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Sample records for abuse treatment clinics

  1. HIV Rapid Testing in Substance Abuse Treatment: Implementation Following a Clinical Trial

    ERIC Educational Resources Information Center

    Haynes, L. F.; Korte, J. E.; Holmes, B. E.; Gooden, L.; Matheson, T.; Feaster, D. J.; Leff, J. A.; Wilson, L.; Metsch, L. R.; Schackman, B. R.

    2011-01-01

    The Substance Abuse Mental Health Services Administration has promoted HIV testing and counseling as an evidence-based practice. Nevertheless, adoption of HIV testing in substance abuse treatment programs has been slow. This article describes the experience of a substance abuse treatment agency where, following participation in a clinical trial,…

  2. 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…

  3. 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

  4. 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. PMID:16716846

  5. Differences in methylphenidate abuse rates among methadone maintenance treatment patients in two clinics.

    PubMed

    Peles, Einat; Schreiber, Shaul; Linzy, Shirley; Domani, Yoav; Adelson, Miriam

    2015-07-01

    Methylphenidate, an amphetamine-like prescription medication for attention deficit hyperactivity disorder (ADHD) was suspected as being abused among methadone maintenance treatment (MMT) patients. We tested its presence in the routine urine monitoring of all patients in both Tel Aviv and Las Vegas MMT clinics. Data on demographic and addiction history, ADHD (Wender Utah Rating Scale), cognitive impairment (Mini Mental State Exam), and lifetime DSM-IV-TR psychiatric diagnosis from admission were retrieved, and retention following 6 months. None of the 190 patients in Las Vegas tested positive for methylphenidate, while 14.7% (45/306) did in Tel Aviv. Abusers were less educated (p = 0.01), had higher ADHD scores (p = 0.02), lower cognitive scores (p = 0.05), and a higher benzodiazepine (BDZ) abuse rate (p < 0.0005), with no difference in age, gender, duration in MMT, cannabis, opiates, and cocaine abuse and infectious disease. Of the methylphenidate abuse 42.2% have take-home methadone dose privileges. Not like opiate use, being methylphenidate positive did not relate to 6-months retention. Compared to Tel Aviv, Las Vegas patients were more educated, with lower BDZ, and cocaine abuse. The greater abuse of methylphenidate among ADHD subjects might indicate their using it as self-medication, raising a possible indication for its prescription for that subgroup of MMT patients. The high rate of methylphenidate abuse in Israel needs future study. PMID:25605438

  6. 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

  7. Treatment of Adolescent Marijuana Abuse: A Randomized Clinical Trial. Presentation 1: Structure of the Cannabis Youth Treatment Study.

    ERIC Educational Resources Information Center

    Titus, Janet C.; Dennis, Michael L.; Diamond, Guy; Godley, Susan H.; Babor, Thomas; Donaldson, Jean; Herrell, James; Tims, Frank; Webb, Charles

    The Cannabis Youth Treatment (CYT) study is a multi-site randomized field experiment examining five outpatient treatment protocols for adolescents who abuse or are dependent on marijuana. The purpose of the CYT project is twofold: (a) to test the relative clinical effectiveness and cost-effectiveness of five promising interventions targeted at…

  8. Motivational incentives research in the National Drug Abuse Treatment Clinical Trials Network.

    PubMed

    Stitzer, Maxine L; Petry, Nancy M; Peirce, Jessica

    2010-06-01

    The purpose of this article is to review both main findings and secondary analyses from studies of abstinence incentives conducted in the National Drug Abuse Treatment Clinical Trials Network (CTN). Previous research has supported the efficacy of tangible incentives provided contingent on evidence of recent drug abstinence. CTN conducted the first multisite effectiveness trial of this novel intervention. Study participants were stimulant abusers (N = 803) participating in treatment at 14 clinical sites and randomly assigned to treatment as usual with or without a prize draw incentive program. Study participants could earn up to $400 over 3 months for submission of drug-free urine and breath (BAL) specimens. Three-month retention was significantly improved by incentives offered to psychosocial counseling clients (50% incentive vs. 35% control retained), whereas ongoing stimulant drug use was significantly reduced in methadone maintenance clients (54.4% incentive vs. 38.7% control samples testing stimulant-negative). In both settings, duration of continuous abstinence achieved was improved in the incentive condition. These studies support effectiveness of one abstinence incentive intervention and highlight the different outcomes that can be expected with application in methadone maintenance versus psychosocial counseling treatment settings. Secondary analyses have shown the importance of early treatment positive versus negative urine screens in moderating the outcome of abstinence incentives and have explored both safety and cost-effectiveness of the intervention. Implications for the use of motivational incentive methods in clinical practice are discussed. PMID:20307797

  9. Clinical supervision, emotional exhaustion, and turnover intention: a study of substance abuse treatment counselors in the Clinical Trials Network of the National Institute on Drug Abuse.

    PubMed

    Knudsen, Hannah K; Ducharme, Lori J; Roman, Paul M

    2008-12-01

    An intriguing hypothesis is that clinical supervision may protect against counselor turnover. This idea has been mentioned in recent discussions of the substance abuse treatment workforce. To test this hypothesis, we extend our previous research on emotional exhaustion and turnover intention among counselors by estimating the associations between clinical supervision and these variables in a large sample (N = 823). An exploratory analysis reveals that clinical supervision was negatively associated with emotional exhaustion and turnover intention. Given our previous findings that emotional exhaustion and turnover intention were associated with job autonomy, procedural justice, and distributive justice, we estimate a structural equation model to examine whether these variables mediated clinical supervision's associations with emotional exhaustion and turnover intention. These data support the fully mediated model. We found that the perceived quality of clinical supervision is strongly associated with counselors' perceptions of job autonomy, procedural justice, and distributive justice, which are, in turn, associated with emotional exhaustion and turnover intention. These data offer support for the protective role of clinical supervision in substance abuse treatment counselors' turnover and occupational well-being. PMID:18424048

  10. The taking of free condoms in a drug abuse treatment clinic: the effects of location and posters.

    PubMed

    Amass, L; Bickel, W K; Higgins, S T; Budney, A J; Foerg, F E

    1993-10-01

    Drug abuse treatment programs can help reduce high-risk sexual behavior in drug users by promoting condom use. This study examined the influence of distribution location and poster prompts on the taking of free condoms in a drug abuse treatment clinic. Over 6 months, condoms were available alternately, with and without poster prompts, in the clinic's private restroom or public waiting area. Overall, 381% more condoms were taken from the restroom. The presence of poster prompts did not affect condom taking. These results suggest that distribution location is a critical factor in promoting condom taking in public clinic. PMID:8214242

  11. Clinical presentations of substance abuse in bipolar heroin addicts at time of treatment entry

    PubMed Central

    2012-01-01

    Background Studies on the ‘self-medication hypothesis’ have focused on substance abuse as an attempt to alleviate emotional suffering. Methods We have investigated concomitant substances of abuse in 150 bipolar heroin addicts clustered according to their clinical presentation at treatment entry (depressive episode, hypomanic episode, manic episode and mixed episode). Bipolar heroin addicted patients were chosen because they tend to have a concomitant poly-substance abuse and because, as compared with patients suffering for other mental illnesses, they more clearly reveal a variety of identifiable affective states. Results Patients with a depressive episode more frequently used non-prescribed anxiolytic-hypnotics. They were found to use cocaine-amphetamines more frequently during a hypomanic episode, whereas the use of cannabis and cocaine-amphetamines occurred more frequently during a manic episode. The associated use of alcohol, cocaine-amphetamines and cannabinoids was more frequently encountered during a mixed episode. Limitations: apart from the difficulty in determining whether the substance use modifies the mood or the mood state determines the substance used, this is a report on a retrospective analysis, rather than a study specifically designed to elucidate the issue; in addition, no information was available on the temperament of our subjects. Assessments of the same subject in various clinical presentations would have provided a better level of information. Conclusions Besides one expected result – the prominent use of CNS stimulants during a depressive phase of bipolar patients – this study supports the hypothesis that mood elation is a pleasurable, rewarding experience that, in bipolar patients, can be started or prolonged by means of CNS stimulant drugs. Stimulant use was, therefore, more prevalent during the ‘up’ rather than the ‘down’ phase of the illness. PMID:22943591

  12. [Women in outpatient treatment for alcohol abuse: sociodemographic and clinical characteristics].

    PubMed

    Esper, Larissa Horta; Corradi-Webster, Clarissa Mendonça; Carvalho, Ana Maria Pimenta; Furtado, Erikson Felipe

    2013-06-01

    Quantitative and descriptive study aimed to identify sociodemographic and clinical characteristics of women undergoing outpatient treatment for alcohol abuse. Data were collected from medical records of women with alcohol-related disorders who were treated at a psychiatric outpatient service We performed a reading and descriptive analysis of such data. The sample was composed of 27 medical records, the average age of women was 50 years, mostly married (59.6%), not working (70.4%) with incomplete primary education (70.4%), with an alcoholic family (81.5%) and other psychiatric diagnoses (70.3%). Losses physical, social and emotional was the most common symptoms resulting from alcohol withdrawal syndrome (66.7%), family conflicts (72%) and "sadness" (79.2%). Family violence was recorded in 11 records (40.7%). There was low education, unemployment, psychiatric comorbidities and the presence of other family members with alcohol abuse as common characteristics. We emphasize the importance of professional knowledge about the peculiarities of female alcoholism for health activities more effective. PMID:24015467

  13. Treatment for Sexually Abused Children and Adolescents.

    ERIC Educational Resources Information Center

    Saywitz, Karen J.; Mannarino, Anthony P.; Berliner, Lucy; Cohen, Judith A.

    2000-01-01

    Reviews research demonstrating the variable effects of childhood sexual abuse, need for intervention, and effectiveness of available treatment. Proposes extending and modifying treatment from mainstream clinical child psychology to sexually abused children. Interventions range from psychoeducation and screening, to short-term, abuse-focused…

  14. Cigarette smoking during substance use disorder treatment: Secondary outcomes from a National Drug Abuse Treatment Clinical Trials Network study

    PubMed Central

    McClure, Erin A.; Campbell, Aimee N. C.; Pavlicova, Martina; Hu, Meichen; Winhusen, Theresa; Vandrey, Ryan G.; Ruglass, Lesia M.; Covey, Lirio S.; Stitzer, Maxine L.; Kyle, Tiffany L.; Nunes, Edward V.

    2015-01-01

    Introduction The majority of patients enrolled in treatment for substance use disorders (SUDs) also use tobacco. Many will continue to use tobacco even during abstinence from other drugs and alcohol, often leading to smoking-related illnesses. Despite this, little research has been conducted to assess the influence of being a smoker on SUD treatment outcomes and changes in smoking during a treatment episode. Methods In this secondary analysis, cigarette smoking was evaluated in participants completing outpatient SUD treatment as part of a multi-site study conducted by the National Drug Abuse Treatment Clinical Trials Network. Analyses included the assessment of changes in smoking and nicotine dependence via the Fagerström Test for Nicotine Dependence during the 12-week study among all smokers (Aim #1), specifically among those in the experimental treatment group (Aim #2), and the moderating effect of being a smoker on treatment outcomes (Aim #3). Results Participants generally did not reduce or quit smoking throughout the course of the study. Among a sub-set of participants with higher baseline nicotine dependence scores randomized to the control arm, scores at the end of treatment were lower compared to the experimental arm, though measures of smoking quantity did not appear to decrease. Further, being a smoker was associated with poorer treatment outcomes compared to non-smokers enrolled in the trial. Conclusions This study provides evidence that patients enrolled in community-based SUD treatment continue to smoke, even when abstaining from drugs and alcohol. These results add to the growing literature encouraging the implementation of targeted, evidence-based interventions to promote abstinence from tobacco among SUD treatment patients. PMID:25595301

  15. Characteristics of Northern Plains American Indians seeking substance abuse treatment in an urban, non-tribal clinic: a descriptive study.

    PubMed

    Kropp, Frankie; Somoza, Eugene; Lilleskov, Maurine; Moccasin, Mabel Granados-Bad; Moore, Michelle; Lewis, Daniel; Boetel, Brenda; Smith, Corey; Winhusen, Theresa

    2013-12-01

    Because few data exist on substance abuse rates in American Indian (AI) communities, the Methamphetamine and Other Drug project was developed and implemented by five nodes within the National Institute on Drug Abuse Clinical Trials Network (NIDA CTN). This article presents findings from AI clients in a Northern Plains urban non-Native substance abuse treatment setting. Alcohol and marijuana were used earlier, longer, and by more clients, followed by stimulants and prescription opioids. Most regularly smoked tobacco. Differences in substance use patterns were associated with age of onset and victimization. Age of onset was correlated with victimization, gender, cognitive impairment, and suicidal behavior. Despite considerable health and economic disparities, most clients found support for recovery in relationships and elements of Native culture. PMID:22843125

  16. Zipeprol (Zinolta) abuse among American adolescents in Korea: a discussion of the problem, clinical presentation, and treatment.

    PubMed

    Ritchie, E C; Andress, D; Yi, S; Styles, J R

    1996-01-01

    Zipeprol dihydrochloride (Zinolta) is a Korean medication that is abused by American dependent teenagers in Korea. The adolescents usually present for medical care after a seizure. Since this medication is not available in the United States, many physicians are unfamiliar with zipeprol-induced seizures. The extent of the problem, the pharmacology and mechanism of action of zipeprol, the clinical presentation, and suggestions for treatment are discussed. Military physicians should consider zipeprol overdose when a teenager presents with a seizure. PMID:11082743

  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. The use and abuse of attachment theory in clinical practice with maltreated children, part II: treatment.

    PubMed

    Allen, Brian

    2011-01-01

    Recent years have witnessed a growing debate about the role of attachment theory in the treatment of maltreated children. Many professional organizations have issued statements against physically restraining children as some attachment therapists promote; however, often lost in these debates is the fundamental issue of what attachment theory and research proposes as the appropriate form of treatment. Given that these attachment therapies are often directed toward maltreated children, it becomes critical for clinicians working with abused and neglected children to understand these issues and recognize unethical and dangerous treatments. This article provides a summary of the theoretical and empirical bases for the use of attachment theory in the treatment of maltreated school-age children, an examination of the ways questionable approaches to treatment have misinterpreted and misapplied attachment theory, and a conceptualization of attachment-based intervention grounded in current theory and research. PMID:21288932

  19. Dental Treatment Abuse

    PubMed Central

    Ataide, Ida De Noronha De; Krishnan, Ramesh; Pavaskar, Rajdeep

    2014-01-01

    These case reports highlight dental treatment abuse performed by a quack on children. The anterior teeth of these children were metal capped using cement, which were otherwise healthy. The treatment was done on children without parental consent by a quack from Denmark who gave the reason as for resolving proclination of upper permanent incisors. The unanatomic, unaesthetic metal caps were removed after the child reported to the Department of Pedodontics and Preventive Dentistry. PMID:25177645

  20. Dental treatment abuse.

    PubMed

    Chalakkal, Paul; Ataide, Ida De Noronha De; Krishnan, Ramesh; Pavaskar, Rajdeep

    2014-07-01

    These case reports highlight dental treatment abuse performed by a quack on children. The anterior teeth of these children were metal capped using cement, which were otherwise healthy. The treatment was done on children without parental consent by a quack from Denmark who gave the reason as for resolving proclination of upper permanent incisors. The unanatomic, unaesthetic metal caps were removed after the child reported to the Department of Pedodontics and Preventive Dentistry. PMID:25177645

  1. Vocational Rehabilitation of the Drug Abuser: Treatment Planning and Clinical Supervision. No. 5 in a Series.

    ERIC Educational Resources Information Center

    Wolkstein, Eileen; Richman, Alex

    An outline of vocational rehabilitation of the ex-addict is presented, with emphasis placed on the development of treatment plans, counselor inservice training, and clinical procedures. Discussion is based on the Beth Israel Medical Center (BIMC) programs of Methadone Maintenance Treatment and Alcohol Treatment. Section 1, Proceedings, defines…

  2. Sexual Abuse and its Relation to Chronic Pain among Women from a Methadone Maintenance Clinic versus a Sexual Abuse Treatment Center.

    PubMed

    Peles, Einat; Seligman, Zivya; Bloch, Miki; Potik, David; Sason, Anat; Schreiber, Shaul; Adelson, Miriam

    2016-01-01

    To determine the effect of sexual abuse history on chronic pain and its relation to opioid addiction and methadone maintenance treatment (MMT), we studied current women MMT patients, and women patients from a sexual abuse treatment center with no history of opioid addiction. Questionnaires included Chronic Pain, Chronic Severe Pain, the Yale-Brown Obsessive Compulsive Scale, the Dissociative Experiences Scale (DES), and the Structured Interview for Disorders of Extreme Stress (complex-PTSD). Chronic severe pain was most prevalent among sexually abused women with no history of opioid addiction (64% of 25), followed by sexually abused MMT women (30.9% of 68), and MMT women with no history of sexual abuse (25% of 8, p = 0.01). Pain severity correlated with dissociation and complex-PTSD scores. The sexually abused non-MMT women had higher rates of high dissociation scores (DES ≥ 30) and complex-PTSD, but fewer obsessive-compulsive disorder symptoms (scored ≥16) than the MMT sexually abused women. Chronic pain was found to be highly prevalent among sexually abused women, independent of being methadone-maintained with an addiction history. The high known prevalence of chronic pain among MMT patients, which may be attributable to opioid-induced hyperalgesia, may partially reflect the sexual abuse history, and should be targeted in future studies evaluating pain indices. PMID:27430532

  3. Clinical differences between opioid abuse classes ameliorated after 1 year of buprenorphine-medication assisted treatment.

