features on drug abuse changed in the past decades, and the prevalence of new psychoactive substances abuse potentially somehow offset the achievement of MMT. This paper concised the information on research and surveys of this issue that targeting on the current situation, characteristics, related factors and relevant public health problem on new psychoactive substances abuse, among patients who have been on MMT, in China.

  13. The Development of a Substance Abuse Treatment Program for Forensic Patients with Cognitive Impairment

    ERIC Educational Resources Information Center

    Glassmire, David M.; Welsh, Robert K.; Clevenger, Jeanne K.

    2007-01-01

    The Substance Abuse and Mental Illness (SAMI) program combines cognitive rehabilitation and dual-diagnosis substance abuse treatment within a stages of change context. This article describes the development, implementation, and preliminary outcome analysis of the SAMI program in a forensic hospital.

  14. Sexual abuses.

    PubMed

    Abel, G G; Rouleau, J L

    1995-03-01

    The sexual abuses described in this article are occurring so frequently that they constitute a public health problem. Superficially they appear to be quite dissimilar because they involve individuals of different ages, different settings, and different power relationships. Basic to each of them, however, is an absence of consent by the victim and the misuse of power by the perpetrator in order to accomplish the abuse. We now have an adequate understanding of each of these abuses and it is now time to make a concerted effort to stop these abuses. This will require the combined efforts of the education of the public, improved identification of the abuses, treatment of the victims, and an appropriate criminal justice response combined with treatment of the perpetrator.

  15. Perceptions of Organizational Functioning in Substance Abuse Treatment Facilities in South Africa

    ERIC Educational Resources Information Center

    Bowles, Steven; Louw, Johann; Myers, Bronwyn

    2011-01-01

    Directors' and treatment staff's perceptions of organizational functioning within substance abuse treatment facilities in four provinces in South Africa were examined via the Texas Christian University's Organizational Readiness for Change instrument. Forty-four treatment facilities (out of 89) participated in the study. Results indicated that…

  16. NIDA's Clinical Trials Network: an opportunity for HIV research in community substance abuse treatment programs.

    PubMed

    Tross, Susan; Campbell, Aimee N C; Calsyn, Donald A; Metsch, Lisa R; Sorensen, James L; Shoptaw, Steven; Haynes, Louise; Woody, George E; Malow, Robert M; Brown, Lawrence S; Feaster, Daniel J; Booth, Robert E; Mandler, Raul N; Masson, Carmen; Holmes, Beverly W; Colfax, Grant; Brooks, Audrey J; Hien, Denise A; Schackman, Bruce R; Korthuis, P Todd; Miele, Gloria M

    2011-09-01

    HIV continues to be a significant problem among substance users and their sexual partners in the United States. The National Drug Abuse Treatment Clinical Trials Network (CTN) offers a national platform for effectiveness trials of HIV interventions in community substance abuse treatment programs. This article presents the HIV activities of the CTN during its first 10 years. While emphasizing CTN HIV protocols, this article reviews the (1) HIV context for this work; (2) the collaborative process among providers, researchers, and National Institute on Drug Abuse CTN staff, on which CTN HIV work was based; (3) results of CTN HIV protocols and HIV secondary analyses in CTN non-HIV protocols; and (4) implications for future HIV intervention effectiveness research in community substance abuse treatment programs. While the feasibility of engaging frontline providers in this research is highlighted, the limitations of small to medium effect sizes and weak adoption and sustainability in everyday practice are also discussed.

  17. Training substance abuse treatment staff to care for co-occurring disorders.

    PubMed

    Hunter, Sarah B; Watkins, Katherine E; Wenzel, Suzanne; Gilmore, Jim; Sheehe, John; Griffin, Belle

    2005-04-01

    Although co-occurring disorders have been associated with poorer substance abuse treatment outcomes and higher costs of care, few individuals with co-occurring disorders receive appropriate mental health care. This article describes the design and implementation of an intervention to improve the quality of mental health care provided in outpatient substance abuse treatment programs without requiring new treatment staff. The intervention focuses on individuals with affective and anxiety disorders and consists of three components: training and supervising staff, educating and activating clients, and linking with community resources. We evaluated three treatment programs (one intervention and two comparison) for the first component by having program staff complete both self-administered questionnaires and semistructured interviews. Staff knowledge and attitudes about co-occurring disorders, job satisfaction, and morale all indicated an improvement at the intervention relative to the comparison sites. The evaluation is still under way; results for implementation of the other two components and for outcomes will be reported later.

  18. American Youths' Access to Substance Abuse Treatment: Does Type of Treatment Facility Matter?

    ERIC Educational Resources Information Center

    Lo, Celia C.; Cheng, Tyrone C.

    2013-01-01

    Using data from the 2007 National Survey on Drug Use and Health, this study examines whether several social exclusion and psychological factors affect adolescents' receipt of substance abuse treatment. Multinomial logistic regression techniques were used to analyze data. The study asked how the specified factors provide pathways to receipt of…

  19. Providers' perceptions of the implementation of a performance measurement system for substance abuse treatment: A process evaluation of the Service Quality Measures initiative.

    PubMed

    Myers, Bronwyn; Williams, Petal Petersen; Johnson, Kim; Govender, Rajen; Manderscheid, Ron; Koch, J Randy

    2016-02-22

    In South Africa, concerns exist about the quality of substance abuse treatment. We developed a performance measurement system, known as the Service Quality Measures (SQM) initiative, to monitor the quality of treatment and assess efforts to improve quality of care. In 2014, the SQM system was implemented at six treatment sites to evaluate how implementation protocols could be improved in preparation for wider roll-out. To describe providers' perceptions of the feasibility and acceptability of implementing the SQM system, including barriers to and facilitators of implementation. We conducted 15 in-depth interviews (IDIs) with treatment providers from six treatment sites (two sites in KwaZulu-Natal and four in the Western Cape). Providers were asked about their experiences in implementing the system, the perceived feasibility of the system, and barriers to implementation. All IDIs were audio-recorded and transcribed verbatim. A framework approach was used to analyse the data. Providers reported that the SQM system was feasible to implement and acceptable to patients and providers. Issues identified through the IDIs included a perceived lack of clarity about sequencing of key elements in the implementation of the SQM system, questions on integration of the system into clinical care pathways, difficulties in tracking patients through the system, and concerns about maximising patient participation in the process. Findings suggest that the SQM system is feasible to implement and acceptable to providers, but that some refinements to the implementation protocols are needed to maximise patient participation and the likelihood of sustained implementation.

  20. The Relationship Between Client Characteristics and Wraparound Services in Substance Use Disorder Treatment Centers

    PubMed Central

    Paino, Maria; Aletraris, Lydia; Roman, Paul

    2016-01-01

    Objective: The National Institute on Drug Abuse (NIDA) recommends a comprehensive treatment program for individuals with substance use disorder (SUD) in order to treat needs they often have in addition to their SUD. Specifically, NIDA suggests providing services related to the following issues: medical care, mental health care, HIV/AIDS, child care, educational, vocational, family counseling, housing, transportation, financial, and legal. By providing a comprehensive model that combines core and wraparound services, treatment centers can deliver a higher quality of treatment. In this article, we assessed the relationship between client characteristics and the availability of wraparound services in SUD treatment centers. Method: We combined two nationally representative samples of treatment centers and used a negative binomial regression and a series of logistic regressions to analyze the relationship between client characteristics and wraparound services. Results: On average, centers offered fewer than half of the wraparound services endorsed by NIDA. Our results indicated that client characteristics were significantly related to the provision of wraparound services. Most notably, the proportion of adolescent clients was positively related to educational services, the proportion of female clients was positively related to child care, but the proportion of clients referred from the criminal justice system was negatively associated with the provision of multiple wraparound services. Conclusions: Our findings have important implications for SUD clients and suggest that, although centers are somewhat responsive to their clients’ ancillary needs, most centers do not offer the majority of wraparound services. PMID:26751366

  1. The Relationship Between Client Characteristics and Wraparound Services in Substance Use Disorder Treatment Centers.

    PubMed

    Paino, Maria; Aletraris, Lydia; Roman, Paul

    2016-01-01

    The National Institute on Drug Abuse (NIDA) recommends a comprehensive treatment program for individuals with substance use disorder (SUD) in order to treat needs they often have in addition to their SUD. Specifically, NIDA suggests providing services related to the following issues: medical care, mental health care, HIV/AIDS, child care, educational, vocational, family counseling, housing, transportation, financial, and legal. By providing a comprehensive model that combines core and wraparound services, treatment centers can deliver a higher quality of treatment. In this article, we assessed the relationship between client characteristics and the availability of wraparound services in SUD treatment centers. We combined two nationally representative samples of treatment centers and used a negative binomial regression and a series of logistic regressions to analyze the relationship between client characteristics and wraparound services. On average, centers offered fewer than half of the wraparound services endorsed by NIDA. Our results indicated that client characteristics were significantly related to the provision of wraparound services. Most notably, the proportion of adolescent clients was positively related to educational services, the proportion of female clients was positively related to child care, but the proportion of clients referred from the criminal justice system was negatively associated with the provision of multiple wraparound services. Our findings have important implications for SUD clients and suggest that, although centers are somewhat responsive to their clients' ancillary needs, most centers do not offer the majority of wraparound services.

  2. Who Benefits from Gender Responsive Treatment? Accounting for Abuse History on Longitudinal Outcomes for Women in Prison.

    PubMed

    Saxena, Preeta; Messina, Nena; Grella, Christine E

    2014-04-01

    This study explores outcome variation among women offenders who participated in gender-responsive substance abuse treatment (GRT). In order to identify subgroups of participants that may differentially benefit from this treatment, secondary analyses examined the interaction between randomization into GRT and a history of abuse (physical/sexual) on depression and number of substances used post- treatment. The sample consisted of 115 incarcerated women assessed at baseline and 6- and 12-months post parole. Longitudinal regression showed that women reporting abuse randomized into GRT had significantly reduced odds of depression ( OR = .29, p < .05, 95% CI = .10 - .86) and lowered rates of number of substances used ( IRR = .52, p < .05, 95% CI = 0.28-0.98), in comparison to those who reported abuse and were randomized to the non-GRT group. GRT for women offenders who have experienced prior abuse would maximize the benefits of the trauma-informed, gender-sensitive intervention.

  3. Legal and Social Service Responses to Child Sexual Abuse: A Primer and Discussion of Relevant Research

    ERIC Educational Resources Information Center

    Wiley, Tisha R. A.

    2009-01-01

    This paper provides a broad overview of legal and social service responses to child sexual abuse, the overarching legal framework provided by federal legislation, and funding mandates and the unique and shared investigative concerns of law enforcement and child protective service entities. Relevant psychological research is highlighted throughout,…

  4. Elder Abuse Awareness Project.

    ERIC Educational Resources Information Center

    Doyle, Kathleen; Morrow, Marilyn J.

    1985-01-01

    The Elder Abuse Awareness Project was undertaken: (1) to determine the incidence of abuse and neglect in seven Illinois counties; and (2) to develop, produce, and distribute educational materials on elder abuse for the service provider and for senior citizens. Results are presented and discussed. (MT)

  5. Emotion regulation promotes persistence in a residential substance abuse treatment.

    PubMed

    Hopwood, Christopher J; Schade, Nick; Matusiewicz, Alexis; Daughters, Stacey B; Lejuez, Carl W

    2015-01-01

    Emotion regulation at treatment entry was evaluated among 115 patients in an inner-city substance use residential facility who either persisted (N = 94) or discontinued treatment (N = 21). Emotion regulation capacity including emotional clarity and the ability to engage in goal-directed behavior despite emotional distress, as well as lower scores on a measure of trait-negative emotionality, were associated with treatment persistence, whereas motivational variables were not. Findings indicate the importance of regulating negative emotions for treatment engagement among substance abusers.