    PubMed

    Tkacz, Joseph; Severt, Jamie; Kassed, Cheryl; Ruetsch, Charles

    2012-01-01

    This study compared the clinical and demographic profiles of three opioid-dependent user groups, and measured their response to 1 year of buprenorphine-medication assisted treatment. Opioid prescription, street, and combination (street + prescription) users completed the Addiction Severity Index multiple times over the course of one treatment year. Although groups differed on all measured demographics (P values <.05) and on six of seven Addiction Severity Index composite scores at induction (P values <.05), differences were ameliorated after 1 year. Findings highlight the disparities between the various opioid-dependent patient subpopulations and suggest that buprenorphine-medication assisted treatment is an effective treatment across user subtypes. PMID:22540432

  4. Clinical supervision, emotional exhaustion, and turnover intention: A study of substance abuse treatment counselors in NIDA’s Clinical Trials Network

    PubMed Central

    Knudsen, Hannah K.; Ducharme, Lori J.; Roman, Paul M

    2008-01-01

    An intriguing hypothesis is that clinical supervision may protect against counselor turnover. This idea has been mentioned in recent discussions of the substance abuse treatment workforce. To test this hypothesis, we extend our previous research on emotional exhaustion and turnover intention among counselors by estimating the associations between clinical supervision and these variables in a large sample (n = 823). An exploratory analysis reveals that clinical supervision was negatively associated with emotional exhaustion and turnover intention. Given our previous findings that emotional exhaustion and turnover intention were associated with job autonomy, procedural justice, and distributive justice, we estimate a structural equation model to examine whether these variables mediated clinical supervision’s associations with emotional exhaustion and turnover intention. These data support the fully mediated model. We found the perceived quality of clinical supervision is strongly associated with counselors’ perceptions of job autonomy, procedural justice, and distributive justice, which are, in turn, associated with emotional exhaustion and turnover intention. These data offer support for the protective role of clinical supervision in substance abuse treatment counselors’ turnover and occupational wellbeing. PMID:18424048

  5. Comorbidity of Schizophrenia and Substance Abuse: Implications for Treatment.

    ERIC Educational Resources Information Center

    Mueser, Kim T.; And Others

    1992-01-01

    Reviews substance abuse disorders in schizophrenia patients, including prevalence of comorbid disorders, assessment, hypothesized mechanisms underlying abuse, and clinical effects of abuse on course of illness and cognitive functioning. Outlines principles of treatment for dual-diagnosis schizophrenia patients, noting limitations of existing…

  6. Overview: Clinical Identification of Sexually Abused Children.

    ERIC Educational Resources Information Center

    Corwin, David L.; Olafson, Erna

    1993-01-01

    This introduction to the special issue on clinical identification of sexually abused children reviews the history of the study of child sexual abuse and describes the 14 papers included in the special issue. (JDD)

  7. Medical marijuana users in substance abuse treatment

    PubMed Central

    2010-01-01

    Background The rise of authorized marijuana use in the U.S. means that many individuals are using cannabis as they concurrently engage in other forms of treatment, such as substance abuse counseling and psychotherapy. Clinical and legal decisions may be influenced by findings that suggest marijuana use during treatment serves as an obstacle to treatment success, compromises treatment integrity, or increases the prevalence or severity of relapse. In this paper, the author reviews the relationship between authorized marijuana use and substance abuse treatment utilizing data from a preliminary pilot study that, for the first time, uses a systematic methodology to collect data examining possible effects on treatment. Methods Data from the California Outcomes Measurement System (CalOMS) were compared for medical (authorized) marijuana users and non-marijuana users who were admitted to a public substance abuse treatment program in California. Behavioral and social treatment outcomes recorded by clinical staff at discharge and reported to the California Department of Alcohol and Drug Programs were assessed for both groups, which included a sample of 18 reported medical marijuana users. Results While the findings described here are preliminary and very limited due to the small sample size, the study demonstrates that questions about the relationship between medical marijuana use and involvement in drug treatment can be systematically evaluated. In this small sample, cannabis use did not seem to compromise substance abuse treatment amongst the medical marijuana using group, who (based on these preliminary data) fared equal to or better than non-medical marijuana users in several important outcome categories (e.g., treatment completion, criminal justice involvement, medical concerns). Conclusions This exploratory study suggests that medical marijuana is consistent with participation in other forms of drug treatment and may not adversely affect positive treatment outcomes

  8. Clinical characteristics and treatment outcome of depression in patients with and without a history of emotional and physical abuse.

    PubMed

    Miniati, M; Rucci, P; Benvenuti, A; Frank, E; Buttenfield, J; Giorgi, G; Cassano, G B

    2010-04-01

    Clinical features and treatment outcome were compared in depressed outpatients with and without a history of emotional and physical abuse (EPA), including childhood maltreatment. Patients were initially randomized to IPT or SSRI and then augmented with the second treatment if they did not remit with monotherapy. Assessments included the SCID-I, the SCID-II for DSM-IV diagnoses, the HRSD, the QIDS and the Mood Spectrum Self-Report (MOODS-SR). Seventy-eight (25%) patients reported a history of EPA; 60 (76.9%) were women. Patients with a history of EPA did not differ from those without on HRSD scores at baseline, but showed an earlier age at onset of depression and a longer duration of illness. The two groups differed on several mood spectrum factors, namely: 'depressivemood' (15.6+/-4.9 vs. 13.5+/-5.4; p<0.004), 'psychomotorretardation' (11.7+/-4.5 vs. 9.6+/-4.7; p<0.001), 'drugandillness-relateddepression' (1.3+/-1.3 vs. 0.6+/-1.0; p<0.0001), and 'neurovegetativesymptoms' (8.3+/-2.6 vs. 6.9+/-2.9; p<0.0001). Patients with EPA had also a significantly longer time to remission (89 vs. 67days, log-rank test, p=0.035). The need for augmentation treatment was significantly more frequent among patients with EPA than in those without. The present study suggests that patients with a history of EPA show a subtype of depression characterized by poor treatment response and more severe neurovegetative and psychomotor symptoms. PMID:19800634

  9. Clinical Characteristics and Treatment Outcome of Depression in Patients with and without a History of Emotional and Physical Abuse

    PubMed Central

    Miniati, M.; Rucci, P.; Benvenuti, A.; Frank, E.; Buttenfield, J.; Giorgi, G.; Cassano, G.B.

    2009-01-01

    Clinical features and treatment outcome were compared in depressed outpatients with and without a history of emotional and physical abuse (EPA), including childhood maltreatment. Patients were initially randomized to IPT or SSRI and then augmented with the second treatment if they did not remit with monotherapy. Assessments included the SCID-I, the SCID-II for DSM-IV diagnoses, the HRSD, the QIDS and the Mood Spectrum Self-Report (MOODS-SR). Seventy-eight (25%) patients reported a history of EPA; 60 (76.9%) were women. Patients with a history of EPA did not differ from those without on HRSD scores at baseline, but showed an earlier age at onset of depression and a longer duration of illness. The two groups differed on several mood spectrum factors, namely: ‘depressive mood’ (15.6±4.9 vs. 13.5±5.4; p<0.004), ‘psychomotor retardation’ (11.7±4.5 vs. 9.6±4.7; p<0.001), ‘drug and illness-related depression’ (1.3±1.3 vs. 0.6±1.0; p<0.0001), and ‘neurovegetative symptoms’ (8.3±2.6 vs. 6.9±2.9; p<0.0001). Patients with EPA had also a significantly longer time to remission (89 vs. 67 days, log-rank test, p=0.035). The need for augmentation treatment was significantly more frequent among patients with EPA than in those without. The present study suggests that patients with a history of EPA show a subtype of depression characterized by poor treatment response and more severe neurovegetative and psychomotor symptoms. PMID:19800634

  10. Treatment for Childhood Chemical Abuse.

    ERIC Educational Resources Information Center

    Beschner, George

    1985-01-01

    Describes intervention and treatment services available to youth and adolescents with chemical abuse problems. Discusses necessary components of a comprehensive approach. Reviews research on treatment outcomes within the various types of programs along with research on the treatment models employed. (Author/LHW)

  11. Contingency management: utility in the treatment of drug abuse disorders.

    PubMed

    Stitzer, M L; Vandrey, R

    2008-04-01

    Contingency management (CM) is a strategy that uses positive reinforcement to improve the clinical outcomes of substance abusers in treatment, especially sustained abstinence from drugs of abuse. Further, CM has been adopted to improve methodology and interpretation of outcomes in clinical trials testing new pharmacotherapies and to improve adherence to efficacious medications in substance abuse patients. Thus, CM has proven to be widely useful as a direct therapeutic intervention and as a tool in treatment development. PMID:18305456

  12. Effect of dispenser location on taking free condoms in an outpatient cocaine abuse treatment clinic

    PubMed Central

    Carrigan, Danielle R.; Kirby, Kimberly C.; Marlowe, Douglas B.

    1995-01-01

    Crack cocaine use increases risky sexual behavior and HIV exposure; therefore, safe sexual practices should be encouraged during cocaine addiction treatment. Research indicates that placing condom dispensers in private restrooms increases taking free condoms. We investigated two other dispenser locations (a day room vs. counselors' offices) and found that substantially more condoms were taken when dispensers were in the day room. This is an important issue for public health facilities without private restrooms. PMID:16795876

  13. Long-term Outcomes from the National Drug Abuse Treatment Clinical Trials Network Prescription Opioid Addiction Treatment Study

    PubMed Central

    Weiss, Roger D.; Potter, Jennifer Sharpe; Griffin, Margaret L.; Provost, Scott E.; Fitzmaurice, Garrett D.; McDermott, Katherine A.; Srisarajivakul, Emily N.; Dodd, Dorian R.; Dreifuss, Jessica A.; McHugh, R. Kathryn; Carroll, Kathleen M.

    2015-01-01

    Background Despite the growing prevalence of prescription opioid dependence, longitudinal studies have not examined long-term treatment response. The current study examined outcomes over 42 months in the Prescription Opioid Addiction Treatment Study (POATS). Methods POATS was a multi-site clinical trial lasting up to 9 months, examining different durations of buprenorphine-naloxone plus standard medical management for prescription opioid dependence, with participants randomized to receive or not receive additional opioid drug counseling. A subset of participants (N=375 of 653) enrolled in a follow-up study. Telephone interviews were administered approximately 18, 30, and 42 months after main-trial enrollment. Comparison of baseline characteristics by follow-up participation suggested few differences. Results At Month 42, much improvement was seen: 31.7% were abstinent from opioids and not on agonist therapy; 29.4% were receiving opioid agonist therapy, but met no symptom criteria for current opioid dependence; 7.5% were using illicit opioids while on agonist therapy; and the remaining 31.4% were using opioids without agonist therapy. Participants reporting a lifetime history of heroin use at baseline were more likely to meet DSM-IV criteria for opioid dependence at Month 42 (OR=4.56, 95% CI=1.29-16.04, p<.05). Engagement in agonist therapy was associated with a greater likelihood of illicit-opioid abstinence. Eight percent (n=27/338) used heroin for the first time during follow-up; 10.1% reported first-time injection heroin use. Conclusions Long-term outcomes for those dependent on prescription opioids demonstrated clear improvement from baseline. However, a subset exhibited a worsening course, by initiating heroin use and/or injection opioid use. PMID:25818060

  14. 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

  15. Brief Family Treatment Intervention to Promote Aftercare among Substance Abusing Patients in Inpatient Detoxification: Transferring A Research Intervention to Clinical Practice

    PubMed Central

    O’Farrell, Timothy J.; Murphy, Marie; Alter, Jane; Fals-Stewart, William

    2008-01-01

    Two earlier studies showed that a brief family treatment (BFT) intervention for substance abusing patients in inpatient detoxification increased aftercare treatment post-detox. BFT consisted of meeting with the patient and a family member with whom the patient lived to review aftercare plans for the patient. A phone conference was used when logistics prevented an in-person family meeting. Based on the earlier research results, we trained a newly hired staff person to continue providing BFT. We monitored key process benchmarks derived from the earlier research studies to ensure ongoing fidelity in delivering BFT. This method proved successful in transferring BFT from delivery in a research study to ongoing delivery in routine clinical practice after the research ended. It also ensured that a high proportion of patients had their families contacted and included in planning the patients’ aftercare. PMID:18063317

  16. 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…

  17. 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…

  18. Psychopathology among cocaine abusers entering treatment.

    PubMed

    Kleinman, P H; Miller, A B; Millman, R B; Woody, G E; Todd, T; Kemp, J; Lipton, D S

    1990-07-01

    A number of different indicators of psychopathology were assessed in this study of 76 cocaine and crack abusers who entered outpatient treatment in New York City between June and December 1987. The majority (75%) had used cocaine for 4 years or more, and the majority (62%) spent over one thousand dollars a month on cocaine in the 6 months before entry into treatment. Forty-seven percent of the sample were found to be clinically depressed. Phobic disorders were the only other axis I diagnoses found in addition to depression, and all persons who were found to have phobic disorders also were diagnosed as having some form of depressive disorder. The four most common axis II diagnoses were antisocial personality (21%), passive-aggressive (21%), borderline (18%) and self-defeating (18%). Subjects were classified as falling into one of the following three categories of a newly developed "psychopathology classification": a) no diagnosed psychopathology except substance abuse or dependency; b) one or more axis II diagnoses, but no axis I diagnoses except for substance abuse or dependency; c) at least one axis I diagnosis in addition to drug disorders whether or not accompanied by an axis II diagnosis. Mean scores on subscales and total score on the SCL-90, as well as total score on the Beck Depression Inventory, were ordered by category of the classification scheme, with those having no diagnosed psychopathology except substance abuse having the lowest score and persons in the third category having the highest score.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2366058

  19. PTSD substance abuse comorbidity and treatment utilization.

    PubMed

    Brown, P J; Recupero, P R; Stout, R

    1995-01-01

    The present study investigates the prevalence of posttraumatic stress disorder (PTSD) among a sample of treatment-seeking substance abusers and examines the relationship between PTSD comorbidity and rates of inpatient substance abuse treatment. Eighty-four patients (48 male and 36 female) admitted for detoxification at a private hospital were administered self-report measures of lifetime stressor events, PTSD symptomatology, and prior treatment history. Approximately one quarter of the sample was found to present with significant PTSD symptomatology. Women were more likely than men to have been physically and sexually abused, and women reported experiencing a greater number of traumatic events. Consequently, more women than men were classified as having possible PTSD. With respect to inpatient substance abuse treatment admission rates, the PTSD group reported a greater number of hospitalizations than their non-PTSD counterparts. Implications of these findings for routine trauma screening and more effective treatment for substance abusers with concomitant PTSD are highlighted. PMID:7484319

  20. Substance abuse: clinical identification and management.

    PubMed

    Kulberg, A

    1986-04-01

    Substance abuse is a significant health problem in the adolescent population. Prevention is a formidable challenge, but attempts at discouraging experimentation in early adolescence and the promotion of healthy adult role models may be effective strategies. Questions that may elicit a history suggestive of abuse should be a routine part of the adolescent medical history. Pediatricians should be familiar with the important clinical findings resulting from intoxication with the various substances of abuse and should be able to recognize the "telltale" signs of abuse. Effective management is based on attention to the basics of life support, careful attention to the physical findings, and judicious use of specific therapeutic agents. Above all, a compassionate attitude should prevail if acute-phase recovery and long-term rehabilitation are to be successful. PMID:2870461

  1. Seeking Drug Abuse Treatment: Know What to Ask

    MedlinePlus

    ... Abuse Treatment: Know What To Ask » Introduction Seeking Drug Abuse Treatment: Know What To Ask Email Facebook Twitter Introduction The goal of drug abuse treatment is to stop drug use and allow ...

  2. Financing of substance abuse treatment services.

    PubMed

    Horgan, C M; Merrick, E L

    2001-01-01

    The financing of treatment for substance abuse problems has differed from the rest of financing of health care in part because of the dominant role of the public sector as the payer of services. Nonetheless, the rise of managed care has affected substance abuse treatment services as well as the rest of the health care system. Alternative payment mechanisms are one important component of some managed care approaches. Behavioral health carve-outs are another managed care development that has affected substance abuse services. In this chapter, salient features of financing for substance abuse treatment are reviewed within the conceptual framework of payers (purchasers and intermediaries), providers, and consumers. Existing literature on substance abuse treatment financing is summarized, while recognizing that much remains to be researched. PMID:11449744

  3. What Sex Abusers Say about Their Treatment: Results from a Qualitative Study on Pedophiles in Treatment at a Canadian Penitentiary Clinic

    ERIC Educational Resources Information Center

    Drapeau, Martin; Korner, Annett C.; Granger, Luc; Brunet, Louis

    2005-01-01

    This exploratory study used qualitative methodology to examine what pedophiles think about treatment, as well as their daily experience of a treatment program. To this end, twenty-three offenders receiving treatment from the La Macaza federal penitentiary clinic were interviewed using non-directive semi-structured interviews. Comparative analysis…

  4. 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…

  5. Outpatient Treatment for Substance-Abusing Offenders.

    ERIC Educational Resources Information Center

    Hirschel, J. David; Keny, Janet R.

    1990-01-01

    Discusses trend towards involving criminal offenders in substance abuse programs and utilizing outpatient settings in treatment. Appraises the treatment performance of both court-referred and voluntary clients and the impacts criminal-justice-referred clients may have upon other persons in treatment programs to which they are admitted. Discusses…

  6. Expanding psychiatry's role in child abuse treatment.

    PubMed

    Green, A H

    1979-10-01

    Child abuse, a problem that has plagued societies for centuries, has been largely ignored by psychiatrists, the author asserts. He traces the relatively recent interest in the problem of other medical specialists such as pediatricians and radiologists and maintains that it is time for psychiatrists to become more involved. He explains how problems of confidentiality, the patient's lack of motivation for treatment, and other factors have discouraged many psychiatrists from treating child abusers. He demonstrates ways psychiatrists can treat both the abused child and his family if they are willing to use non-traditional services such as home intervention. PMID:90001

  7. Substance Abuse Treatment Facility Locator

    MedlinePlus

    ... nbspMilitary insurance (e.g., TRICARE)   IHS/Tribal/Urban (ITU) funds   Access to recovery (ATR) voucher & ... abuse   Persons who have experienced intimate partner violence, domestic violence   Children with serious emotional disturbance ( ...