  6. Intimate justice: confronting issues of accountability, respect, and freedom in treatment for abuse and violence.

    PubMed

    Jory, B; Anderson, D; Greer, C

    1997-10-01

    Intimate justice theory is a set of nine interrelated concepts that describe the ethical dimensions of equality, fairness, and care in ongoing partnerships. Understanding ethical dimensions involves examining internalized beliefs and behavior in terms of their motivation and impact on the partner, particularly as they empower, disempower, or abuse power. The concepts of intimate justice theory are applied to confront disempowerment and abuses of power, to challenge internalized beliefs about how one should treat one's partner, to explore how internalized beliefs were developed through experiences in the family of origin, and to develop an awareness of the linkages between intimate partner abuse and social injustice. This article demonstrates how therapists can utilize three of the concepts --accountability, respect, and freedom--to structure the opening phase of treatment for abuse and violence. The primary focus of the opening phase is on establishing accountability for change in the abusive man and protecting the safety of the injured partner. This involves challenging the abuser's sense of entitlement and working to rethink what respect is and restoring freedom to his partner. The discussion incorporates the findings of an exploratory, qualitative study that investigated the experiences of 30 abusive men and their partners who were clients in a university-based counseling clinic. The article elaborates six interventions that can be utilized in clinical settings to structure treatment with abusive men.

  7. Benning House: The Grass Roots Beginning of Army Substance Abuse Treatment

    DTIC Science & Technology

    2013-09-01

    59 McLaughlin, A. E . (1974). The abusers. AMEDD SPECTRUM, 1(1), 54. 60 White, W. L. (2003). The road not taken: The lost roots of addiction counseling. Counselor, 4(2), 22-23. ...military front lines of addiction treatment today. FORMING THE TEAM Four individuals with unique backgrounds converged in 1969 to form the team that...Public Welfare, 91st Congress, 2nd session. (1970). Examination of drug abuse and alcoholism in the armed forces. p.800-827. 2 McLaughlin, A. E

  8. NCADI's 1995 National Directory of Drug Abuse and Alcoholism Treatment and Prevention Programs That Have a Special Program for American Indians/Alaska Natives.

    ERIC Educational Resources Information Center

    Vanderbilt, Rebecca, Comp.; Schacht, Robert M., Comp.

    This state-by-state directory lists over 500 alcohol and drug abuse treatment and prevention services that target American Indians and Alaska Natives. The directory was compiled from the website of the National Clearinghouse for Alcohol and Drug Information (NCADI). Their home page on the Internet is located at http://www.health.org/index.htm. The…

  9. Child Abuse Experiences and Perceived Need for Care and Mental Health Service Use among Members of the Canadian Armed Forces.

    PubMed

    Turner, Sarah; Taillieu, Tamara; Cheung, Kristene; Zamorski, Mark; Boulos, David; Sareen, Jitender; Afifi, Tracie O

    2017-06-01

    Child abuse is associated with poor mental health outcomes in adulthood. However, little is known about how a history of child abuse may be related to perceived need for care (PNC) and mental health service use (MHSU) among Canadian military personnel. The objectives of this study were to determine 1) the relationship between child abuse history and PNC and 2) the relationship between child abuse history and MHSU in the Canadian military. Data were drawn from the 2013 Canadian Forces Mental Health Survey ( n = 6692 Regular Force personnel between the ages of 18 and 60 years). Logistic regression was used to examine the relationships between individual child abuse types and PNC and MHSU while adjusting for sociodemographic variables, the presence of mental disorders, deployment-related variables, and other types of child abuse. Population attributable fractions (PAFs) were calculated to estimate the proportion of PNC and MHSU that may be attributable to child abuse. Each individual child abuse type was associated with increased odds of PNC and MHSU after adjusting for all covariates (adjusted odds ratio ranging from 1.26 to 1.80). PAFs showed that if any child abuse did not occur, PNC and MHSU among Regular Force personnel may be reduced by approximately 14.3% and 11.3%, respectively. This study highlights that preenlistment factors, such as a history of child abuse, have an independent association with PNC and MHSU and hence need to be considered when assessing the mental health service needs of the Canadian Regular Force personnel.

  10. Child Abuse Experiences and Perceived Need for Care and Mental Health Service Use among Members of the Canadian Armed Forces

    PubMed Central

    Turner, Sarah; Taillieu, Tamara; Cheung, Kristene; Zamorski, Mark; Boulos, David; Sareen, Jitender

    2017-01-01

    Objective: Child abuse is associated with poor mental health outcomes in adulthood. However, little is known about how a history of child abuse may be related to perceived need for care (PNC) and mental health service use (MHSU) among Canadian military personnel. The objectives of this study were to determine 1) the relationship between child abuse history and PNC and 2) the relationship between child abuse history and MHSU in the Canadian military. Method: Data were drawn from the 2013 Canadian Forces Mental Health Survey (n = 6692 Regular Force personnel between the ages of 18 and 60 years). Logistic regression was used to examine the relationships between individual child abuse types and PNC and MHSU while adjusting for sociodemographic variables, the presence of mental disorders, deployment-related variables, and other types of child abuse. Population attributable fractions (PAFs) were calculated to estimate the proportion of PNC and MHSU that may be attributable to child abuse. Results: Each individual child abuse type was associated with increased odds of PNC and MHSU after adjusting for all covariates (adjusted odds ratio ranging from 1.26 to 1.80). PAFs showed that if any child abuse did not occur, PNC and MHSU among Regular Force personnel may be reduced by approximately 14.3% and 11.3%, respectively. Conclusions: This study highlights that preenlistment factors, such as a history of child abuse, have an independent association with PNC and MHSU and hence need to be considered when assessing the mental health service needs of the Canadian Regular Force personnel. PMID:28562093

  11. 78 FR 45544 - Center for Substance Abuse Treatment (CSAT) National Advisory Council; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-29

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration... will include a discussion of the Center's current administrative, legislative, and program developments... meeting by accessing the SAMHSA Committee Web site at http://nac.samhsa.gov/CSATcouncil/index.aspx or...