  8. Psychiatric diagnoses of treatment-seeking cocaine abusers.

    PubMed

    Rounsaville, B J; Anton, S F; Carroll, K; Budde, D; Prusoff, B A; Gawin, F

    1991-01-01

    In a sample of 298 cocaine abusers seeking inpatient (n = 149) or outpatient (n = 149) treatment, rates of psychiatric disorders were determined by means of the Schedule for Affective Disorders and Research Diagnostic Criteria. Overall, 55.7% met current and 73.5% met lifetime criteria for a psychiatric disorder other than a substance use disorder. In common with previous reports from clinical samples of cocaine abusers, these overall rates were largely accounted for by major depression, minor bipolar conditions (eg, hypomania, cyclothymic personality), anxiety disorders, antisocial personality, and history of childhood attention deficit disorder. Affective disorders and alcoholism usually followed the onset of drug abuse, while anxiety disorders, antisocial personality, and attention deficit disorder typically preceded drug abuse. PMID:1984761

  9. Informal Discussions in Substance Abuse Treatment Sessions

    PubMed Central

    Martino, Steve; Ball, Samuel A.; Nich, Charla; Frankforter, Tami L.; Carroll, Kathleen M.

    2009-01-01

    This study evaluated the extent to which counselors initiated informal discussions (i.e., general discussions and self-disclosures about matters unrelated to treatment) with their clients during treatment sessions within two National Institute on Drug Abuse Clinical Trial Network protocols involving adaptations of motivational interviewing (MI). Sixty counselors across the two protocols had 736 sessions independently rated for counselor treatment fidelity and the occurrence of informal discussions. The results showed that 88% of the counselors initiated informal discussions in their sessions and that the majority of these discussions involved counselors sharing personal information or experiences they had in common with their clients. The major finding was that counselor training in MI was associated with significantly less informal discussion across sessions. A higher frequency of informal discussion was related to less counselor MI proficiency and less in-session change in client motivation, though unrelated to client program retention and substance use outcomes. The findings suggest that while some informal discussion may help build an alliance between counselors and clients, too much of it may hinder counselors' proficient implementation of MI treatment strategies and the clients' motivational enhancement process. PMID:18835679

  10. Voucher-based incentives. A substance abuse treatment innovation.

    PubMed

    Higgins, Stephen T; Alessi, Sheila M; Dantona, Robert L

    2002-01-01

    In this report we provide an overview of research on the voucher-based incentives approach to substance abuse treatment. This approach was originally developed as a novel method for improving retention and increasing cocaine abstinence among cocaine-dependent outpatients. The efficacy of vouchers for those purposes is now well established, and plans are underway to move the intervention into effectiveness testing in community clinics. The use of vouchers also has been extended to the treatment of alcohol, marijuana, nicotine, and opioid dependence. Particularly noteworthy is that vouchers hold promise as an efficacious intervention with special populations of substance abusers, including pregnant and recently postpartum women, adolescents, and those with serious mental illness. Overall, voucher-based incentives hold promise as an innovative treatment intervention that has efficacy across a wide range of substance abuse problems and populations. PMID:12369474

  11. 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…

  12. Child Abuse: Differential Diagnosis, Differential Treatment.

    ERIC Educational Resources Information Center

    Land, Helen M.

    1986-01-01

    Assesses the relationship between treatment intensity and rehabilitation of 89 child abusers whose MMPI (Minnesota Multiphasic Personality Inventory) profiles revealed high levels of psychological distress. The relationship was positive and statistically significant. The client receiving intense weekly treatment for longer durations was assessed…

  13. What sex abusers say about their treatment: results from a qualitative study on pedophiles in treatment at a Canadian penitentiary clinic.

    PubMed

    Drapeau, Martin; Korner, Annett C; Granger, Luc; Brunet, Louis

    2005-01-01

    This exploratory study used qualitative methodology to examine what pedophiles think about treatment, as well as their daily experience of a treatment program. To this end, twenty-three offenders receiving treatment from the La Macaza federal penitentiary clinic were interviewed using non-directive semi-structured interviews. Comparative analysis was used to analyze the resulting material. The following themes are discussed based on the results of this analysis: (a) the participants' past experience of therapy; (b) motivations for choosing the La Macaza clinic for treatment; (c) the structure of the program; (d) the group dynamics; (e) the therapists; and (f) the hardships and difficulties of treatment. Results suggest that the therapists and the program may have a function of containment or holding. Although part of the therapeutic process involves a focus on identifying and reducing cognitive distortions, results also warn therapists against misusing this concept by applying it to legitimately different opinions. Findings are discussed in terms of possible program improvements. The authors conclude that greater attention must be given to process research. PMID:15914407

  14. Developing adaptive treatment strategies in substance abuse research.

    PubMed

    Murphy, Susan A; Lynch, Kevin G; Oslin, David; McKay, James R; TenHave, Tom

    2007-05-01

    For many individuals, substance abuse possesses characteristics of chronic disorders in that individuals experience repeated cycles of cessation and relapse; hence viewing drug dependence as a chronic, relapsing disorder is increasingly accepted. The development of a treatment for a chronic disorder requires consideration of the ordering of treatments, the timing of changes in treatment, and the use of measures of response, burden and adherence collected during treatment to make further treatment decisions. Adaptive treatment strategies provide a vehicle through which these issues can be addressed and thus provide a means toward improving and informing the clinical management of chronic substance abuse disorders. The sequential multiple assignment randomized trial (SMART) is particularly useful in developing adaptive treatment strategies. Simple analyses that can be used with the SMART design are described. Furthermore, the SMART design is compared with standard experimental designs. PMID:17056207

  15. 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

  16. Medical Student Abuse During Clinical Clerkships in Japan

    PubMed Central

    Nagata-Kobayashi, Shizuko; Sekimoto, Miho; Koyama, Hiroshi; Yamamoto, Wari; Goto, Eiji; Fukushima, Osamu; Ino, Teruo; Shimada, Tomoe; Shimbo, Takuro; Asai, Atsushi; Koizumi, Shunzo; Fukui, Tsuguya

    2006-01-01

    OBJECTIVE To assess the prevalence of medical student abuse during clinical clerkships in Japan. DESIGN A cross-sectional questionnaire survey. SETTING Six medical schools in Japan. PARTICIPANTS Final year (sixth-year) and fifth-year medical students in the period from September 2003 to January 2004. From a total of 559 students solicited, 304 (54.4%) returned the questionnaire, and 276 (49.4%: 178 male and 98 female) completed it. MEASUREMENTS Prevalence of medical student abuse in 5 categories: verbal abuse, physical abuse, academic abuse, sexual harassment, and gender discrimination; differences in abusive experience between male and female students; types of alleged abusers; reporting abusive experiences to authorities; and emotional effects of abusive experiences. RESULTS Medical student abuse was reported by 68.5% of the respondents. Verbal abuse was the most frequently experienced abuse (male students 52.8%, female students 63.3%). Sexual harassment was experienced significantly more often (P<.001) by female students (54.1%) than by male students (14.6%). Faculty members were most often reported as abusers (45.2% of cases). Abuse occurred most frequently during surgical rotations (42.0% of cases), followed by internal medicine (25.1%) and anesthesia rotations (21.8%). Very few abused students reported their abusive experiences to authorities (8.5%). The most frequent emotional response to abuse was anger (27.1% of cases). CONCLUSIONS Although experience of abuse during clinical clerkships is common among medical students in Japan, the concept of “medical student abuse” is not yet familiar to Japanese. To improve the learning environment, medical educators need to take action to resolve this serious issue. PMID:16390504

  17. Ethical Considerations for the Use of Family Therapy in Substance Abuse Treatment.

    ERIC Educational Resources Information Center

    Whittinghill, David

    2002-01-01

    This article examines the unique ethical considerations for the provision of family therapy as substance abuse treatment. Use of family therapy as substance abuse treatment has grown rapidly, but the ethical codes that guide clinical practice have not kept pace. Ethical pitfalls specific to family counseling within alcohol and drug treatment…

  18. 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.

  19. Substance Dependence, Abuse and Treatment: Findings from the 2000 National Household Survey on Drug Abuse.

    ERIC Educational Resources Information Center

    Epstein, Joan F.

    This report provides the first information on substance dependence, abuse, and treatment obtained from the 2000 National Household Survey on Drug Abuse (NHSDA). Several important changes to the NHSDA in 1999 and 2000 affected the estimates of drug use, as well as the estimates for dependence, abuse, and needing and receiving treatment. Following…

  20. 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,…

  1. Enactment and the treatment of abuse survivors.

    PubMed

    Plakun, E M

    1998-01-01

    Regardless of the approach employed, treatment of patients with histories of sexual or other abuse is a formidable challenge. One reason for this is the vulnerability to "enactment" inherent in therapeutic work with such patients. Enactment is a recently elaborated psychoanalytic notion, defined as a pattern of nonverbal interactional behavior between the two parties in a therapeutic situation, with unconscious meaning for both. It involves mutual projective identification between therapist and patient. This paper clarifies the nature of enactment (conceptualized here as involving either refusal or actualization of the transference by the therapist) and its treatment implications. Transference-countertransference enactment paradigms encountered in work with survivors of abuse are presented. The therapeutic consequences of failing to recognize and respond to such enactments in work with these patients are explored. Unrecognized enactments may lead therapists unwittingly to abdicate the therapeutic role by becoming abusive, abused or vicariously traumatized, excessively guilty, seductive, overinvolved, and/or exhortatory or to implant false memories. Ways of utilizing enactment to advance treatment are also described and illustrated. PMID:9559350

  2. Modeling Treatment Motivation in Substance-Abusing Women with Children

    ERIC Educational Resources Information Center

    Wilke, Dina J.; Kamata, Akihito; Cash, Scottye J.

    2005-01-01

    Objectives: Children are often considered a primary motivator for women seeking substance abuse treatment. This study tested a model predicting treatment motivation in substance-abusing mothers. Methods: This study was a secondary analysis of the Drug Abuse Treatment Outcome Study (DATOS). It used structural equation modeling to describe factors…

  3. Total Quality Management and Performance in Substance Abuse Treatment Centers

    PubMed Central

    Fields, Dail; Roman, Paul M

    2010-01-01

    Objective To examine the relationship of organizational characteristics of substance abuse treatment centers with their use of quality management practices (total quality management [TQM]) and the contribution of TQM use to a center's provision of comprehensive care and to use of evidence-based treatment practices. Data Sources Data were collected from a national sample of over 700 private and public substance abuse treatment centers in the National Treatment Center Study. Study Design The design was a cross-sectional field study. The key variables were three TQM practices, the provision of comprehensive treatment services, and the implementation of evidence-based treatment practices. Numerous organizational characteristics were controlled. Data Collection The data were obtained through interviews with administrative directors and clinical directors of the treatment centers in 2002–2004. Principal Findings In multivariate models, TQM practices were positively related to provision of comprehensive care and use of evidence-based practices. A limited set of organizational characteristics predicted the use of TQM practices. Conclusions Substance abuse treatment centers' implementation of TQM processes may be positively related to the quality and cost-effectiveness of care provided. PMID:20698897

  4. Delay Discounting Predicts Adolescent Substance Abuse Treatment Outcome

    PubMed Central

    Stanger, Catherine; Ryan, Stacy R.; Fu, Hongyun; Landes, Reid D.; Jones, Bryan A.; Bickel, Warren K.; Budney, Alan J.

    2014-01-01

    The purpose of the current study was to identify predictors of delay discounting among adolescents receiving treatment for marijuana abuse or dependence, and to test delay discounting as a predictor of treatment outcome. Participants for this study were 165 adolescents (88% male) between the ages of 12 and 18 (M =15.8; SD = 1.3) who enrolled in a clinical trial comparing three behavioral treatments for adolescent marijuana abuse or dependence. Participants completed a delay discounting task at treatment onset for $100 and $1,000 of hypothetical money and marijuana. Overall, smaller magnitude rewards were discounted more than larger magnitude rewards. Delay discounting rates were concurrently related to demographic variables (SES, race). Delay discounting of $1,000 of money predicted during treatment abstinence outcomes among adolescent marijuana abusers, over and above the effects of type of treatment received. Teens who show higher levels of discounting of the future may be an important subgroup to identify at treatment onset. Youth with a greater tendency to discount the future may require different intervention strategies that address their impulsivity (e.g., targeting executive function or inhibitory control) and/or different schedules of reinforcement to address their degree of preference for immediate rewards. PMID:22182419

  5. Delay discounting predicts adolescent substance abuse treatment outcome.

    PubMed

    Stanger, Catherine; Ryan, Stacy R; Fu, Hongyun; Landes, Reid D; Jones, Bryan A; Bickel, Warren K; Budney, Alan J

    2012-06-01

    The purpose of the current study was to identify predictors of delay discounting among adolescents receiving treatment for marijuana abuse or dependence, and to test delay discounting as a predictor of treatment outcome. Participants for this study were 165 adolescents (88% male) between the ages of 12 and 18 (mean age = 15.8 years; standard deviation = 1.3 years) who enrolled in a clinical trial comparing three behavioral treatments for adolescent marijuana abuse or dependence. Participants completed a delay discounting task at treatment onset for $100 and $1,000 of hypothetical money and marijuana. Overall, smaller magnitude rewards were discounted more than larger magnitude rewards. Delay discounting rates were concurrently related to demographic variables (socioeconomic status, race). Delay discounting of $1,000 of money predicted during treatment abstinence outcomes among adolescent marijuana abusers, over and above the effects of type of treatment received. Teens who show higher levels of discounting of the future may be an important subgroup to identify at treatment onset. Youth with a greater tendency to discount the future may require different intervention strategies that address their impulsivity (e.g., targeting executive function or inhibitory control) and/or different schedules of reinforcement to address their degree of preference for immediate rewards. PMID:22182419

  6. Developing Treatments for Stimulant Abuse: A Brief Overview.

    PubMed

    Davidson, C

    2016-06-01

    The abuse of stimulants such as cocaine, amphetamine, and methamphetamine is a huge problem in many parts of the world. Abuse of these drugs does not ruin just the user's life, but also adversely affects those around them. Despite many years of research, there are no approved medications for stimulant dependence, and treatment is focused on psychotherapy and abstinence. Over the last 10 to 20 years, there have been some major changes in approach to medication development for stimulant dependence. These include assessing ligands for non-dopaminergic sites, atypical dopamine transporter ligands, blocking long-term potentiation and / or memory reconsolidation, vaccines against the stimulant, and molecular approaches including pharmacogenomics and gene silencing. Also included in this overview are non-drug treatments such as deep brain stimulation and psychosurgery. This overview highlights recent preclinical and clinical studies of treatment development for stimulant dependence. PMID:27377486

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-01

    ... HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse... Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (CSAT.... Committee Name: Substance Abuse and Mental Health Services Administration's CSAT National Advisory...

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

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-01

    ... HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse... Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (CSAT.... Committee Name: Substance Abuse and Mental Health Services Administration's CSAT National Advisory...

  9. [Clinical study of BRON-L syrup (cough suppressant) abuse].

    PubMed

    Miyatake, Ryosuke; Doi, Tomoko; Date, Kenji; Naitoh, Tomomichi; Suwaki, Hiroshi

    2002-02-01

    In 1980s, abuse and dependence of BRON-W syrup (cough suppressant), which contains methylephedrine, dihydrocodeine, chlorpheniramine and caffeine, were prevalent in Japan. Pharmacological and clinical studies suggest that methylephedrine and dihydrocodeine cause dependence. Although BRON-L syrup, newly modified cough suppressant contains only chlorpheniramine and caffeine, there still are abuse and dependence of this drug. In this report, three cases of BRON-L syrup abuse are demonstrated. All cases started using BRON-L syrup in the late teens in their peer groups, and dropped out from school. Case 1 misused only BRON-L syrup, but case 2 and 3 were multi-drug abusers (case 2: amphetamine, cocaine, and marijuana, case 3: solvent, alcohol, bromovalerylurea), and had kept in tough with the peer groups. Case 2 and 3 hospitalized more than 2 times. Withdrawal symptoms, such as headache, insomnia, and irritability were mild and improved in a few weeks after drug use was stopped. These findings suggest that 1) psychosocial backgrounds of these cases are in common with those of BRON-W syrup abusers, but 2) the clinical course and prognosis of multi-drug abusers are different from the BRON single abuser, 3) chlorpheniramine and caffeine possibly cause dependence, 4) abusers are likely to choose BRON brand although two main dependence-producing constituents are removed from it now. Therefore, prevention and care of BRON-L abusers requires both psychosocial and pharmacological aspects. PMID:11915306

  10. 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…

  11. Pregabalin Abuse amongst Opioid Substitution Treatment Patients.

    PubMed

    McNamara, S; Stokes, S; Kilduff, R; Shine, A

    2015-01-01

    Pregabalin (Lyrica®) is used in treating epilepsy, nerve pain and anxiety. Pregabalin was initially thought to have a low misuse potential however there are emerging reports of Pregabalin being abused. A study was commenced at the National Drug Treatment Centre's (NDTC) Drug Analysis Laboratory to determine the level of usage of Pregabalin within the addiction services population in Ireland. A total of 498 urine samples representing samples from 440 individual opioid substitution patients, initially screened by immunoassay for drugs of abuse, were subjected to further analysis for Pregabalin by Liquid Chromatography/Mass Spectrometry (LC/MS). Of 440 patients tested, 39 tested positive for Pregabalin (9.2%). Only 10 patients from this group were prescribed this drug to our knowledge thus giving an estimated rate of misuse of 7.0%. Other drugs detected in the Pregabalin positive patients were Opiates (31.8%), Cocaine (11.4%), Benzodiazepines (79.5%) and Cannabis (77.8%). Our study confirms that Pregabalin abuse is taking place amongst the addiction services population. We believe that misuse of this prescription drug is a serious emerging issue which should be monitored carefully. PMID:26817289

  12. Psychological, physical, and sexual abuse in addicted patients who undergo treatment.

    PubMed

    Fernández-Montalvo, Javier; López-Goñi, José J; Arteaga, Alfonso

    2015-05-01

    This study explored the prevalence of a history as victims of abuse among patients who sought outpatient treatment for drug addiction. A sample of 252 addicted patients was assessed. Information was collected on the patients' lifetime history of abuse (psychological, physical, and/or sexual abuse), sociodemographic factors, consumption factors, psychopathological factors, and personality variables. Drug-addicted patients who present a lifelong history of abuse were compared with patients who were not abused. Of the total sample, 46% of the patients (n = 115) who were addicted to drugs had been victims of abuse. There was a statistically significant difference between the victimization rates of men (37.8%) and women (79.6%). Moreover, for some variables, significant differences were observed between patients who had been abused and those who had not. Compared with patients who had not been abused, the addicted patients with a history of victimization scored significantly higher on several European Addiction Severity Index, Millon Clinical Multiaxial Inventory-II, and maladjustment variables but not on the Symptom Checklist-90-Revised. The current results indicate that patients who present a lifelong history of abuse exhibit both a more severe addiction than patients who were not abused and several comorbidities. The implications of these results for further research and clinical practice are discussed. PMID:24992952

  13. The treatment of chronic insomnia: drug indications, chronic use and abuse liability. Summary of a 2001 New Clinical Drug Evaluation Unit meeting symposium.