  12. The impact of childhood sexual abuse on the outcome of intensive trauma-focused treatment for PTSD.

    PubMed

    Wagenmans, Anouk; Van Minnen, Agnes; Sleijpen, Marieke; De Jongh, Ad

    2018-01-01

    Background : It is assumed that PTSD patients with a history of childhood sexual abuse benefit less from trauma-focused treatment than those without such a history. Objective : To test whether the presence of a history of childhood sexual abuse has a negative effect on the outcome of intensive trauma-focused PTSD treatment. Method : PTSD patients, 83% of whom suffered from severe PTSD, took part in a therapy programme consisting of 2 × 4 consecutive days of Prolonged Exposure (PE) and EMDR therapy (eight of each). In between sessions, patients participated in sport activities and psycho-education sessions. No prior stabilization phase was implemented. PTSD symptom scores of clinician-administered and self-administered measures were analysed using the data of 165 consecutive patients. Pre-post differences were compared between four trauma groups; patients with a history of childhood sexual abuse before age 12 (CSA), adolescent sexual abuse (ASA; i.e. sexual abuse between 12 and 18 years of age), sexual abuse (SA) at age 18 and over, or no history of sexual abuse (NSA). Results : Large effect sizes were achieved for PTSD symptom reduction for all trauma groups (Cohen's d  = 1.52-2.09). For the Clinical Administered PTSD Scale (CAPS) and the Impact of Event Scale (IES), no differences in treatment outcome were found between the trauma (age) groups. For the PTSD Symptom Scale Self Report (PSS-SR), there were no differences except for one small effect between CSA and NSA. Conclusions : The results do not support the hypothesis that the presence of a history of childhood sexual abuse has a detrimental impact on the outcome of first-line (intensive) trauma-focused treatments for PTSD.

  13. The impact of childhood sexual abuse on the outcome of intensive trauma-focused treatment for PTSD

    PubMed Central

    Wagenmans, Anouk; Van Minnen, Agnes; Sleijpen, Marieke; De Jongh, Ad

    2018-01-01

    ABSTRACT Background: It is assumed that PTSD patients with a history of childhood sexual abuse benefit less from trauma-focused treatment than those without such a history. Objective: To test whether the presence of a history of childhood sexual abuse has a negative effect on the outcome of intensive trauma-focused PTSD treatment. Method: PTSD patients, 83% of whom suffered from severe PTSD, took part in a therapy programme consisting of 2 × 4 consecutive days of Prolonged Exposure (PE) and EMDR therapy (eight of each). In between sessions, patients participated in sport activities and psycho-education sessions. No prior stabilization phase was implemented. PTSD symptom scores of clinician-administered and self-administered measures were analysed using the data of 165 consecutive patients. Pre-post differences were compared between four trauma groups; patients with a history of childhood sexual abuse before age 12 (CSA), adolescent sexual abuse (ASA; i.e. sexual abuse between 12 and 18 years of age), sexual abuse (SA) at age 18 and over, or no history of sexual abuse (NSA). Results: Large effect sizes were achieved for PTSD symptom reduction for all trauma groups (Cohen’s d = 1.52–2.09). For the Clinical Administered PTSD Scale (CAPS) and the Impact of Event Scale (IES), no differences in treatment outcome were found between the trauma (age) groups. For the PTSD Symptom Scale Self Report (PSS-SR), there were no differences except for one small effect between CSA and NSA. Conclusions: The results do not support the hypothesis that the presence of a history of childhood sexual abuse has a detrimental impact on the outcome of first-line (intensive) trauma-focused treatments for PTSD. PMID:29441153

  14. Suicide attempts among men with histories of child sexual abuse: examining abuse severity, mental health, and masculine norms.

    PubMed

    Easton, Scott D; Renner, Lynette M; O'Leary, Patrick

    2013-06-01

    Men who were sexually abused during childhood are at risk for a variety of long-term mental health problems, including suicidality. However, little is known about which factors are related to recent suicide attempts for this vulnerable, under-researched population. The purpose of this study was to examine the relationship between abuse severity, mental health, masculine norms and recent suicide attempts among men with histories of child sexual abuse (CSA). We analyzed survey data gathered from a purposive sample of 487 men who were sexually abused during childhood. The age of the sample ranged from 19 to 84 years (μ = 50.4 years). Recent suicide attempts served as the dependent variable in the study. Self-reported measures of sexual abuse severity, child physical abuse, mental health, masculine norms, and demographic information (age, race) represented the independent variables. The results from logistic regression modeling found that five variables - duration of the sexual abuse, use of force during the sexual abuse, high conformity to masculine norms, level of depressive symptoms, and suicidal ideation - increased the odds of a suicide attempt in the past 12 months. To improve mental health services for men with histories of CSA, mental health practitioners should incorporate sexual abuse severity, current mental health, and adherence to masculine norms into assessment and treatment planning. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Variables Associated with Environmental Scanning among Clinicians at Substance Abuse Treatment Clinics

    ERIC Educational Resources Information Center

    Koch, Alison L.; Arfken, Cynthia L.; Agius, Elizabeth; Dickson, Marcus W.; Mitchelson, Jacqueline K.

    2005-01-01

    Introduction: Environmental scanning, as a component of absorptive capacity, has been shown to be associated with increased use of innovative treatment techniques at substance abuse treatment programmes. As the transfer of innovative, evidence-based treatment techniques from research to practice is gaining attention, we aimed to identify variables…

  16. Elder Abuse and Neglect: Assessment Tools, Interventions, and Recommendations for Effective Service Provision

    ERIC Educational Resources Information Center

    Imbody, Bethany; Vandsburger, Etty

    2011-01-01

    With our communities rapidly aging, there is always a clear need for greater knowledge on how to serve elders. Professionals must be able to recognize cases of abuse and neglect and provide appropriate follow up services. Through reviewing recent literature, this paper surveys existing assessment tools and interventions, describes characteristics…

  17. Circadian Rhythms and Substance Abuse: Chronobiological Considerations for the Treatment of Addiction.

    PubMed

    Webb, Ian C

    2017-02-01

    Reward-related learning, including that associated with drugs of abuse, is largely mediated by the dopaminergic mesolimbic pathway. Mesolimbic neurophysiology and motivated behavior, in turn, are modulated by the circadian timing system which generates ∼24-h rhythms in cellular activity. Both drug taking and seeking and mesolimbic dopaminergic neurotransmission can vary widely over the day. Moreover, circadian clock genes are expressed in ventral tegmental area dopaminergic cells and in mesolimbic target regions where they can directly modulate reward-related neurophysiology and behavior. There also exists a reciprocal influence between drug taking and circadian timing as the administration of drugs of abuse can alter behavioral rhythms and circadian clock gene expression in mesocorticolimbic structures. These interactions suggest that manipulations of the circadian timing system may have some utility in the treatment of substance abuse disorders. Here, the literature on bidirectional interactions between the circadian timing system and drug taking is briefly reviewed, and potential chronotherapeutic considerations for the treatment of addiction are discussed.

  18. Counselor Treatment of Coexisting Domestic Violence and Substance Abuse: A Qualitative Study.

    ERIC Educational Resources Information Center

    Chartas, Nicole D.; Culbreth, John R.

    2001-01-01

    This study explored the philosophical issues hindering the linkage of substance abuse and domestic violence treatment. Results suggest that counselors tend to use treatment models that could not concurrently assign responsibility and address either present or past victimization. (Author)

  19. A Meta-Analysis of Parent-Involved Treatment for Child Sexual Abuse

    ERIC Educational Resources Information Center

    Corcoran, Jacqueline; Pillai, Vijayan

    2008-01-01

    Sexual abuse in children not only occurs with alarming frequency, it also potentially leads to deleterious consequences for victims. Previous narrative reviews have touted the benefits of including the nonoffending caregiver in child sexual treatment. Objective: A meta-analysis is conducted to determine the effects of parent-involved treatment in…

  20. CULTURAL COMPETENCE IN OUTPATIENT SUBSTANCE ABUSE TREATMENT: MEASUREMENT AND RELATIONSHIP TO WAIT TIME AND RETENTION

    PubMed Central

    Guerrero, Erick; Andrews, Christina M.

    2011-01-01

    BACKGROUND Culturally competent practice is broadly acknowledged to be an important strategy to increase the quality of services for racial/ethnic minorities in substance abuse treatment. However, few empirically derived measures of organizational cultural competence exist, and relatively little is known about how these measures affect treatment outcomes. METHOD Using a nationally representative sample of outpatient substance abuse treatment (OSAT) programs, this study used item response theory to create two measures of cultural competence-organizational practices and managers' culturally sensitive beliefs—and examined their relationship to client wait time and retention using Poisson regression modeling RESULTS The most common and precisely measured organizational practices reported by OSAT managers included matching providers and clients based on language/dialect; offering cross-cultural training; and fostering connections with community and faith-based organizations connected to racial and ethnic minority groups. The most culturally sensitive belief among OSAT managers was support for language/dialect matching for racial and ethnic minority clients. Results of regression modeling indicate that organizational practices were not related to either outcome. However, managers' culturally sensitive beliefs were negatively associated with average wait time (p < 0.05), and positively associated with average retention (p < 0.01). CONCLUSIONS Managers' culturally sensitive beliefs—considered to be influential for effective implementation of culturally competent practices—may be particularly relevant in influencing wait time and retention in OSAT organizations that treat Latinos and African American clients. PMID:21680111

  1. [Response to treatment of patients abusing the "dappou drug" who participated in a group relapse prevention program: a comparison with patients abusing methamphetamine].

    PubMed

    Hikitsuchi, Emi; Matsumoto, Toshihiko; Wada, Kiyoshi; Tanibuchi, Yuko; Takano, Ayumi; Imamura, Fumi; Kawachi, Hiraku; Wakabayashi, Asako; Kato, Takashi

    2014-12-01

    In this study, we compared the efficacy of a group relapse prevention program using the cognitive behavioral therapy-based workbook, Serigaya Methamphetamine Relapse Prevention Program (SMARPP), between patients abusing the so-called "dappou drugs" (designer drug in Japan, and those abusing methamphetamine (MAP). Both groups participated in the SMARPP at the Center Hospital, National Center of Neurology and Psychiatry. Results showed that, no significant differences were found in the rates of participation in the program or self-reported frequency of drug or alcohol use between the patients abusing "dappou drugs" or MAP. However, patients using "dappou drugs" reported no significant increase in their confidence in their ability to resist the temptation to use drugs on the self- report drug abuse scales after the SMARPP intervention, while patients abusing MAP reported a significant positive difference in their ability to resist temptation. In addition, insight into substance abuse problems and motivation to participate in further treatment slightly declined in those using "dappou drugs," while there was a significant increase reported by the patients using MAP. These results suggested that the SMARPP might not be as effective for patients abusing "dappou drugs" as for those abusing MAP. The development of a relapse prevention program specifically designed for patients abusing "dappou drugs" is required.