    PubMed

    Mendelson, Wallace B; Roth, Thomas; Cassella, James; Roehrs, Timothy; Walsh, James K; Woods, James H; Buysse, Daniel J; Meyer, Roger E

    2004-02-01

    This paper summarizes a group of presentations and panel discussions on chronic insomnia at the 2001 NCDEU meeting. The presentations and discussions focused on the twin issues of efficacy and concerns of abuse liability with long-term hypnotic therapy. The panel concluded that insomnia may be an epidemiological marker for a variety of difficulties including accidents, increased health care utilization and subsequent development of major depression. Whether or not treatment of insomnia will prevent these long-term problems has not yet been determined. Since the mid-1980s there has been a rapid rise in the off-label use of antidepressants, particularly trazodone, for treating insomnia. Some participants expressed concern at the lack of data for this practice, particularly the absence of dose-response and tolerance information, and noted that the small amount of efficacy data available is not encouraging. Similarly, there are minimal data to support the use of antihistamines as sleep aids; moreover, their side effect profile and interactions with other drugs may be under appreciated. The limited data available on nightly long-term usage of the newer non-benzodiazepine hypnotics, primarily of six-months' duration, suggest an absence of tolerance, but more data for both nightly and non-nightly administration are needed. Insomniacs tend to show therapy-seeking, rather than drug-seeking behavior, and patients without histories of drug abuse are unlikely to self-escalate dosage of currently available hypnotics. There is fairly good agreement on the characteristics of an ideal hypnotic. All currently available agents, while effective and safe, do not achieve this ideal. The next few years are likely to see the appearance of a variety of agents with new and promising mechanisms of action. PMID:15062207

  14. Sexual Abuse of Children: A Clinical Spectrum

    ERIC Educational Resources Information Center

    Summit, Roland; Kryso, JoAnn

    1978-01-01

    The paper suggests that incest has been underestimated as a significant determinant of emotional disturbance, and that misuse of sexuality between parents and children can have detrimental consequences that parallel those resulting from other forms of child abuse. (Author)

  15. Psychiatric comorbidity of patients on methadone maintenance treatment with a history of sexual abuse.

    PubMed

    Peles, Einat; Potik, David; Schreiber, Shaul; Bloch, Miki; Adelson, Miriam

    2012-12-01

    The aim of this study was to assess the prevalence of a history of sexual abuse and its relation to psychiatric comorbidity among former opiate addicts currently on methadone maintenance treatment (MMT). We evaluated the history of sexual abuse and current clinical obsessive compulsive disorder (OCD), dissociative identity disorder (DID), and complex posttraumatic distress disorder (cPTSD), and administered the Life Events Inventory Questionnaire among 125 MMT patients (76 females and 49 males). Eighty (64%) patients had experienced sexual abuse, 69 (55.2%) met the criteria for clinical OCD, 20 (16.0%) for cPTSD and 13 (10.4%) for DID. More females had clinical OCD than males (63.2% vs. 42.9%, respectively, p=0.03). Sexually abused patients had higher rates of clinical OCD than their non-abused counterparts (67.5% vs. 33.3%, respectively, p<0.0005) and a higher mean number of negative life events (8.0±2.0 vs. 7.1±1.8, p=0.01). Sexually abused patients showed a trend towards a higher Dissociative Experiences Scale score (17.6±10.1 vs. 14.6±8.1, p=0.08) and rate of DID (13.8% vs. 4.4%, p=0.1), but no significant difference in the rate of cPTSD (17.5% vs. 13.3%, p=0.6) compared to non-abused subjects. The 80 sexually abused patients were mostly female (85%), and 57.5% of them were abused by a family member. In summary, more sexually abused MMT patients were diagnosed with clinical OCD and fewer with cPTSD and DID. Those with cPTSD were characterized by more negative life events, higher dissociation scores, and assaults by a family member. We conclude that sexually abused MMT patients should be screened for clinical OCD. PMID:22564825

  16. Infrequent Illicit Methadone Use Among Stimulant-Using Patients in Methadone Maintenance Treatment Programs: A National Drug Abuse Treatment Clinical Trials Network Study

    PubMed Central

    Wu, Li-Tzy; Blazer, Dan G.; Stitzer, Maxine L.; Patkar, Ashwin A.; Blaine, Jack D.

    2009-01-01

    We sought to determine the prevalence, patterns, and correlates of past-month illicit methadone use and history of regular illicit use among stimulant-using methadone maintenance treatment patients. We obtained self-reported information on illicit methadone use from 383 participants recruited from six community-based methadone maintenance programs. Overall, 1.6% of participants reported illicit use in the past month, and 4.7% reported a history of regular use. Younger age and history of outpatient psychological treatment were associated with increased odds of past-month illicit use. Illicit methadone use among patients in maintenance programs is infrequent; however, a number of factors may increase risk of illicit use. PMID:18612886

  17. Pay-for-performance in a community substance abuse clinic

    PubMed Central

    Vandrey, Ryan; Stitzer, Maxine L.; Acquavita, Shauna P.; Quinn-Stabile, Patricia

    2011-01-01

    Pay-for-performance (P4P) strategies improve employee productivity and morale in business settings and are increasingly being implemented in medical care settings. This study investigated whether P4P could improve treatment utilization and retention at a community drug treatment clinic. Counselors had the opportunity to earn cash bonuses based on therapy attendance rates of individual clients as well as the quarterly retention rates of their caseload. Using a pre-post study design, average therapy sessions attended during the first month of treatment increased from 4.6 sessions prior to the intervention to 5.5 sessions per client during the intervention. The 90-day client retention rate increased from 40% to 53%. Additional analyses suggest that the improvement in 90-day retention was mediated by the increase in attendance during the first month of treatment. This project demonstrates that implementing a P4P incentive program in community drug abuse treatment clinics is feasible and effective at improving utilization and retention. PMID:21489739

  18. Pay-for-performance in a community substance abuse clinic.

    PubMed

    Vandrey, Ryan; Stitzer, Maxine L; Acquavita, Shauna P; Quinn-Stabile, Patricia

    2011-09-01

    Pay-for-performance (P4P) strategies improve employee productivity and morale in business settings and are increasingly being implemented in medical care settings. This study investigated whether P4P could improve treatment utilization and retention at a community drug treatment clinic. Counselors had the opportunity to earn cash bonuses based on therapy attendance rates of individual clients and on the quarterly retention rates of their caseload. Using a pre-post study design, average therapy sessions attended during the first month of treatment increased from 4.6 sessions prior to the intervention to 5.5 sessions per client during the intervention. The 90-day client retention rate increased from 40% to 53%. Additional analyses suggest that the improvement in the 90-day retention was mediated by the increase in attendance during the first month of treatment. This project demonstrates that implementing a P4P incentive program in community drug abuse treatment clinics is feasible and effective at improving utilization and retention. PMID:21489739

  19. The Relationship Between the Clinical Orientation of Substance Abuse Professionals and Their Clinical Decisions

    ERIC Educational Resources Information Center

    Toriello, Paul J.; Leierer, Stephen J.

    2005-01-01

    In this study, the authors examined the relationship between the clinical orientations of substance abuse professionals (SAPs) and their clinical decisions. Cluster analysis grouped a sample of 245 SAPs on two clinical orientations that differed in their relative endorsement of traditional versus contemporary substance abuse counseling processes…

  20. Adolescent Victims of Abuse: A Treatment Model.

    ERIC Educational Resources Information Center

    Anderson-Merchant, Darlene

    This paper presents a theory and model for treating adolescent victims of physical and sexual abuse and neglect. The theory examines issues related to abuse or neglect and the effect that an abusive history has on adolescent development. Specific issues noted are depression, anger, low self-esteem, self-shame, lack of trust, a sense of…

  1. Early identification of alcohol abuse: 2: Clinical and laboratory indicators.

    PubMed Central

    Holt, S; Skinner, H A; Israel, Y

    1981-01-01

    Despite awareness of the wide variety of clinical and laboratory abnormalities associated with alcohol abuse, drinking problems often remain undetected in hospital and in general medical practice. The diagnosis of alcohol abuse has been emphasized repeatedly in the literature but far less attention has been paid to indicators that would permit detection of excessive drinking at a stage when intervention might be more effective and less costly. The search for indicators of early alcohol abuse is complicated since many of the medical sequelae of alcoholism are nonspecific and may only be manifested after a number of years of excessive drinking. Part 2 of this two-part series considers various clinical and laboratory features related to alcohol abuse and highlights items that are potentially more sensitive for detecting early stages of problem drinking. Use by physicians of a composite profile of both biomedical and psychosocial indicators of excessive alcohol consumption is recommended for early identification of this problem. PMID:7016289

  2. Health services for HIV/AIDS, HCV, and sexually transmitted infections in substance abuse treatment programs.

    PubMed

    Brown, Lawrence S; Kritz, Steven; Goldsmith, R Jeffrey; Bini, Edmund J; Robinson, Jim; Alderson, Donald; Rotrosen, John

    2007-01-01

    The National Drug Abuse Treatment Clinical Trials Network conducted this study to determine the availability of and factors associated with infection-related health services in substance abuse treatment settings. In a cross-sectional descriptive design, state policies, reimbursement for providers, state level of priority, and treatment program characteristics were studied via written surveys of administrators of substance abuse treatment programs and of state health and substance abuse departments. Data from health departments and substance abuse agencies of 48 states and from 269 substance abuse treatment programs revealed that human immunodeficiency virus/acquired immunodeficiency syndrome-related services are more frequent than hepatitis C virus or sexually transmitted infection-related services, and that nonmedical services are more frequent than medical services. While the availability of infection-related health services is associated with medical staffing patterns, addiction pharmacotherapy services, and state priorities, reimbursement was the most significant determining factor. These findings suggest that greater funding of these health services in substance abuse treatment settings, facilitated by supportive state policies, represents an effective response to the excess morbidity and mortality of these substance use-related infections. PMID:17639646

  3. Behavioral treatment of alcohol and drug abuse. What do we know and where shall we go?

    PubMed

    Hester, R K; Nirenberg, T D; Begin, A M

    1990-01-01

    Over the last 20 years there has been a substantial increase in the use of alcohol and drugs in industrialized nations and a concomitant shift in the emphasis of treatment for alcohol and drugs. Rather than seeking treatment for alcohol alone or a single class of drug, many individuals are seeking treatment for alcohol and/or a number of drugs. While theoreticians have been exploring the similarities in the addictive behaviors, clinical researchers are only just beginning to do so. Unfortunately, most treatment research has focused almost exclusively on alcohol abusers or drug abusers, with little research conducted to date with alcohol and drug abusers. Behavioral interventions developed for alcohol abuse are now being tested with drug abusers, and vice versa. The purpose of this chapter is fourfold: (1) to briefly discuss the similarities in the assessment of alcohol and drug abuse; (2) to describe behavioral interventions that have been supported by research and briefly review this treatment outcome research; (3) to discuss the theoretical similarities in behavioral interventions for alcohol and drug abuse; and (4) to make recommendations for future advancements in treatment and research. PMID:2185523

  4. Sex differences in drug abuse: Etiology, prevention, and treatment.

    PubMed

    Evans, Suzette M; Reynolds, Brady

    2015-08-01

    This special issue exemplifies one of the major goals of the current editor of Experimental and Clinical Psychopharmacology (Dr. Suzette Evans): to increase the number of manuscripts that emphasize females and address sex differences. Taken together, these articles represent a broad range of drug classes and approaches spanning preclinical research to treatment to better understand the role of sex differences in drug abuse. While not all studies found sex differences, we want to emphasize that finding no sex difference is just as important as confirming one, and should be reported in peer-reviewed journals. It is our intention and hope that this special issue will further advance scientific awareness about the importance of accounting for sex differences in the study of substance abuse. Participant sex is an essential variable to consider in developing a more comprehensive understanding of substance abuse. Rather than viewing investigating sex differences as burdensome, investigators should seize this opportune area ripe for innovative research that is long overdue. PMID:26237316

  5. Measurement of Gender-Sensitive Treatment for Women in Mixed-Gender Substance Abuse Treatment Programs†

    PubMed Central

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

    2011-01-01

    Background 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. Methods 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. Results 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. Conclusions 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. PMID:22138537

  6. 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…

  7. 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. PMID:15851510

  8. Assessment and Treatment of Sexually Abused Children and Adolescents.

    ERIC Educational Resources Information Center

    King, H. Elizabeth; And Others

    These papers on child and adolescent sexual abuse address the psychological consequences, psychological assessment techniques, and clinical issues in group therapy with sexually abused girls. In the first paper. H. Elizabeth King discusses the psychological consequences of sexual assault and incest on minors particularly in regard to family…

  9. Is managed care closing substance abuse treatment units?

    PubMed

    Wells, Rebecca; Harris Lemak, Christy; Alexander, Jeffrey A; Roddy, Brian L; Nahra, Tammie A

    2007-03-01

    Despite high levels of unmet need for outpatient substance abuse treatment, a significant percentage of outpatient units have closed over the past several years. This study drew on 1999-2000 and 2005 national surveys to determine if managed care was associated with outpatient substance abuse treatment units' likelihood of surviving. Each substance abuse unit director was asked about the presence of any managed care contracts, percentage revenues from managed care, percentage of clients for whom prior authorization was required, and percentage of clients for whom concurrent review was required. A multiple logistic regression revealed that none of these factors was associated with substance abuse treatment unit survival. At this point, neither the presence nor the structure of managed care appears to affect the survival of outpatient substance abuse treatment units. Given the need for these facilities, however, and their vulnerability to closure, continued attention to managed care's potential influence is warranted. PMID:17458479

  10. Psychometric properties of the Drug Use Disorders Identification Test (DUDIT) with substance abusers in outpatient and residential treatment.

    PubMed

    Voluse, Andrew C; Gioia, Christopher J; Sobell, Linda Carter; Dum, Mariam; Sobell, Mark B; Simco, Edward R

    2012-01-01

    The psychometric properties of the Drug Use Disorders Identification Test (DUDIT), an 11-item self-report questionnaire developed to screen individuals for drug problems, are evaluated. The measure, developed in Sweden and evaluated there with individuals with severe drug problems, has not been evaluated with less severe substance abusers or with clinical populations in the United States. Participants included 35 drug abusers in an outpatient substance abuse treatment program, 79 drug abusers in a residential substance abuse treatment program, and 39 alcohol abusers from both treatment settings who did not report a drug abuse problem. The DUDIT was found to be a psychometrically sound drug abuse screening measure with high convergent validity (r=.85) when compared with the Drug Abuse Screening Test (DAST-10), and to have a Cronbach's alpha of .94. In addition, a single component accounted for 64.91% of total variance, and the DUDIT had sensitivity and specificity scores of .90 and .85, respectively, when using the optimal cut-off score of 8. Additionally, the DUDIT showed good discriminant validity as it significantly differentiated drug from alcohol abusers. These findings support the DUDIT as a reliable and valid drug abuse screening instrument that measures a unidimensional construct. Further research is warranted with additional clinical populations. PMID:21937169

  11. [Child sexual abuse. Epidemiology, clinical diagnostics, therapy, and prevention].

    PubMed

    Fegert, J M; Hoffmann, U; Spröber, N; Liebhardt, H

    2013-02-01

    The article provides an overview of the research on sexual abuse and the current political developments in Germany. First, the terminology of sexual child abuse is discussed, followed by the presentation of epidemiological data. The section on diagnostics and therapy shows that--because of mostly nonspecific indicators--the diagnosis of child sexual abuse is very difficult to define. Child sexual abuse is discussed as a traumatic experience for children and adolescents with different psychiatric and physical diseases. Current studies have shown that especially cognitive behavioral therapeutic-oriented approaches are effective in curing posttraumatic stress disorders. Based on the new German Child Protection Act, the focus lies on the clarification of confidentiality for medical professionals and their right to consulting services for child protection. In conclusion, guidelines and minimum standards for a child prevention and protection model are presented as well as institutional recommendations addressed to all institutions (also clinical) that take care of or treat children and adolescents. PMID:23361204

  12. Including siblings in the treatment of child sexual abuse.

    PubMed

    Baker, J N; Tanis, H J; Rice, J B

    2001-01-01

    Siblings are often not included in treatment programs for children who have been sexually abused. This article describes the necessity of including siblings in the treatment of victims of child sexual abuse. Including siblings in treatment permits families to realize the maximum benefits of therapy for the victim as well as each family member. Theoretical and practical reasons to include siblings in treatment are discussed (i.e., preventing future abuse, providing support for siblings, teaching siblings to refrain from victim-blaming). Case examples using a particular intervention approach at The Family Learning Program and results of client satisfaction surveys are described. PMID:17521997

  13. Predictors of Substance Abuse Treatment Outcomes in Tennessee.

    ERIC Educational Resources Information Center

    Kedia, Satish; Williams, Charles

    2003-01-01

    Identifies and analyzes several variables important in predicting the likelihood of abstinence among substance abuse clients. Data was collected from 1,350 clients treated for alcohol or drug abuse in residential, halfway house, or outpatient facilities. Analyzing 22 variables as possible treatment outcome predictors, results found one…

  14. 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…

  15. 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…

  16. Adolescent Drug Use: Trends in Abuse, Treatment and Prevention.

    ERIC Educational Resources Information Center

    Gordon, Susan M.