  2. Substance Abuse Disorders Treatment in El Salvador: Analysis of Policy-Making-Related Failure

    PubMed Central

    Dickson-Gómez, Julia

    2016-01-01

    Illicit drug use and substance abuse disorders have increased dramatically in developing countries during recent decades. Sadly, treatment for people diagnosed as manifesting and/or attributed with substance abuse disorders in developing countries is usually inadequate to meet demand, not evidence based, and of poor quality. In response, international health organizations have developed best-practice guidelines for substance user treatment in developing countries, although little research has evaluated their implementation. This opinion piece will examine one such effort to improve substance user treatment in El Salvador. It will be argued that the program failed (2007–2008) because of a lack of political will by the Salvadoran government through their Ministry of Health to effectively supervise, monitor, and subsidize substance user treatment. PMID:23186469

  3. Child Sexual Abuse: Prevention and Treatment. Continuing Education Manual.

    ERIC Educational Resources Information Center

    Stovall, Bennie

    This self-study manual, for use by individuals or groups, was developed for social work practitioners, and focuses on total family assessment to determine prevention and treatment intervention in cases of child sexual abuse and neglect. The introduction presents the philosophy of continuing education on which the manual is based, an overview of…

  4. Medical Marijuana Use among Adolescents in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Salomonsen-Sautel, Stacy; Sakai, Joseph T.; Thurstone, Christian; Corley, Robin; Hopfer, Christian

    2012-01-01

    Objective: To assess the prevalence and frequency of medical marijuana diversion and use among adolescents in substance abuse treatment and to identify factors related to their medical marijuana use. Method: This study calculated the prevalence and frequency of diverted medical marijuana use among adolescents (n = 164), ages 14-18 years (mean age…

  5. Hospitalization of abused and neglected children.

    PubMed

    Marshall, W N

    1997-03-01

    To describe the use of inpatient hospitalization for abused and neglected children living in a metropolitan area. Retrospective record review of abused and neglected children admitted in 1992 and 1993 to hospitals with 87% of metropolitan area pediatric admissions; comparison of these data with population, crisis nursery, and child protective services data. Thirty-four abused and neglected children were admitted to hospital, representing 0.3% (34/11,066; 95% confidence interval, 0%-1.2%) of pediatric admissions and 0.2% (34/19,950; 95% confidence interval, 0%-0.6%) of child protective services reports. This represents a rate of hospitalization for child abuse of 10 children (95% confidence interval, 0-46) per 100,000 child population per year. Seven hundred fifteen children were admitted to the crisis nursery by child protective services. Of those admitted to the hospital, 12 needed intensive care, 5 of whom died. Only 3 of 34 hospital-admitted children had private health insurance; 19 of 34 were younger than 1 year. Inpatient hospitalization for abuse represented a small fraction of total pediatric admissions and of child protective services reports. Comprehensive medical care for most abused children and medical education about child abuse must occur in outpatient settings.

  6. Substance Abuse Treatment For Adults in the Criminal Justice System. Treatment Improvement Protocol (TIP) Series 44

    ERIC Educational Resources Information Center

    Bartlett, Catalina; Dinsmore, Janet; Gilbert, J. Max; Kornblum, Annette; Latham, Joyce; Oliff, Helen; Paisner, Susan; Sutton, David

    2005-01-01

    This Treatment Improvement Protocol (TIP) provides guidelines for counselors and criminal justice personnel who treat offenders with substance use disorders. TIPs are best-practice guidelines that make the latest research in substance abuse treatment available to counselors and educators. The content was generated by a panel of experts in the…

  7. Associations between mental health, substance use, and sexual abuse experiences among Latinas.

    PubMed

    Ulibarri, Monica D; Ulloa, Emilio C; Salazar, Marissa

    2015-01-01

    This study examined self-reported sexually abusive experiences in childhood and adulthood as correlates of current drug use, alcohol abuse, and depression and posttraumatic stress disorder (PTSD) symptoms. Participants were 204 Latina women 18-34 years old. Results indicated significant relationships between history of sexual abuse (regardless of age of occurrence), depression symptoms, PTSD symptoms, alcohol abuse, and drug use. When examined separately, childhood sexual abuse was associated with symptoms of depression, PTSD, and substance use but not alcohol abuse behaviors. Experiencing sexual abuse in adulthood was associated with symptoms of depression, alcohol abuse behaviors, and substance use but not PTSD symptoms. Structural equation modeling showed that substance use partially mediated the relationship between sexual abuse and mental health outcomes. These findings suggest mental health and substance use services should incorporate treatment for trauma, which may be the root of comorbid mental health and substance use issues.

  8. Training Needs for Substance Abuse Treatment and Assessment among Rehabilitation Counselors: California State Project

    ERIC Educational Resources Information Center

    Ong, Lee Za; Lee, Dal-Yob; Cha, Grace; Arokiasamy, Charles

    2008-01-01

    One hundred rehabilitation counselors in California reported that about 90% of consumers with whom they worked with had substance abuse and cooccurring issues, yet about half rated their graduate training in substance abuse treatment and assessment as poor and their practices as marginally proficient. The correlation analysis revealed that…

  9. An Exploration of Smoking Among People Attending Residential Substance Abuse Treatment: Prevalence and Outcomes at Three Months Post-Discharge.

    PubMed

    Ingram, Isabella; Kelly, Peter J; Deane, Frank P; Baker, Amanda L; Lyons, Geoff; Blackman, Russell

    2017-01-01

    Smoking continues to be a major health concern for people with a history of alcohol or other substance use problems. The current research is aimed to (1) describe the prevalence of smoking in residential addictions treatment services and (2) compare characteristics of people who had or had not quit smoking. Participants were attending residential substance abuse treatment provided by the Australian Salvation Army. These programs are up to 10 months in length and offer a range of low-intensity smoking cessation supports. Measures of smoking, substance use, and clinical characteristics were collected from 2008 to 2015 at baseline and three months post-discharge from treatment (N = 702). At baseline, 86% of people were smokers (n = 606). At follow-up, only 48 participants who were smokers at baseline (7%) had quit smoking. Participants who had quit smoking at follow-up also reported higher rates of abstinence from alcohol or other substances at follow-up (72%) than people who had not quit smoking (46%; OR = 2.95, 95% CI [1.52, 5.74]). There is potential for smoking cessation to be better addressed as part of routine care in substance abuse treatment settings. Future research should evaluate the provision of more systematic smoking cessation interventions within these settings.

  10. Admissions of injection drug users to drug abuse treatment following HIV counseling and testing.

    PubMed

    McCusker, J; Willis, G; McDonald, M; Lewis, B F; Sereti, S M; Feldman, Z T

    1994-01-01

    The outcomes of counseling and testing programs related to human immunodeficiency virus (HIV) infection and risk of infection among injection drug users (IDUs) are not well known or understood. A counseling and testing outcome of potential public health importance is attaining admission to drug abuse treatment by those IDUs who are either infected or who are at high risk of becoming infected. The authors investigated factors related to admission to drug abuse treatment among 519 IDUs who received HIV counseling and testing from September 1987 through December 1990 at a men's prison and at community-based testing sites in Worcester, MA. By June 1991, 123 of the 519 IDUs (24 percent) had been admitted to treatment. Variables associated with their admission included a long history of drug injection, frequent recent drug injection, cleaning injection equipment using bleach, prior drug treatment, and a positive HIV test result. Logistic regression analyses, controlling for effects of recruitment site, year, sex, and area of residence, generally confirmed the associations. IDUs in the study population who were HIV-infected sought treatment or were admitted to treatment more frequently than those who were not infected. The results indicate that access to drug abuse treatment should be facilitated for high-risk IDUs and for those who have begun to inject drugs recently.

  11. Treatment of childhood sexual abuse in anorexia nervosa and bulimia nervosa: a feminist psychodynamic approach.

    PubMed

    Kearney-Cooke, A; Striegel-Moore, R H

    1994-05-01

    In this article a parallel is drawn between the psychological problems experienced by victims of childhood sexual abuse and by clients with eating disorders. In particular, we describe how sexual abuse has a significant and lasting effect on body image, identity, self-regulation, and interpersonal functioning. Treatment issues are outlined including the nature of the healing relationship, assessment of abuse, development of capacity for self-soothing, techniques for assisting in memory recall, sculpting of images, description and reenactment of abuse, dealing with shame, and ending the cycle of repeated victimization.

  12. Organizational Readiness for Change in Correctional and Community Substance Abuse Programs

    ERIC Educational Resources Information Center

    Lehman, Wayne E. K.; Greener, Jack M.; Rowan-Szal, Grace A.; Flynn, Patrick M.

    2012-01-01

    Significant needs exist for increased and better substance abuse treatment services in our nation's prisons. The TCU Organizational Readiness for Change (ORC) survey has been widely used in community-based treatment programs and evidence is accumulating for relationships between readiness for change and implementation of new clinical practices.…

  13. A Systems Approach to Child Abuse: Management and Treatment Issues.

    ERIC Educational Resources Information Center

    Asen, Karl; And Others

    1989-01-01

    An approach to the treatment of child abuse used in a British clinic involves interventions that block or change destructive family interaction patterns. Real life stress situations are recreated in a multifamily group so that families can find new, nonviolent solutions to everyday problems. (MSE)

  14. Evaluation of a suicide prevention training curriculum for substance abuse treatment providers based on Treatment Improvement Protocol Number 50 (TIP 50)

    PubMed Central

    Conner, Kenneth R.; Wood, Jane; Pisani, Anthony R.; Kemp, Janet

    2013-01-01

    Substance use disorders (SUD) confer risk for suicide yet there are no empirically supported suicide prevention training curricula tailored to SUD treatment providers. We assessed the efficacy of a 2-hour training that featured a suicide prevention training video produced by the Department of Veterans Affairs (VA). The video was based on Treatment Improvement Protocol Number 50, TIP 50, a practical manual to manage suicide risk produced by the Substance Abuse and Mental Health Services Administration (SAMHSA). The training was provided in small groups to 273 SUD treatment providers in 18 states. Results were evaluated using self-report assessments obtained at pre-test, post-test, and 2-month follow-up. Statistically significant changes (p<.001) within subjects were obtained on self-efficacy, knowledge, and frequency of suicide prevention practice behaviors. The positive results together with the brevity of the training and its ease of implementation indicate high potential for widespread adoption and the importance of further study. PMID:22417671

  15. Informal Discussions in Substance Abuse Treatment Sessions with Spanish-speaking Clients

    PubMed Central

    Bamatter, Wendy; Carroll, Kathleen M.; Añez, Luis M.; Paris, Manuel; Ball, Samuel A.; Nich, Charla; Frankforter, Tami L.; Suarez-Morales, Lourdes; Szapocznik, Jose; Martino, Steve

    2010-01-01

    This study investigated the extent to which bilingual counselors initiated informal discussions about topics that were unrelated to the treatment of their monolingual Spanish-speaking Hispanic clients in a National Institute on Drug Abuse Clinical Trial Network protocol examining the effectiveness of motivational enhancement therapy (MET). Session audiotapes were independently rated to assess counselor treatment fidelity and the incidence of informal discussions. Eighty-three percent of the 23 counselors participating in the trial initiated informal discussions at least once in one or more of their sessions. Counselors delivering MET in the trial initiated informal discussion significantly less often than the counselors delivering standard treatment. Counselors delivering standard treatment were likely to talk informally the most when they were ethnically non-Latin. Additionally, informal discussion was found to have significant inverse correlations with client motivation to reduce substance use and client retention in treatment. These results suggest that informal discussion may have adverse consequences on Hispanic clients’ motivation for change and substance abuse treatment outcomes and that maintaining a more formal relationship in early treatment sessions may work best with Hispanic clients. Careful counselor training and supervision in MET may suppress the tendency of counselors to talk informally in sessions. PMID:20817381

  16. Reasons for dropout from drug abuse treatment: symptoms, personality, and motivation.

    PubMed

    Ball, Samuel A; Carroll, Kathleen M; Canning-Ball, Monica; Rounsaville, Bruce J

    2006-02-01

    Previous research has identified risk factors for early attrition from substance abuse treatment, but has not assessed reasons for dropout from the client's perspective. Interview and self-report assessment data were collected from 24 clients who prematurely terminated outpatient treatment to evaluate their subjective reasons for dropping out and the association of these reasons with demographic and clinical variables. Items from scales indicating problems with client motivation or conflicts with program staff were the most commonly endorsed. The severity of participant's symptoms and logistical problems interfering with appointments were less commonly reported as reasons for dropping out. Demographic, substance abuse, and motivational stage indicators were infrequently associated with subjective reasons for dropout. In contrast, indicators of maladaptive personality functioning were strongly associated with many reasons for dropping out, especially concerns about privacy and boundary issues within the program. Results from this preliminary evaluation will guide the development of an instrument and intervention focused on dropout risk factors and treatment reengagement.