    This report highlights the important trends in adolescent drug use. Although the focus is on the abuse of alcohol, nicotine, marijuana, cocaine, heroin, and inhalants, it is important to remember that adolescents abuse a wide range and combination of drugs. This report also addresses state-of-the-art treatment methods, and summarizes research on…

  17. 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…

  18. Juvenile Offender Comprehensive Reentry Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Watson, Donnie W.

    2004-01-01

    The literature provides ample evidence of the relationship of substance abuse to crime. Research over the last 20 years has established a strong correlation between substance abuse and juvenile delinquency (held, 1998). Currently, there are more than 350,000 juveniles on probation and in continuing care programs in the U.S. who have substance…

  19. Predicting Adolescent Drug Abuse Treatment Outcome with the Personal Experience Inventory (PEI)

    ERIC Educational Resources Information Center

    Stinchfield, Randy; Winters, Ken C.

    2004-01-01

    The purposes of this study were to examine the clinical utility of the Personal Experience Inventory (PEI) Psychosocial scales to predict adolescent drug abuse treatment outcome. The role of psychosocial risk factors in predicting treatment outcome also has theoretical interest given that such factors have been associated with the development of…

  20. Teaching About Substance Abuse with Objective Structured Clinical Exams

    PubMed Central

    Parish, Sharon J; Ramaswamy, Megha; Stein, Melissa R; Kachur, Elizabeth K; Arnsten, Julia H

    2006-01-01

    BACKGROUND Although residents commonly manage substance abuse disorders, optimal approaches to teaching these specialized interviewing and intervention skills are unknown. OBJECTIVE We developed a Substance Abuse Objective Structured Clinical Exam (OSCE) to teach addiction medicine competencies using immediate feedback. In this study we evaluated OSCE performance, examined associations between performance and self-assessed interest and competence in substance abuse, and assessed learning during the OSCE. DESIGN Five-station OSCE, including different substance abuse disorders and readiness to change stages, administered during postgraduate year-3 ambulatory rotations for 2 years. PARTICIPANTS One hundred and thirty-one internal and family medicine residents. MEASUREMENTS Faculty and standardized patients (SPs) assessed residents' general communication, assessment, management, and global skills using 4-point scales. Residents completed a pre-OSCE survey of experience, interest and competence in substance abuse, and a post-OSCE survey evaluating its educational value. Learning during the OSCE was also assessed by measuring performance improvement from the first to the final OSCE station. RESULTS Residents performed better (P<.001) in general communication (mean ± SD across stations = 3.12 ± 0.35) than assessment (2.65 ± 0.32) or management (2.58 ± 0.44), and overall ratings were lowest in the contemplative alcohol abuse station (2.50 ± 0.83). Performance was not associated with residents' self-assessed interest or competence. Perceived educational value of the OSCE was high, and feedback improved subsequent performance. CONCLUSIONS Although internal and family medicine residents require additional training in specialized substance abuse skills, immediate feedback provided during an OSCE helped teach needed skills for assessing and managing substance abuse disorders. PMID:16704387

  1. Rural Drug Users: Factors Associated with Substance Abuse Treatment Utilization

    PubMed Central

    Oser, Carrie B.; Leukefeld, Carl G.; Tindall, Michele Staton; Garrity, Thomas F.; Carlson, Robert G.; Falck, Russel; Wang, Jichuan; Booth, Brenda M.

    2010-01-01

    The purpose of this study is to use a modified version of Andersen’s (1968, 1995) Behavioral Model of Health Services Use to identify the correlates of the number of substance abuse treatment episodes received by rural drug users. Data were collected from face-to-face interviews with 711 drug users in rural areas of Ohio, Arkansas, and Kentucky. Descriptive analyses examine rural drug users’ substance use histories and retrospective substance abuse treatment service utilization patterns. A negative binomial regression model indicated that selected predisposing, historical health, and enabling factors were significantly associated with the utilization of substance abuse treatment among rural drug users. Despite high levels of recent and lifetime self-reported substance use among these rural drug users, treatment services were underutilized. Future studies are needed to examine the impact of the health care system and characteristics of the external environment associated with rural substance abuse treatment in order to increase utilization among drug users. PMID:20463206

  2. Treatment of drug abusers in Malaysia: a comparison.

    PubMed

    Johnson, S H

    1983-10-01

    The purpose of this paper is to compare two forms of treatment for heroin abusers in Malaysia--traditional medicine and institutional--and to evaluate which form of treatment the drug abusers consider more effective. The study involved interviewing 100 male drug abusers in Malaysia who had had treatment from an institution and from a traditional healer. The data revealed that traditional medicine was better for some abusers, but institutional treatment was better for others, depending upon an individual's own needs and personality. Advantages and disadvantages of both forms of treatment were given by those interviewed. The data can be used as guidelines for the development of a more flexible, individualized program within an institutional setting in Malaysia. PMID:6642801

  3. Challenges to providing quality substance abuse treatment services for American Indian and Alaska native communities: perspectives of staff from 18 treatment centers

    PubMed Central

    2014-01-01

    Background Substance abuse continues to exact a significant toll, despite promising advancements in treatment, and American Indian and Alaska Native (AI/AN) communities remain disproportionately impacted. Understanding the challenges to providing quality substance abuse treatment to AI/AN communities could ultimately result in more effective treatment interventions, but no multi-site studies have examined this important issue. Methods This qualitative study examined the challenges of providing substance abuse treatment services for American Indian and Alaska Native (AI/AN) communities. We conducted key informant interviews and focus groups at 18 substance abuse treatment programs serving AI/AN communities. Seventy-six service participants (21 individuals in clinical administrative positions and 55 front-line clinicians) participated in the project. Interview transcripts were coded to identify key themes. Results We found that the challenges of bringing effective substance abuse treatment to AI/AN communities fell into three broad categories: challenges associated with providing clinical services, those associated with the infrastructure of treatment settings, and those associated with the greater service/treatment system. These sets of challenges interact to form a highly complex set of conditions for the delivery of these services. Conclusions Our findings suggest that substance abuse treatment services for AI/AN communities require more integrated, individualized, comprehensive, and longer-term approaches to care. Our three categories of challenges provide a useful framework for eliciting challenges to providing quality substance abuse treatment in other substance abuse treatment settings. PMID:24938281

  4. Cycles of abuse nurtured by concealment: a clinical report.

    PubMed

    Wijma, Barbro; Thapar-Björkert, Suruchi; Hammarström, Nevija Cah; Swahnberg, Katarina

    2007-09-01

    At present, health care staff do not seem to have sufficient knowledge about their patients' abusive experiences. The aim of the present study is to analyze and discuss what the implications might be for the encounter between patients and health care professionals, when experiences of abuse are concealed. The methodology of this article is varied: a personal narrative, medical records, sociological theoretical literature and empirical evidence. From the narrative we learn that concealment of abuse was devastating for the patient. She was "treated" in vain as a correct diagnosis was not made, while abuse by her father continued. Health care staff also violated her, which she told her therapist, but her protests were not acknowledged. Ten years of treatment thus made her even more sick. This case story focuses on the mechanisms which nurture concealment of a patient's history of abuse, such as structural and symbolic violence. We also suggest ways to break "cycles of abuse". Help the patient to stop concealing also means that she/he leaves a victim role, gets in charge of the situation and takes a first step towards empowerment. In this way, health care settings can become enabling and empowering environments. PMID:17577758

  5. Substance Abuse and Clinical Counseling Students' Characteristics and Career Goals

    ERIC Educational Resources Information Center

    Goodwin, Lloyd R., Jr.; Sias, Shari M.

    2007-01-01

    Students from a master's program in Substance Abuse and Clinical Counseling (SACC) at a midsize southeastern university were surveyed to determine personal characteristics and career goals. Sixty-two of the 68 students currently enrolled in the program volunteered to anonymously complete the questionnaire. The typical profile of the SACC student…

  6. Laboratory approach for diagnosis of toluene-based inhalant abuse in a clinical setting

    PubMed Central

    Jain, Raka; Verma, Arpita

    2016-01-01

    The steady increase of inhalant abuse is a great challenge for analytical toxicologists. This review describes an overview of inhalant abuse including the extent of the problem, types of products abused, modes of administration, pharmacology and effects of inhalants, the role of laboratory, interpretation of laboratory results and clinical considerations. Regular laboratory screening for inhalant abuse as well as other substance abuse and health risk behaviors must be a part of standard clinical care. PMID:26957863

  7. Comorbid psychiatric and substance abuse disorders: recent treatment research.

    PubMed

    Riggs, Paula; Levin, Frances; Green, Alan I; Vocci, Frank

    2008-01-01

    Psychiatric comorbidity is defined as the co-occurrence of a psychiatric disorder in a patient with a substance use disorder. Psychiatric disorders in substance abuse patients can antedate the substance use disorder or be a consequence of the substance abuse. There is emerging evidence that drug use in adolescence may alter the onset of certain psychiatric disorders in vulnerable individuals. Patients with concurrent comorbid disorders present special challenges for the substance abuse treatment system in terms of diagnosis and management because each disorder has the capability of exacerbating the other. This manuscript is a summary of an ISAM symposium that featured three speakers who discussed the following topics: 1. Etiology and treatment of comorbid psychiatric and substance use disorders in adolescents; 2. Treatment of ADHD and substance use disorders in adults; 3. Effects of substance abuse on the onset, severity, and treatment of schizophrenia. Recommendations for further research will be presented. PMID:19042206

  8. Substance Abuse Treatment for Children and Adolescents: Questions to Ask

    MedlinePlus

    ... breadcrumb navigation Substance Abuse Treatment For Children And Adolescents: Questions To Ask Quick Links Facts For Families ... No. 41; Reviewed July 2013 Many children and adolescents use alcohol and other drugs. Some develop serious ...

  9. Best Clinical Practices for Male Adult Survivors of Childhood Sexual Abuse: “Do No Harm”

    PubMed Central

    Gallo-Silver, Les; Anderson, Christopher M; Romo, Jaime

    2014-01-01

    The health care literature describes treatment challenges and recommended alterations in practice procedures for female survivors of childhood sexual abuse, a subtype of adverse childhood experiences. Currently, there are no concomitant recommendations for best clinical practices for male survivors of childhood sexual abuse or other adverse clinical experiences. Anecdotal information suggests ways physicians can address the needs of adult male survivors of childhood sexual abuse by changes in communication, locus of control, and consent/permission before and during physical examinations and procedures. The intent of this article is to act as a catalyst for improved patient care and more research focused on the identification and optimal responses to the needs of men with adverse childhood experiences in the health care setting. PMID:25106042

  10. Prescription Drug Abuse & Diversion: Role of the Pain Clinic

    PubMed Central

    Rigg, Khary K.; March, Samantha J.; Inciardi, James A.

    2010-01-01

    The goal of this research is to better understand the role that South Florida pain management clinics may be playing in the abuse and diversion of prescription drugs. This study explores 1) the characteristics and practices of pain clinics that may be facilitating the drug-seeking endeavors of prescription drug abusers and 2) the drug-seeking behaviors of prescription drug abusers who use pain clinics as a primary source for drugs. Thirty in-depth interviews were conducted with prescription drug abusers in South Florida. Interviews were transcribed verbatim and codes were generated based on thematic analyses of the data. Using grounded theory strategies, the analysis revealed six main themes: “pill mills”, on-site pharmacies, liberal prescribing habits, “sponsoring” drug diversion, pain doctor/pharmacy shopping, and faking symptoms/documentation. These findings should provide insights for law enforcement, regulatory agencies, and industry as they attempt to develop appropriate policy initiatives and recommendations for best practices. PMID:21278927

  11. 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,...

  12. Treatment of child abuse: a review of the behavioral interventions.

    PubMed

    Isaacs, C D

    1982-01-01

    Child abuse has probably existed as a social problem as long as parents and children have lived under the same roof, and in recent years it has received tremendous attention. Most of the research has focused on etiology rather than treatment, leaving large gaps in our knowledge about remediating abuse. Behavioral scientists have only begun to formulate a conceptual framework from which to work. Many theoretical questions are yet unanswered, particularly the question of what constitutes abuse. Burgess (1978) believes that conceptual problems exist because abuse falls along a continuum of parent-child relationships--a continuum that at one end might include verbal punishment (e.g., threats, ridicule) or milder forms of physical punishment (e.g., slap on the hand, spanking), and at the other end include extreme forms of physical punishment that exceed community mores (for example, hitting a child with a closed fist, scalding a child in hot water, torturing or killing a child). Thus, the question-- where does discipline stop and abuse begin?-- faces every researcher who must operationally define abuse. Identifying the consequences of abuse in a child's development is another area of inquiry that remains untreated. Most of the literature is filled with the subjective impressions of professionals speculating that abused children become the juvenile delinquents and the child abusers of the future; however, as yet no longitudinal studies have been conducted that compare the developmental outcomes of abused and non-abused children from early childhood to later adulthood. What if there were no differences? How might this influence our approaches to the treatment of abuse? Answers to these and other questions will take years of study. Increased awareness of the problem of child abuse has led to greater efforts to remediate the problem. Treatment efforts with abusive families are still in the initial stages, but, undoubtedly, information from these early programs can be the

  13. Case studies in the family treatment of drug abuse.

    PubMed

    Noone, R J; Reddig, R L

    1976-09-01

    This article, with case illustrations, attempts to demonstrate that drug-abuse behavior can be understood more clearly in the light of family loyalties and unresolved family crises than from the perspective that drug abusers are social deviates.1 Drug abuse is viewed as symptomatic, as a signal that both drug abuser and his or her family are having difficulty in getting past a particular stage in the natural unfolding life cycle of a family. Treatment of drug abuse is seen primarily as helping the family to become "unstuck," thereby freeing the individual's and family's energy for the task of self-development and growth rather than expending it to maintain rigid patterns of interaction in an attempt to prevent change. PMID:1026451

  14. Relapse Prevention with Substance Abusers: Clinical Issues and Myths.

    ERIC Educational Resources Information Center

    Daley, Dennis C.

    1987-01-01

    Discusses the problems of relapse with alcoholics and other drug abusers from three perspectives: client-related variables, common erroneous beliefs and myths held by professionals regarding relapse, and treatment system problems that may contribute to relapse. Offers proposed solutions and describes a relapse prevention model. (Author/ABB)

  15. Clinical and forensic signs related to opioids abuse.

    PubMed

    Dinis-Oliveira, Ricardo Jorge; Carvalho, Felix; Moreira, Roxana; Duarte, Jose Alberto; Proenca, Jorge Brandao; Santos, Agostinho; Magalhaes, Teresa

    2012-12-01

    For a good performance in Clinical and Forensic Toxicology it is important to be aware of the biological and non-biological signs and symptoms related to xenobiotic exposure. This manuscript highlights and analyzes clinical and forensic imaging related to opioids abuse critically. Particularly, respiratory depression, track marks and hemorrhages, skin "popping", practices of phlebotomy, tissue necrosis and ulceration, dermatitis, tongue hyperpigmentation, "coma blisters", intra-arterial administration, candidiasis, wounds associated with anthrax or clostridium contaminated heroin, desomorphine related lesions and characteristic non-biological evidences are some commonly reported findings in opioids abuse, which will be discussed. For this purpose, clinical and forensic cases from our database (National Institute of Legal Medicine and Forensic Sciences, North Branch, Portugal), in addition to literature data, are reviewed. PMID:23170787

  16. Impact of Physical and Sexual Abuse on Treatment Response in the Treatment of Resistant Depression in Adolescent Study (TORDIA)

    PubMed Central

    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.

    2010-01-01

    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 serotonin re-uptake inhibitor (SSRI) trial (N=334) were randomized to: an alternative SSRI; an alternative SSRI plus cognitive behavior therapy (CBT); venlafaxine; or venlafaxine plus CBT. Analyses examined the effect of history of abuse on response to the pharmacotherapy and combination therapy. Results Those without a history of physical abuse (PA) or sexual abuse (SA) had a higher 12-week response rate to combination therapy compared to medication mono-therapy (62.8% vs. 37.6%; OR=2.8, 95% CI: 1.6–4.7, p<0.001). Those with a history of SA had similar response rates to combination vs. medication monotherapy (48.3% vs. 42.3%; OR=1.3, 95% CI: 0.4–3.7; p=0.66), while those with history of PA had a much lower rate of response to combination therapy (18.4% vs. 52.4%, OR=0.1; 95% CI: 0.02–0.43). Even after adjusting for other clinical predictors, a history of PA moderated treatment outcome. Conclusion These results should be considered within the limitations of a post-hoc analysis, lack of detailed assessment of abuse and other forms of trauma, and neuropsychological status. Depressed patients with history of abuse, especially PA may require specialized clinical approaches. Further work is needed to understand by what mechanisms a history of abuse affects treatment response. PMID:21334569

  17. 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…

  18. 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…

  19. Drug abuse treatment in the context of correctional surveillance.

    PubMed

    Nurco, D N; Hanlon, T E; Bateman, R W; Kinlock, T W

    1995-01-01

    Evaluating drug abuse treatment within a correctional framework presents unique issues and challenges. Given their respective emphases on rehabilitation and incapacitation, treatment and corrections approaches to incarcerated drug abusers often differ in methods aimed at reducing deviant behavior. Although this results in problems in planning integrative drug abuse intervention strategies, the two approaches are not always incompatible. Corrections can help identify those individuals in need of treatment, and for some of these, treatment can lessen the need for incapacitation. Understandably, gaining a drug-abusing offender's cooperation in monitoring routines and engendering trust in the confidentiality of treatment conducted in criminal justice systems settings, while still ensuring public safety, are not easy tasks. Nevertheless, there are decided advantages, in terms of compliance and retention, to the increased surveillance exercised by the criminal justice system in community-based treatment efforts. In these efforts, therapy coupled with urine monitoring appears particularly promising. Along with the presentation of descriptive and preliminary outcome information, this report provides a discussion of treatment/corrections issues within the framework of an ongoing treatment evaluation study involving drug-abusing parolees in Baltimore City. PMID:7752293

  20. Hispanic Subgroups, Acculturation, and Substance Abuse Treatment Outcomes.

    PubMed

    Chartier, Karen G; Carmody, Tom; Akhtar, Maleeha; Stebbins, Mary B; Walters, Scott T; Warden, Diane

    2015-12-01

    This study explored Hispanic subgroup differences in substance use treatment outcomes, and the relationship of acculturation characteristics to these outcomes. Data were from a multisite randomized clinical trial of motivational enhancement therapy versus treatment as usual in a sample of Spanish-speaking substance abusers. Participants were Cuban American (n=34), Mexican American (n=209), Puerto Rican (n=78), and other Hispanic American (n=54). Results suggested that Cuban Americans and individuals with more connection to Hispanic culture had lower treatment retention. Hispanics born in the U.S and those who spoke English at home had a lower percentage of days abstinent during weeks 5-16, although Puerto Ricans born in the U.S. and Cuban Americans living more years in the U.S. had a higher percentage of days abstinent in weeks 1-4 and 5-16, respectively. Results may inform future hypothesis-driven studies in larger Hispanic treatment seeking samples of the relationship between acculturation and treatment outcome. PMID:26362001

  1. Safety Overview of Postmarketing and Clinical Experience of Sodium Oxybate (Xyrem): Abuse, Misuse, Dependence, and Diversion

    PubMed Central

    Wang, Y. Grace; Swick, Todd J.; Carter, Lawrence P.; Thorpy, Michael J.; Benowitz, Neal L.

    2009-01-01

    Study Objectives: This study reviewed the cumulative postmarketing and clinical safety experience with sodium oxybate (Xyrem®), a treatment approved for cataplexy and excessive daytime sleepiness in narcolepsy. Study objectives were to investigate the occurrence of abuse/misuse of sodium oxybate since first market introduction in 2002, classify cases using DSM-IV criteria for substance abuse and dependence, and describe specific characteristics of these cases. Methods: We retrospectively reviewed postmarketing spontaneous adverse event (AE) reports from 15 countries for all cases containing reporting terminology related to abuse/misuse to determine its occurrence. All death cases independent of causality were reviewed to identify associated risk factors. Results: Approximately 26,000 patients worldwide received sodium oxybate from first market introduction in 2002 through March 2008. Of those 26,000 patients, 0.2% reported ≥ 1 of the events studied. These included 10 cases (0.039%) meeting DSM-IV abuse criteria, 4 cases (0.016%) meeting DSM-IV dependence criteria, 8 cases (0.031%, including 3 of the previous 4) with withdrawal symptoms reported after discontinuation of sodium oxybate, 2 confirmed cases (0.008%) of sodium oxybate–facilitated sexual assault, 8 cases (0.031%) of overdose with suicidal intent, 21 deaths (0.08%) in patients receiving sodium oxybate treatment with 1 death known to be related to sodium oxybate, and 3 cases (0.01%) of traffic accidents involving drivers taking sodium oxybate. During this period, approximately 600,000 bottles of sodium oxybate were distributed, and 5 incidents (0.0009%) of diversion were reported. Conclusion: Cumulative postmarketing and clinical experience indicates a very low risk of abuse/misuse of sodium oxybate. Citation: Wang YG; Swick TJ; Carter LP; Thorpy MJ; Benowitz NL. Safety overview of postmarketing and clinical experience of sodium oxybate (xyrem): abuse, misuse, dependence, and diversion. J Clin Sleep

  2. Prevalent Intravenous Abuse of Methylphenidate Among Treatment-Seeking Patients With Substance Abuse Disorders: A Descriptive Population-Based Study

    PubMed Central

    Haraldsson, Haraldur M.; Rafnar, Bjarni O.; Sigurdsson, Engilbert; Steingrimsson, Steinn; Johannsson, Magnus; Bragadottir, Helena; Magnusson, Andres

    2015-01-01

    Objectives: Prescription rates of methylphenidate (MPH) are sharply rising in most Western countries. Although it has been reported that MPH has abuse potential, little is known about the prevalence of intravenous (IV) abuse of MPH. The aim of the study was to investigate the prevalence of IV MPH abuse among treatment-seeking IV substance abusers in Iceland. Methods: This is a descriptive population-based study using a semistructured interview assessing sociodemographics, substance abuse history, and the method of administration of 108 IV substance abusers. During 1 year, consecutively admitted adult inpatients with substance use disorder at any detoxification center in Iceland that reported any IV substance abuse in the past 30 days were invited to participate. Abuse was defined as nontherapeutic use of a substance to gain psychological or physiological effect. Results: Prevalence of any IV MPH abuse among participants was 88% in the last 30 days (95% confidence interval [CI], 0.82-0.94) and MPH was the most commonly abused substance (65%) and the preferred substance (63%). Around one third (30%) reported MPH as the first IV substance ever abused. However, among those reporting a shorter history than 10 years of IV abuse, 42% reported MPH as the first IV substance ever abused. Conclusions: This first nationwide study on IV abuse of MPH shows that it is common among treatment-seeking IV abusers in Iceland and suggests that MPH has high abuse potential. Therefore, both the use and possible abuse of MPH in those with high abuse potential should be monitored, especially in countries where MPH prescriptions rates are on the rise. PMID:25748561

  3. 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

  4. Federal Confidentiality Regulations for Substance Abuse Treatment Facilities: A Case in Applied Ethics.

    ERIC Educational Resources Information Center

    Piazza, Nick J.; Yeager, Rebecca D.

    1990-01-01

    Discusses confidentiality in counseling, basing comments on ethical standards of American Association for Counseling and Development and National Academy of Certified Clinical Mental Health Counselors, as well as federal regulations adopted for drug and alcohol abuse treatment. Discusses disclosures with and without client consent and special…

  5. Culture Specific Approaches to the Treatment of Latin Multiple Substance Abusers: Family and Ecological Intervention Models.

    ERIC Educational Resources Information Center

    Szapocznik, Jose; And Others

    Four models developed for the treatment of Cuban American adult and adolescent drug and alcohol abusers are discussed in this paper. The study reviewed was aimed at (1) investigating the effectiveness of "Ecological Family Systems Therapy," an approach created by the Spanish Family Guidance Clinic in Miami, Florida, and (2) identifying the…

  6. Achieving Cannabis Cessation - Evaluating N-acetylcysteine Treatment (ACCENT): Design and implementation of a multi-site, randomized controlled study in the National Institute on Drug Abuse Clinical Trials Network

    PubMed Central

    McClure, Erin A.; Sonne, Susan C.; Winhusen, Theresa; Carroll, Kathleen M.; Ghitza, Udi E.; McRae-Clark, Aimee L.; Matthews, Abigail G.; Sharma, Gaurav; Van Veldhuisen, Paul; Vandrey, Ryan G.; Levin, Frances R.; Weiss, Roger D.; Lindblad, Robert; Allen, Colleen; Mooney, Larissa J.; Haynes, Louise; Brigham, Gregory S.; Sparenborg, Steve; Hasson, Albert L.; Gray, Kevin M.

    2014-01-01

    Despite recent advances in behavioral interventions for cannabis use disorders, effect sizes remain modest, and few individuals achieve long-term abstinence. One strategy to enhance outcomes is the addition of pharmacotherapy to complement behavioral treatment, but to date no efficacious medications targeting cannabis use disorders in adults through large, randomized controlled trials have been identified. The National Institute on Drug Abuse Clinical Trials Network (NIDA CTN) is currently conducting a study to test the efficacy of N-acetylcysteine (NAC) versus placebo (PBO), added to contingency management, for cannabis cessation in adults (ages 18–50). This study was designed to replicate positive findings from a study in cannabis-dependent adolescents that found greater odds of abstinence with NAC compared to PBO. This paper describes the design and implementation of an ongoing 12-week, intent-to-treat, double-blind, randomized, placebo-controlled study with one follow-up visit four weeks post-treatment. Approximately 300 treatment-seeking cannabis-dependent adults will be randomized to NAC or PBO across six study sites in the United States. The primary objective of this 12-week study is to evaluate the efficacy of twice-daily orally-administered NAC (1200 mg) versus matched PBO, added to contingency management, on cannabis abstinence. NAC is among the first medications to demonstrate increased odds of abstinence in a randomized controlled study among cannabis users in any age group. The current study will assess the cannabis cessation efficacy of NAC combined with a behavioral intervention in adults, providing a novel and timely contribution to the evidence base for the treatment of cannabis use disorders. PMID:25179587

  7. Achieving cannabis cessation -- evaluating N-acetylcysteine treatment (ACCENT): design and implementation of a multi-site, randomized controlled study in the National Institute on Drug Abuse Clinical Trials Network.

    PubMed

    McClure, Erin A; Sonne, Susan C; Winhusen, Theresa; Carroll, Kathleen M; Ghitza, Udi E; McRae-Clark, Aimee L; Matthews, Abigail G; Sharma, Gaurav; Van Veldhuisen, Paul; Vandrey, Ryan G; Levin, Frances R; Weiss, Roger D; Lindblad, Robert; Allen, Colleen; Mooney, Larissa J; Haynes, Louise; Brigham, Gregory S; Sparenborg, Steve; Hasson, Albert L; Gray, Kevin M

    2014-11-01

    Despite recent advances in behavioral interventions for cannabis use disorders, effect sizes remain modest, and few individuals achieve long-term abstinence. One strategy to enhance outcomes is the addition of pharmacotherapy to complement behavioral treatment, but to date no efficacious medications targeting cannabis use disorders in adults through large, randomized controlled trials have been identified. The National Institute on Drug Abuse Clinical Trials Network (NIDA CTN) is currently conducting a study to test the efficacy of N-acetylcysteine (NAC) versus placebo (PBO), added to contingency management, for cannabis cessation in adults (ages 18-50). This study was designed to replicate positive findings from a study in cannabis-dependent adolescents that found greater odds of abstinence with NAC compared to PBO. This paper describes the design and implementation of an ongoing 12-week, intent-to-treat, double-blind, randomized, placebo-controlled study with one follow-up visit four weeks post-treatment. Approximately 300 treatment-seeking cannabis-dependent adults will be randomized to NAC or PBO across six study sites in the United States. The primary objective of this 12-week study is to evaluate the efficacy of twice-daily orally-administered NAC (1200 mg) versus matched PBO, added to contingency management, on cannabis abstinence. NAC is among the first medications to demonstrate increased odds of abstinence in a randomized controlled study among cannabis users in any age group. The current study will assess the cannabis cessation efficacy of NAC combined with a behavioral intervention in adults, providing a novel and timely contribution to the evidence base for the treatment of cannabis use disorders. PMID:25179587

  8. 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…

  9. Implementation of Cognitive-Behavioral Substance Abuse Treatment in Sub-Saharan Africa: Treatment Engagement and Abstinence at Treatment Exit

    PubMed Central

    Burnhams, Warren; Remmert, Jocelyn E.; Myers, Bronwyn; Joska, John A.; Carrico, Adam W.

    2016-01-01

    Aims This study documented the treatment cascade for engagement in care and abstinence at treatment exit as well as examined correlates of these outcomes for the first certified Matrix Model® substance abuse treatment site in Sub-Saharan Africa. Design This retrospective chart review conducted at a resource-limited community clinic in Cape Town, South Africa, assessed treatment readiness and substance use severity at treatment entry as correlates of the number of sessions attended and biologically confirmed abstinence at treatment exit among 986 clients who initiated treatment from 2009–2014. Sociodemographic and clinical correlates of treatment outcomes were examined using logistic regression, modeling treatment completion and abstinence at treatment exit separately. Results Of the 2,233 clients who completed screening, approximately 44% (n = 986) initiated treatment. Among those who initiated treatment, 45% completed at least four group sessions, 30% completed early recovery skills training (i.e., at least eight group sessions), and 13% completed the full 16-week program. Approximately half (54%) of clients who provided a urine sample had negative urine toxicology results for any substance at treatment exit. Higher motivation at treatment entry was independently associated with greater odds of treatment completion and negative urine toxicology results at treatment exit. Conclusions Findings provide initial support for the successful implementation the Matrix Model in a resource-limited setting. Motivational enhancement interventions could support treatment initiation, promote sustained engagement in treatment, and achieve better treatment outcomes. PMID:26816208

  10. 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. PMID:22873185

  11. The impact of abuse and gender on psychopathology, behavioral disturbance, and psychotropic medication count for youth in residential treatment.

    PubMed

    Badura Brack, Amy; Huefner, Jonathan C; Handwerk, Michael L

    2012-10-01

    This study examined the relationship between gender, abuse history, and clinical change in a residential treatment program for youth with emotional and behavioral disturbance. Admission data and data collected after 1 year of treatment or at discharge were examined for 1,303 youth. Measures included the Suicide Probability Scale, Child Behavior Checklist, and the Diagnostic Interview Schedule for Children. Data also included medication count, demographic data, and history of sexual or physical abuse or both. At intake, girls scored significantly more pathologically than boys on 9 out of 12 measures. At intake, abused youth indicated more hostility, anxiety, and mood disorder symptoms as well as psychotropic medication usage than nonabused youth. Youth improved significantly on all outcome measures with treatment, although interaction effects indicate some differing treatment responses by abuse history or gender. After treatment, girls still scored significantly higher than boys on 6 of 8 outcome measures, and abused youth, especially youth experiencing both sexual and physical abuse, had significantly higher anxiety, affective, behavior, and eating disorder symptom counts and were on more psychotropic medications than nonabused youth. Although behaviorally focused treatment was associated with improvement on every measure, the most important implication of our study is that a singular treatment approach does not fit all youth completely as reflected by continuing treatment needs in our most troubled youth. Additional symptom-focused treatment and research attention must be given to girls and abused youth in residential care to maximize their therapeutic outcomes. PMID:23039354

  12. Including Siblings in the Treatment of Child Sexual Abuse.

    ERIC Educational Resources Information Center

    Baker, Juanita N.; Tanis, Heyley J.; Rice, Jennifer B.

    2001-01-01

    Describes the necessity of including siblings in the treatment of victims of child sexual abuse. Theoretical and practical reasons to include siblings in treatment are discussed. Case examples using a particular intervention approach and results of client satisfaction surveys are described. (Contains 18 references.) (GCP)

  13. Inmate Perceptions of Residential Substance Abuse Treatment Programming.

    ERIC Educational Resources Information Center

    Stohr, Mary K.; Hemmens, Craig; Kjaer, Kristin; Gornik, Mark; Dayley, Jed; Noon, Cindy; Baune, Diane

    2002-01-01

    Presents findings from a questionnaire in which inmates were queried regarding their perceptions of a residential substance abuse treatment program. Findings reveal that inmates enrolled in the first and/or third phase of the treatment tended to be more positive in their perception of program content, therapeutic atmosphere, and quality of…

  14. 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…

  15. 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…

  16. Child Physical and Sexual Abuse: Guidelines for Treatment. Final Report.

    ERIC Educational Resources Information Center

    Saunders, B. E.; Berliner, L.; Hanson, R. F.

    Helping child abuse victims receive the mental health treatment they need is an important component of victim advocacy with children, and benefits both the children and the criminal justice system. As part of this work, the National Crime Victims Research and Treatment Center at the Medical University of South Carolina and the Center for Sexual…

  17. 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…

  18. Diagnostic Profiles of Offenders in Substance Abuse Treatment Programs

    PubMed Central

    Grella, Christine E.; Greenwell, Lisa; Prendergast, Michael; Sacks, Stanley; Melnick, Gerald

    2009-01-01

    This study examined the association of Axis I and Axis II disorders among offenders who were in prison-based substance abuse treatment in a national multi-site study. Participants (N = 280) received a psychosocial assessment and a structured diagnostic interview in two separate sessions. Logistic regression models examined the association between lifetime mood and anxiety disorders with two personality disorders, and the relationship of Axis I and Axis II disorders (alone and in combination) to pre-treatment psychosocial functioning. Over two-thirds of the sample met criteria for at least one mental disorder. Borderline personality disorder was strongly associated with having a lifetime mood disorder (odds ratio = 7.5) or lifetime anxiety disorder (odds ratio = 8.7). Individuals with only an Axis II disorder, or who had both Axis I and Axis II disorders, had more severe problems in psychosocial functioning than those without any disorder. Clinical treatment approaches need to address this heterogeneity in diagnostic profiles, symptom severity, and psychosocial functioning. PMID:18683206

  19. 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…

  20. 78 FR 37560 - Center for Substance Abuse Treatment; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-21

    ... 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 Abuse Treatment...

  1. 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...

  2. 75 FR 38112 - Center for Substance Abuse Treatment; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-01

    ... 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 Abuse Treatment...

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 75 FR 47819 - Center for Substance Abuse Treatment; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-09

    ... 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 Abuse Treatment...

  8. Outcome Evaluation of a Group Treatment of Sexually Abused and Reactive Children

    ERIC Educational Resources Information Center

    Duffany, Adrienne; Panos, Patrick T.

    2009-01-01

    Objective: To determine the effectiveness of group therapy in treating sexually abused children to prevent recidivism (subsequently re-abused or becoming abusers themselves). Methods: Recidivism rates of 617 children were compared between sexually abused children who received group treatment with those whose parents refused treatment.…

  9. Treatment of Drug Abuse: An Overview. National Clearinghouse for Drug Abuse Information Report Series 34, Number 1.

    ERIC Educational Resources Information Center

    National Inst. on Drug Abuse (DHEW/PHS), Rockville, MD. National Clearinghouse for Drug Abuse Information.