  17. NIDA’s Clinical Trials Network: An Opportunity for HIV Research in Community Substance Abuse Treatment Programs

    PubMed Central

    Tross, Susan; Campbell, Aimee N. C.; Calsyn, Donald A.; Metsch, Lisa R.; Sorensen, James L.; Shoptaw, Steven; Haynes, Louise; Woody, George E.; Malow, Robert M.; Brown, Lawrence S.; Feaster, Daniel J.; Booth, Robert E.; Mandler, Raul N.; Masson, Carmen; Holmes, Beverly W.; Colfax, Grant; Brooks, Audrey J.; Hien, Denise A.; Schackman, Bruce R.; Korthuis, P. Todd; Miele, Gloria M.

    2012-01-01

    Background/Objectives HIV continues to be a significant problem among substance users and their sexual partners in the United States. The National Drug Abuse Treatment Clinical Trials Network (CTN) offers a national platform for effectiveness trials of HIV interventions in community substance abuse treatment programs. This article presents the HIV activities of the CTN during its first 10 years. Results While emphasizing CTN HIV protocols, this article reviews the (1) HIV context for this work; (2) the collaborative process among providers, researchers, and National Institute on Drug Abuse CTN staff, on which CTN HIV work was based; (3) results of CTN HIV protocols and HIV secondary analyses in CTN non-HIV protocols; and (4) implications for future HIV intervention effectiveness research in community substance abuse treatment programs. Conclusion/Significance While the feasibility of engaging frontline providers in this research is highlighted, the limitations of small to medium effect sizes and weak adoption and sustainability in everyday practice are also discussed. PMID:21854270

  18. Cost-Effectiveness of Connecticut's In-Prison Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Daley, Marilyn; Love, Craig T.; Shepard, Donald S.; Petersen, Cheryl B.; White, Karen L.; Hall, Frank B.

    2004-01-01

    Over the past two decades, the criminal justice population in the US has grown by over 200%, most of this due to an increase in drug-involved offenders. Although there is good evidence that prison-based substance abuse treatment programs can be effective in reducing rearrest, few cost-effectiveness studies have been conducted. Using data from the…

  19. Abuse of elderly people by their carers.

    PubMed Central

    Homer, A C; Gilleard, C

    1990-01-01

    OBJECTIVE--To assess the prevalence of abuse of elderly people by their carers and the characteristics of abusers and the abused. DESIGN--Information on abuse and risk factors was collected over six months from carers and patients. Risk factors were identified in the abused group and compared with those in a non-abused control group. SETTING--Carers were interviewed at home; patients were examined in the wards of Putney and Barnes geriatric hospitals, London. SUBJECTS--All patients referred from any source for respite care to the geriatric services over a six month period and their carers. MAIN OUTCOME MEASURES--Amount of physical and verbal abuse or neglect. Quantification of risk factors and correlation with the presence or absence of abuse. RESULTS--45% Of carers openly admitted to some form of abuse. Few patients admitted abuse. The most significant risk factor for physical abuse was alcohol consumption by the carer (p less than 0.001). Other significant risk factors were a poor pre-morbid relationship and previous abuse over many years. Abuse was often reciprocated and was associated with social dysfunction in many patients. Service delivery, respite care, and level of mental and physical disability were not significantly associated with abuse. CONCLUSION--The high level of abuse found in elderly patients in respite care was particularly associated with alcohol abuse and long term relationships of poor quality, which are difficult to change. Even with increased provision of services, care in the community may not be the best solution for these people. PMID:2271883

  20. A Comparison of Daily Versus Weekly Electronic Cigarette Users in Treatment for Substance Abuse.

    PubMed

    Gubner, Noah R; Pagano, Anna; Tajima, Barbara; Guydish, Joseph

    2018-04-02

    This research examined electronic cigarette (e-cigarette) use by individuals in treatment for substance abuse, a population with a high prevalence of tobacco use and poor smoking cessation outcomes. We surveyed 1127 individuals from 24 substance abuse treatment centers across the United States. Bivariate analyses and logistic regression were used to examine factors associated with daily (N = 87) versus weekly (N = 81) e-cigarette use. Among the full sample, 59.8% reported any lifetime use of e-cigarettes, with 23.6% reporting past 30-day use. Daily e-cigarette users were more likely to have used second-generation, tank-type e-cigarettes, χ2(1,N = 165) = 11.54, p = .001, used more flavors overall, t(168) = 2.15, p = .03, and were more likely to report using their e-cigarette continuously throughout the day, χ2(4,N = 168) = 16.7, p = .002, compared to weekly e-cigarette users. Over half (57.7%) of the daily and weekly e-cigarette users reported having an e-cigarette device that broke. The logistic regression model adjusting for clinic type and days with poor mental health found that daily e-cigarette users were significantly more likely than weekly e-cigarette users to be from methadone clinics (adjusted odds ratio [AOR] = 2.40, p = .04), and former smokers (AOR = 6.37, p < .002). Daily e-cigarette users in substance abuse treatment were more likely to be from methadone clinics and former cigarette smokers. However, the majority (73.6%) of daily e-cigarette users were current cigarette smokers. E-cigarette device type reliability (eg, breakage) may be an important factor to consider among drug treatment and other populations with lower socioeconomic status. This study found several differences in the device type, flavors, and use characteristics of daily versus weekly e-cigarette users. While majority of e-cigarette users in substance abuse treatment were current cigarette smokers, daily e-cigarette users were more likely to be former cigarette smokers