    This report presents a brief review of the development of methods and programs for treatment of drug abusers in the United States. In order to limit the scope of the report, discussion of the treatment of alcohol abuse and alcoholism is excluded. The report focuses primarily on the treatment of opiate dependence, since most of the experience on…

  10. Integrating harm reduction therapy and traditional substance abuse treatment.

    PubMed

    Marlatt, G A; Blume, A W; Parks, G A

    2001-01-01

    One-size-fits-all therapy has not worked well for a majority of substance users seeking help. New approaches to substance abuse treatment are desperately needed. Traditional models of service delivery offer little, if any, help to people who may not choose abstinence as a goal. To address this concern, the Bridging the Gap Conference was sponsored by the San Francisco Department of Public Health. The overall goals of the conference were to improve standards of care, develop best practice principles for integrating harm reduction approaches into traditional substance abuse services, and increase the accessibility of quality services to people in need of alcohol and drug treatment. G. Alan Marlatt gave a keynote address on the integration of harm reduction therapy into traditional treatment services, an expanded version of which is presented in this article. Such integration would broaden the scope of services available to a larger group of consumers of substance abuse treatment. Furthermore, harm reduction therapy would infuse traditional treatment practices with scientifically-based pragmatism that pays close attention to individual and community public health needs. Because of its tolerance of treatment goals other than abstinence, harm reduction therapy offers the greatest hope to expand the availability of substance abuse services to people who have not benefited from traditional abstinence-based treatment models. PMID:11332996

  11. Comprehensive Case Management for Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series 27.

    ERIC Educational Resources Information Center

    Cook, Paddy; Dogoloff, Mary Lou; Harteker, Linda; Nelson, Anne E.; Paul, Michelle M.; Shuman, Deborah J.; Mjoseth, Marcia; Vitzthum, Virginia; Hayes, Elizabeth; Gilbert, Max; Smith, Cara; Nguyen, Y-Lang

    This TIP contains information on the best practice guidelines on case management for substance abuse treatment providers. It serves to educate program coordinators and facilitators about the factors to consider as they decide to modify or implement case management activities. Many substance abuse clients arrive for treatment with a number of other…

  12. Typologies of Prescription Opioid Use in a Large Sample of Adults Assessed for Substance Abuse Treatment

    PubMed Central

    Green, Traci C.; Black, Ryan; Grimes Serrano, Jill M.; Budman, Simon H.; Butler, Stephen F.

    2011-01-01

    Background As a population, non-medical prescription opioid users are not well-defined. We aimed to derive and describe typologies of prescription opioid use and nonmedical use using latent class analysis in an adult population being assessed for substance abuse treatment. Methods Latent class analysis was applied to data from 26,314 unique respondents, aged 18-70, self-reporting past month use of a prescription opioid out of a total of 138,928 cases (18.9%) collected by the Addiction Severity Index-Multimedia Version (ASI-MV®), a national database for near real-time prescription opioid abuse surveillance. Data were obtained from November 2005 through December 2009. Substance abuse treatment, criminal justice, and public assistance programs in the United States submitted data to the ASI-MV database (n = 538). Six indicators of the latent classes derived from responses to the ASI-MV, a version of the ASI modified to collect prescription opioid abuse and chronic pain experience. The latent class analysis included respondent home ZIP code random effects to account for nesting of respondents within ZIP code. Results A four-class adjusted latent class model fit best and defined clinically interpretable and relevant subgroups: Use as prescribed, Prescribed misusers, Medically healthy abusers, and Illicit users. Classes varied on key variables, including race/ethnicity, gender, concurrent substance abuse, duration of prescription opioid abuse, mental health problems, and ASI composite scores. Three of the four classes (81% of respondents) exhibited high potential risk for fatal opioid overdose; 18.4% exhibited risk factors for blood-borne infections. Conclusions Multiple and distinct profiles of prescription opioid use were detected, suggesting a range of use typologies at differing risk for adverse events. Results may help clinicians and policy makers better focus overdose and blood-borne infection prevention efforts and intervention strategies for prescription

  13. Child Sexual Abuse Suspicions: Treatment Considerations during Investigation

    ERIC Educational Resources Information Center

    Kuehnle, Kathryn; Connell, Mary

    2010-01-01

    This article addresses what, if any, psychotherapeutic interventions should be provided to meet the emotional and clinical needs of alleged child victims of sexual abuse while they await judicial determinations from the family, dependency, or criminal courts. The discussion emphasizes that to minimize iatrogenic outcomes, professionals involved in…

  14. Cost-Effectiveness of Case Management in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Saleh, Shadi S.; Vaughn, Thomas; Levey, Samuel; Fuortes, Laurence; Uden-Holmen, Tanya; Hall, James A.

    2006-01-01

    Objective: The purpose of this study, which is part of a larger clinical trial, was to examine the cost-effectiveness of case management for individuals treated for substance abuse in a residential setting. Method: Clients who agreed to participate were randomly assigned to one of four study groups. Two groups received face-to-face case management…

  15. Managing Opioid Abuse in Older Adults: Clinical Considerations and Challenges.

    PubMed

    Loreck, David; Brandt, Nicole J; DiPaula, Bethany

    2016-04-01

    Opioid use disorder is a public health epidemic. There is increasing attention being given to opioid abuse and overdose in the United States. The overall use of illicit substances by older adults is on the rise and in part can be attributed to the aging of Baby Boomers. Furthermore, much attention is being given to prescription opioid drug overdose, but it is important to note that heroin-related deaths have also increased sharply. Heroin use is part of a larger substance abuse problem, with more than nine in 10 individuals who use heroin also using at least one other drug (e.g., cocaine, prescription opioid medication). The current article highlights treatment approaches, namely buprenorphine, buprenorphine/naloxone, and naltrexone; insurance considerations; and resources to aid in understanding and managing this public health crisis. PMID:27027362

  16. A Feasibility Study of a Web Based Performance Improvement System for Substance Abuse Treatment Providers

    PubMed Central

    Forman, Robert; Crits-Christoph, Paul; Kaynak, Övgü; Worley, Matt; Hantula, Donald A.; Kulaga, Agatha; Rotrosen, John; Chu, Melissa; Gallop, Robert; Potter, Jennifer; Muchowski, Patrice; Brower, Kirk; Strobbe, Stephen; Magruder, Kathy; Chellis, A’Delle H.; Clodfelter, Tad; Cawley, Margaret

    2007-01-01

    We report here on the feasibility of implementing a semi-automated performance improvement system - Patient Feedback (PF) - that enables real-time monitoring of patient ratings of therapeutic alliance, treatment satisfaction, and drug/alcohol use in outpatient substance abuse treatment clinics. The study was conducted in 6 clinics within the National Institute on Drug Abuse Clinical Trials Network. It involved a total of thirty-nine clinicians and 6 clinic supervisors. Throughout the course of the study (4 week training period, 4 week baseline, 12 week intervention, 4 week post-intervention assessment, 1 year sustainability phase) there was an overall collection rate of 75.5% of the clinic patient census. In general, the clinicians in these clinics had very positive treatment satisfaction and alliance ratings throughout the study. However, one clinic had worse drug use scores at baseline than other participating clinics, and showed a decrease in self-reported drug use at post-intervention. Although the implementation of the PF system proved to be feasible in actual clinical settings, further modifications of the PF system are needed to enhance any potential clinical usefulness. PMID:17499954

  17. Health care policy issues in the drug abuser treatment field.

    PubMed

    McAuliffe, W E

    1990-01-01

    As we enter the 1990s drug abuse has once again become a major health concern, and for the first time the drug treatment field has had to address many of the policy, regulation, and planning issues resulting from cost inflation that have become commonplace in other parts of the health care field. To avoid serious errors and confusion, drug abuse health policies must recognize the very different needs of the public and private sectors. The public sector, where poor addicts receive drug treatment provided or purchased by the government, has long suffered from chronically inadequate funding. Although responses to several epidemics (heroin, crack, and AIDS) have produced periods of increased allocations for drug abuse treatment, more often than not long waiting lists at programs have rationed treatment to lower-income addicts seeking care. Low salary levels have limited the quality of public treatment services, and the absence of resources has hindered the development of programs that respond to new technical developments and drug abuse problems, such as the crack epidemic. Despite severe resource shortages, the public drug treatment system has sometimes used resources inefficiently, with little attention to appropriateness of admissions, lengths of stay, ambulatory treatment modalities, or varying levels of care. Public sector goals for the 1990s should include filling current shortages in drug treatment services, developing adequate long-term funding for treating addicts who lack third-party coverage, modernizing the treatment system, developing new patterns of practice that use existing resources more efficiently, and developing a plan for treating intravenous drug users infected with the AIDS virus. In the private sector, the advent of working- and middle-class demand for drug treatment in the 1970s and 1980s has produced a new drug treatment system that suffers from many of the policy problems common to the rest of health care. Drug abuse in the workplace has

  18. 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…

  19. Assessment of drug abuser treatment needs in Rhode Island.

    PubMed Central

    McAuliffe, W E; Breer, P; Ahmadifar, N W; Spino, C

    1991-01-01

    BACKGROUND. Rhode Island's Division of Substance Abuse asked us to assess the State's drug treatment needs and make recommendations regarding its treatment system for the next three years. METHODS. We used a statewide telephone drug use survey of 5,176 households supplemented by drug-related hospital discharges, Division of Drug Control statistics, and interviews with providers, state officials, and out-of-state experts. Drug abuse was measured with items from the Diagnostic Interview Schedule. Abusers were asked if they were receiving or wanted to receive treatment. RESULTS. Survey responses, used to estimate the unmet need for drug treatment, indicated a need to triple drug treatment services. Regression models using survey data indicated that the treatment network was overly centralized in the Providence area. Interviews with state officials, clinicians, and out-of-state experts provided material for recommendations on reimbursement policy, treatment mix, quality assurance, and cost containment. CONCLUSIONS. The RI Department of Health's certificate-of-need program adopted our overall recommendation for tripling the drug treatment system as its guideline in evaluating proposals for new treatment facilities. With State funding of a new adolescent center and expansion of outpatient slots in the private sector, this recommendation has now been fully implemented. PMID:1847277

  20. Enhancing Substance Abuse Treatment Engagement in Incarcerated Adolescents

    PubMed Central

    Stein, L. A. R.; Monti, Peter M.; Colby, Suzanne M.; Barnett, Nancy P.; Golembeske, Charles; Lebeau-Craven, Rebecca; Miranda, Robert

    2009-01-01

    The purpose of this study was to determine whether motivational interviewing (MI), compared with an attention control condition (relaxation training [RT]) enhances substance abuse treatment engagement in incarcerated adolescents. At the start of incarceration, adolescents were randomly assigned to individually administered MI or RT. Subsequently, therapists and adolescents (N = 130) rated degree of adolescent participation in the facility's standard care group-based treatments targeting crime and substance use. All adolescents received the facility standard care treatment after their individual MI or RT session. MI statistically significantly mitigated negative substance abuse treatment engagement. Other indicators of treatment engagement were in the expected direction; however, effect sizes were small and nonsignificant. These findings are significant, given concerns regarding the deleterious effects of treating delinquent adolescents in groups and the potential for adolescents to reinforce each other's negative behavior, which in turn may lead to escalated substance use and other delinquent behaviors after release. PMID:20617117

  1. Process and Outcome: Evaluation of the Sexual Abuse Treatment Project.

    ERIC Educational Resources Information Center

    Love, Arnold J.

    1989-01-01

    Assesses the feasibility and effectiveness of the Sexual Abuse Treatment Project used in a child welfare setting in Canada. Also evaluates the therapeutic process, which was based on an intensive psychodynamic model, and assesses its effectiveness for child and adult clients. (RJC)

  2. Medical Student Views of Substance Abuse Treatment, Policy and Training

    ERIC Educational Resources Information Center

    Agrawal, Shantanu; Everett, Worth W.; Sharma, Sonali

    2010-01-01

    Purpose: This study examined the impact of medical education on students' views of substance abuse treatment, public policy options and training. Method: A longitudinal survey was conducted on a single-class cohort of 101 students in a major American, urban medical school. The survey was administered in the Spring semesters of the first to third…

  3. 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…

  4. 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

  5. Characteristics of transgender individuals entering substance abuse treatment.

    PubMed

    Flentje, Annesa; Heck, Nicholas C; Sorensen, James L

    2014-05-01

    Little is known about the needs or characteristics of transgender individuals in substance abuse treatment settings. Transgender (n=199) and non-transgender (cisgender, n=13,440) 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 to 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

  6. Building Collaboration in Substance Abuse Treatment and Vocational Rehabilitation

    ERIC Educational Resources Information Center

    Glenn, Margaret K.; Moore, Lucas C.

    2008-01-01

    This study explored the perceived external and internal issues that may have an effect on collaborative ventures designed to provide vocational rehabilitation services to persons with substance use disorders. Participants in the study were professionals from substance abuse (SA) treatment and vocational rehabilitation (VR) agencies in 1 state…

  7. 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…

  8. Drug Abuse Treatment: The Cart Before the Horse

    ERIC Educational Resources Information Center

    Palais, Elliott S.

    1973-01-01

    Resolution of drug abuse problems is apparently encountering difficulties because of our methods of attacking them. We are directing more money and effort to treatment and rehabilitation than to prevention. It is time to look at the problem in its proper perspective: namely prevention and a willingness on the part of some of us to admit it exists.…

  9. 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…

  10. Predictors of Treatment Outcomes among Depressed Women with Childhood Sexual Abuse Histories

    PubMed Central

    Cort, Natalie A.; Gamble, Stephanie A.; Smith, Phillip N.; Chaudron, Linda H.; Lu, Naiji; He, Hua; Talbot, Nancy L.

    2012-01-01

    Background A notable portion (21%) of female patients receiving treatment for depression in community mental health centers (CMHC) has childhood sexual abuse (CSA) histories. Treatment outcomes in this population are heterogeneous; identifying factors associated with differential outcomes could inform treatment development. This exploratory study begins to address the gap in what is known about predictors of treatment outcomes among depressed women with sexual abuse histories. Method Seventy women with major depressive disorder and CSA histories in a CMHC were randomly assigned to Interpersonal Psychotherapy (n = 37) or usual care (n = 33). Using generalized estimating equations, we examined four pre-treatment predictor domains (i.e., sociodemographic characteristics, clinical features, social and physical functioning, and trauma features) potentially related to depression treatment outcomes. Results Among sociodemographic characteristics, Black race/ethnicity, public assistance income, and unemployment were associated with less depressive symptom reduction over the course of treatment. Two clinical features, chronic depression and borderline personality disorder, were also related to less reduction in depressive symptoms across the treatment period. Conclusion Our results demonstrate the clinical relevance of attending to predictors of depressed women with CSA histories being treated in public sector mental health centers. Particular sociodemographic characteristics and clinical features among these women may be significant indicators of risk for relatively poorer treatment outcomes. PMID:22570264

  11. 75 FR 16487 - Center for Substance Abuse Treatment; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-01

    ... 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 Substance Abuse Treatment...

  12. Sex and Aggression: The Relationship between Gender and Abuse Experience in Youngsters Referred to Residential Treatment

    ERIC Educational Resources Information Center

    Doerfler, Leonard A.; Toscano, Peter F., Jr.; Connor, Daniel F.

    2009-01-01

    We examined the relationship of gender and different forms of abuse experience on internalizing symptoms, externalizing symptoms, and IQ in a sample of 397 youngsters who were admitted to a residential treatment program. Three types of abuse experience were examined in this study: sexual abuse only, physical abuse only, and "both" sexual and…

  13. 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…

  14. 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

    ... HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse... hereby given that the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance Abuse Treatment (CSAT) National Advisory Council will meet August 14, 2013, 9:00 a.m.--4:30...

  15. 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

  16. Patients reporting ritual abuse in childhood: a clinical syndrome. Report of 37 cases.

    PubMed

    Young, W C; Sachs, R G; Braun, B G; Watkins, R T

    1991-01-01

    Thirty-seven adult dissociative disorder patients who reported ritual abuse in childhood by satanic cults are described. Patients came from a variety of separate clinical settings and geographical locations and reported a number of similar abuses. The most frequently reported types of ritual abuse are outlined, and a clinical syndrome is presented which includes dissociative states with satanic overtones, severe post-traumatic stress disorder, survivor guilt, bizarre self abuse, unusual fears, sexualization of sadistic impulses, indoctrinated beliefs, and substance abuse. Questions relating to issues of reliability, credibility and verifiability are addressed in depth, and the findings and implications are discussed. PMID:2043970

  17. Abuse

    MedlinePlus

    ... also may fall prey to strangers who take advantage of their cognitive impairment. Types of abuse Signs ... property) to his or her disadvantage or the advantage of someone else Sexual abuse: touching, fondling or ...

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

    PubMed Central

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

    2006-01-01

    Background 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). Results 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. Conclusion 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 PMID:16959041

  19. Medical Marijuana Use among Adolescents in Substance Abuse Treatment

    PubMed Central

    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 (x□ 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. Results 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 to those who did not use medical marijuana. Conclusions 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. PMID:22721592

  20. 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

  1. Substance abuse, adherence with antiretroviral therapy, and clinical outcomes among HIV-infected individuals.

    PubMed

    Lucas, Gregory M

    2011-05-23

    Substance abuse and addiction are highly prevalent in HIV-infected individuals. Substance abuse is an important comorbidity that affects the delivery and outcomes of HIV medical management. In this paper I will review data examining the associations between substance abuse and HIV treatment and potential strategies to improve outcomes in this population that warrant further investigation. Current - but not past - substance abuse adversely affects engagement in care, acceptance of antiretroviral therapy, adherence with therapy, and long-term persistence in care. Substance abuse treatment appears to facilitate engagement in HIV care, and access to evidence-based treatment for substance abuse is central to addressing the HIV epidemic. Strategies that show promise for HIV-infected substance abusers include integrated treatment models, directly observed therapy, and incentive-based interventions. PMID:20888839

  2. Substance abuse, adherence with antiretroviral therapy, and clinical outcomes among HIV-infected individuals

    PubMed Central

    Lucas, Gregory M.

    2010-01-01

    Substance abuse and addiction are highly prevalent in HIV-infected individuals. Substance abuse is an important comorbidity that affects the delivery and outcomes of HIV medical management. In this paper I will review data examining the associations between substance abuse and HIV treatment and potential strategies to improve outcomes in this population that warrant further investigation. Current - but not past - substance abuse adversely affects engagement in care, acceptance of antiretroviral therapy, adherence with therapy, and long-term persistence in care. Substance abuse treatment appears to facilitate engagement in HIV care, and access to evidence-based treatment for substance abuse is central to addressing the HIV epidemic. Strategies that show promise for HIV-infected substance abusers include integrated treatment models, directly observed therapy, and incentive-based interventions. PMID:20888839

  3. 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...

  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. Adult Attachment Interview differentiates adolescents with Childhood Sexual Abuse from those with clinical depression and non-clinical controls.

    PubMed

    van Hoof, Marie-José; van Lang, Natasja D J; Speekenbrink, Sandra; van IJzendoorn, Marinus H; Vermeiren, Robert R J M

    2015-01-01

    Although attachment representation is considered to be disturbed in traumatized adolescents, it is not known whether this is specific for trauma, as comparative studies with other clinical groups are lacking. Therefore, attachment representation was studied by means of the Adult Attachment Interview in adolescents with Childhood Sexual Abuse (CSA) (N = 21), clinical depression (N = 28) and non-clinical controls (N = 28). Coherence of mind and unresolved loss or trauma, as well as the disorganized attachment classification differentiated the CSA group from the clinical depression group and controls, over and above age, IQ, and psychiatric symptomatology. In the current era of sustained criticism on criteria-based classification, this may well carry substantial clinical relevance. If attachment is a general risk or vulnerability factor underlying specific psychopathology, this may guide diagnostic assessment as well as treatment. PMID:26047034

  6. Organizational Characteristics of Drug Abuse Treatment Programs for Offenders

    PubMed Central

    Grella, Christine E.; Greenwell, Lisa; Prendergast, Michael; Farabee, David; Hall, Elizabeth; Cartier, Jerome; Burdon, William

    2007-01-01

    This paper examines the association between organizational characteristics of drug abuse treatment programs for offenders and the provision of wrap-around services and three types of treatment orientations. Data are from the National Criminal Justice Treatment Practices Survey that was conducted with program directors (N = 217). A greater number of wrap-around services provided was associated with inpatient treatment, specialized treatment facilities, community setting (versus correctional), services provided for more types of client populations, college-educated staff, and planned treatment for more than 180 days. Therapeutic community orientation was associated with prison-based treatment and specialized treatment facilities. Cognitive behavioral therapy orientation was associated with higher perceived importance on community treatment, more perceived staff influence on treatment, and treatment for 91–180 days. The 12-step orientation was most strongly associated with having staff specialized in substance abuse. Study findings have implications for developing effective re-entry programs for offenders that bridge correctional and community treatment. PMID:17383553

  7. [Experiences from two HIV prevention projects among drug abusers in Oslo. Is methadone maintenance treatment useful?].

    PubMed

    Skogstad, M

    1990-06-10

    Experience from two HIV-preventive projects among drug abusers in Oslo, Norway, shows that HIV-positive drug abusers carry on their drug abuse independent of visits to residential drug-free treatment or prison. HIV-positive former drug abusers show a tendency to relapse to drug abuse. In terms of HIV-prevention among drug abusers it is important to reduce injection of drugs among HIV-positive drug abusers. Thus, methadone maintenance programmes should be considered in HIV-prevention in Norway. PMID:2363170

  8. Mental Health and Substance Use Characteristics of Flight Attendants Enrolled in an In-Patient Substance Abuse Treatment Program

    ERIC Educational Resources Information Center

    Horton, Gail; Diaz, Naelys; McIlveen, John; Weiner, Michael; Mullaney, Donald

    2011-01-01

    The purpose of this study was to explore the prevalence rates of co-occurring mental health problems among 70 flight attendants in substance abuse treatment. Results indicated that flight attendants in treatment were more likely to experience alcohol dependency than drug dependency. A high proportion of participants reported clinical levels of…

  9. 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…

  10. Secondary Traumatic Stress in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Bride, Brian E.; Walls, Erin

    2006-01-01

    The terms secondary traumatic stress (STS), vicarious traumatization (VT), and compassion fatigue (CF) have all been used, sometimes interchangeably, to refer to the observation that those who provide clinical services to trauma survivors may themselves experience considerable emotional disruption, becoming indirect victims of the trauma.…

  11. Study protocol: a randomized controlled trial of a computer-based depression and substance abuse intervention for people attending residential substance abuse treatment

    PubMed Central

    2012-01-01

    intervention. Participants will also complete weekly self-report measures during the treatment period. Discussion This study will provide comprehensive data on the effect of introducing a computer delivered, cognitive behavioral therapy based co-morbidity treatment program within a residential substance abuse setting. If shown to be effective, this intervention can be disseminated within other residential substance abuse programs. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000618954 PMID:22325594

  12. [Diuretic-Abuse in Chronic Bulimia Nervosa--Case Report and Clinical Management].

    PubMed

    Greetfeld, Martin; Bröckel-Ristevski, Nicole; Fumi, Markus; Cuntz, Ulrich; Voderholzer, Ulrich

    2015-09-01

    We give account of a patient, who works in health care, with bulimia nervosa (BN) and a long term abuse of Furosemide. Due to patients' tendency to conceal addictive behavior and symptoms of BN, the prevalence of purging behavior caused by the intake of diuretics is difficult to quantify 10% of BN patients exhibit a long-term harmful abuse. Discontinuation of diuretics causes the development of edema, attributable to pathophysiological changes with hyperaldosteronism. These can lead to renewed escalation of purging behaviour, provoked either by phobia of weight gain or by unbearable feelings of tension in the facial area or in the legs. For an adequate clinical management, it is vital to have thorough knowledge of the pathophysiological context which consists of psychoeducation, provision of information, treatment of water-electrolyte imbalance and, in individual cases, the administration of aldosterone antagonists. PMID:26039368

  13. Emerging drugs of abuse: clinical and legal considerations.

    PubMed

    Aoun, Elie G; Christopher, Paul P; Ingraham, James W

    2014-06-01

    Over the past several decades, nontraditional drugs of abuse, including bath salts, synthetic cannabinoids, and salvia, have increased in popularity and use. Despite this fact, they remain unfamiliar to many healthcare providers. Commonly marketed as "legal highs," these substances are being used for their desired neuropsychiatric effects, taking advantage of their accessibility, low cost, variable legality, and limited detection on traditional urine drug screens. Similar to traditional drugs of abuse, these substances have varying degrees of toxicity and may lead to potentially adverse effects, ranging from benign to life threatening. This paper offers a review of three of the more widely-used emerging drugs (or classes of drugs): bath salts, synthetic cannabinoids, and salvia. For each we review its history and development, the neurochemical basis for its clinical effects, the nature and route of ingestion, the range of desired effects, potential toxicities, diagnostic and therapeutic approaches, as well as social and legal considerations. [Full text available at http://rimed.org/rimedicaljournal-2014-06.asp, free with no login]. PMID:24905374

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. Increasing Ethnic Minority Participation in Substance Abuse Clinical Trials: Lessons Learned in the National Institute on Drug Abuse’s Clinical Trials Network

    PubMed Central

    Burlew, Kathleen; Larios, Sandra; Suarez-Morales, Lourdes; Holmes, Beverly; Venner, Kamilla; Chavez, Roberta

    2012-01-01

    Underrepresentation in clinical trials limits the extent to which ethnic minorities benefit from advances in substance abuse treatment. The objective of this article is to share the knowledge gained within the Clinical Trials Network (CTN) of the National Institute on Drug Abuse and other research on recruiting and retaining ethnic minorities into substance abuse clinical trials. The article includes a discussion of two broad areas for improving inclusion— community involvement and cultural adaptation. CTN case studies are included to illustrate three promising strategies for improving ethnic minority inclusion: respondent-driven sampling, community-based participatory research, and the cultural adaptation of the recruitment and retention procedures. The article concludes with two sections describing a number of methodological concerns in the current research base and our proposed research agenda for improving ethnic minority inclusion that builds on the CTN experience. PMID:21988575

  1. Factors related to the process of seeking and completing treatment for drug abuse (qualitative methods in drug abuse research).

    PubMed

    Otiashvili, D; Djordjevic, A; Morales, D; Parsons, A; Platt, E; Stempliuk, V

    2005-05-01

    Numerous studies have demonstrated the effectiveness of drug abuse treatment. Yet many drug abusers do not enter treatment, many who do enter leave prematurely, and relapse following treatment is common. Understanding motivation for change and treatment readiness is key to understanding how to induct and engage drug users in treatment. To the extent that treatment programs focus initially on reducing drug use, rather than psychosocial problems that motivate individuals to seek treatment, treatment programs may fail to meet the primary needs of users and thus fail to attract or engage them. Outcomes of substance abuse treatment programs historically have been measured by successful program completion, reduced drug use and illegal activity, and improved social functioning (employment, education etc). There is minimal reference to client expectations of treatment and factors that influenced treatment-seeking behavior. Studies that have assessed client dropout from substance abuse treatment have generally focused upon quantitative measures that attempt to determine what types of clients drop out or stay, or what types of characteristics best predict client dropout. Qualitative methods are the most appropriate to fill these gaps in substance abuse treatment research. PMID:15988078

  2. Withholding treatment from Baby Doe: from discrimination to child abuse.

    PubMed

    Rhoden, N K; Arras, J D

    1985-01-01

    Questions surrounding withholding treatment from severely impaired newborns have elicited three significantly different substantive and procedural responses: from the Reagan administration's Department of Health and Human Services through the Carter President's Commission on Ethical Problems, and subsequent congressional legislation on child abuse. Movement from a rigid and simplistic application of medical imperatives to ambiguous and abstract criteria of the child's "best interest" represented limited progress. A new legislative compromise principle is an imperfect but practical accommodation to moral and medical realities. PMID:3158840

  3. The effectiveness of an abuse assessment protocol in public health prenatal clinics.

    PubMed Central

    Wiist, W H; McFarlane, J

    1999-01-01

    OBJECTIVES: This study evaluated whether incorporation of an abuse assessment protocol into the routine procedures of the prenatal clinics of a large urban public health department led to increased referral for and assessment, identification, and documentation of abuse. METHODS: Evaluation was conducted at 3 matched prenatal clinics serving a total of 12,000 maternity patients per year. Two clinics used the abuse protocol and 1 did not. An audit was performed at the clinics on a randomly selected sample of 540 maternity patient charts for the 15 months before the protocol was initiated and of 540 records for the 15 months after the protocol was introduced. Ninety-six percent of the patients represented in the sample were Latina. RESULTS: At the clinics using the protocol, abuse assessment increased from 0 to 88%. Detection of abuse increased from 0.8% to 7%. There were no changes at the comparison clinic. CONCLUSIONS: Incorporation of an abuse assessment protocol into the routine procedures of public health department prenatal clinics increases the assessment, identification, and documentation of and referral for abuse among pregnant women. An abuse protocol should be a routine part of maternity care. PMID:10432909

  4. Violence against Native Women in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Saylors, Karen; Daliparthy, Nalini

    2006-01-01

    Many mental health problems among substance abusing populations are directly linked to high rates of abuse and trauma. There is increasing evidence of associations between childhood physical and sexual abuse to adult substance use and HIV-risk behavior. The relationship of abuse, mental health problems, substance abuse, and high-risk sexual…

  5. Screening for psychiatric and substance abuse disorders in clinical practice.

    PubMed

    Ford, D E; Kamerow, D B

    1990-01-01

    Psychiatric disorders, particularly depression and alcohol abuse, represent a large burden of illness to the society. Many individuals with these disorders receive all of their care from health care providers who are not mental health specialists. There is evidence that non-psychiatric physicians frequently do not recognize these disorders in their patients. Screening questionnaires have been introduced to improve detection of these patients. Several studies have found that these screening questionnaires can increase detection rates, but no important impact on patient outcomes has been demonstrated. This review article outlines several reasons why it has been difficult to discern improvement in patient outcomes: inadequate study design, insufficient physician education, interdependence of psychiatric and medical conditions, and vague treatment guidelines. Practical use of the current psychiatric screening questionnaires and key areas for further investigation are considered. PMID:2231063

  6. Substance abuse and intimate partner violence: treatment considerations.

    PubMed

    Klostermann, Keith C

    2006-01-01

    Given the increased use of marital- and family-based treatments as part of treatment for alcoholism and other drug disorders, providers are increasingly faced with the challenge of addressing intimate partner violence among their patients and their intimate partners. Yet, effective options for clinicians who confront this issue are extremely limited. While the typical response of providers is to refer these cases to some form of batterers' treatment, three fundamental concerns make this strategy problematic: (1) most of the agencies that provide batterers' treatment only accept individuals who are legally mandated to complete their programs; (2) among programs that do accept nonmandated patients, most substance-abusing patients do not accept such referrals or drop out early in the treatment process; and (3) available evidence suggests these programs may not be effective in reducing intimate partner violence. Given these very significant concerns with the current referral approach, coupled with the high incidence of IPV among individuals entering substance abuse treatment, providers need to develop strategies for addressing IPV that can be incorporated and integrated into their base intervention packages. PMID:16925813

  7. A Framework for Conducting a National Study of Substance Abuse Treatment Programs Serving American Indian and Alaska Native Communities

    PubMed Central

    Novins, Douglas K.; Moore, Laurie A.; Beals, Janette; Aarons, Gregory A.; Rieckmann, Traci; Kaufman, Carol E.

    2013-01-01

    Background Because of their broad geographic distribution, diverse ownership and operation, and funding instability, it is a challenge to develop a framework for studying substance abuse treatment programs serving American Indian and Alaska Native communities at a national level. This is further complicated by the historic reluctance of American Indian and Alaska Native communities to participate in research. Objectives and Methods We developed a framework for studying these substance abuse treatment programs (n = 293) at a national level as part of a study of attitudes toward, and use of, evidence-based treatments among substance abuse treatment programs serving AI/AN communities with the goal of assuring participation of a broad array of programs and the communities that they serve. Results Because of the complexities of identifying specific substance abuse treatment programs, the sampling framework divides these programs into strata based on the American Indian and Alaska Native communities that they serve: (1) the 20 largest tribes (by population); (2) urban AI/AN clinics; (3) Alaska Native Health Corporations; (4) other Tribes; and (5) other regional programs unaffiliated with a specific AI/AN community. In addition, the recruitment framework was designed to be sensitive to likely concerns about participating in research. Conclusion and Scientific Significance This systematic approach for studying substance abuse and other clinical programs serving AI/AN communities assures the participation of diverse AI/AN programs and communities and may be useful in designing similar national studies. PMID:22931088

  8. Does Integrated Trauma-Informed Substance Abuse Treatment Increase Treatment Retention?

    ERIC Educational Resources Information Center

    Amaro, Hortensia; Chernoff, Miriam; Brown, Vivian; Arevalo, Sandra; Gatz, Margaret

    2007-01-01

    This article presents findings from a quasi-experimental, nonrandomized group design study that explored whether trauma-enhanced substance abuse treatment results in longer residential treatment stays and improved outcomes compared with treatment-as-usual. We used a subsample (N = 461) of participants in the Women, Co-Occurring Disorders and…

  9. [Diagnostics and treatment of Wernicke-Korsakoff syndrome patients with an alcohol abuse].

    PubMed

    Nilsson, Maria; Sonne, Charlotte

    2013-04-01

    Wernicke-Korsakoff syndrome is a condition with high morbidity and mortality and occurs as a consequence of thiamine deficiency. Clinical symptoms are often ambiguous and post-mortem examinations show that the syndrome is underdiagnosed and probably undertreated. There is sparse clinical evidence concerning optimal dosage and duration of treatment. This article reviews the current literature and concludes that all patients with a history of alcohol abuse should be treated with high dosage IV thiamine for an extended period of time, albeit further research is needed. PMID:23582065

  10. The efficacy of group treatment in sexually abused girls.

    PubMed

    McGain, B; McKinzey, R K

    1995-09-01

    The efficacy of the outpatient, once a week group treatment of sexually abused girls was examined using a pre-post, matched control/treatment design. The 30 girls were 9-12 years old, within 1 year of trauma, and were screened for psychosis. The Quay Revised Behavioral Problem Checklist (RBPC) and the Eyberg Child Behavior Inventory (ECBI) were used as dependent measures, and given 6 months apart. Depending on the scale, and excepting the RBPC's Psychotic Behavior Scale, 60-100% of the girls had abnormal scores pretreatment, with no significant differences between the two groups. Significant (p < .001) treatment effects were found. After treatment, 0-33% of the treated girls had abnormal scores, while 60-100% of the control group continued to have abnormal scores. Assuming generalization is possible, it appears that this and similar treatment programs are effective in reducing the girls' perceived problematical anxiety and misbehavior. PMID:8528821

  11. Contrasting faith-based and traditional substance abuse treatment programs.

    PubMed

    Neff, James Alan; Shorkey, Clayton T; Windsor, Liliane Cambraia

    2006-01-01

    This article (a) discusses the definition of faith-based substance abuse treatment programs, (b) juxtaposes Durkheim's theory regarding religion with treatment process model to highlight key dimensions of faith-based and traditional programs, and (c) presents results from a study of seven programs to identify key program dimensions and to identify differences/similarities between program types. Focus group/Concept Mapping techniques yielded a clear "spiritual activities, beliefs, and rituals" dimension, rated as significantly more important to faith-based programs. Faith-based program staff also rated "structure and discipline" as more important and "work readiness" as less important. No differences were found for "group activities/cohesion" and "role modeling/mentoring," "safe, supportive environment," and "traditional treatment modalities." Programs showed substantial similarities with regard to core social processes of treatment such as mentoring, role modeling, and social cohesion. Implications are considered for further research on treatment engagement, retention, and other outcomes. PMID:16377452

  12. The interrelationship of substance abuse and posttraumatic stress disorder. Epidemiological and clinical considerations.

    PubMed

    Keane, T M; Gerardi, R J; Lyons, J A; Wolfe, J

    1988-01-01

    This chapter reviews the data available on the relationship of substance abuse and posttraumatic stress disorder (PTSD). Delimiting the review to those studies of Vietnam veterans, we found that levels of combat exposure seemed to be positively related to subsequent alcohol use, although not all studies confirmed this relationship. When studies of patients seeking treatment for PTSD were examined, we learned that 60-80% of these patients had concurrent diagnoses of substance abuse, alcohol abuse, or dependence. Methodological limitations of all the studies are discussed and conclusions regarding the status of the PTSD-substance abuse relationship are drawn cautiously. Alternative suggestions for treatment are presented and discussed. PMID:3283857

  13. Predicting substance abuse treatment completion using a new scale based on the theory of planned behavior.

    PubMed

    Zemore, Sarah E; Ajzen, Icek

    2014-02-01

    We examined whether a 9-item scale based on the theory of planned behavior (TPB) predicted substance abuse treatment completion. Data were collected at a public, outpatient program among clients initiating treatment (N=200). Baseline surveys included measures of treatment-related attitudes, norms, perceived control, and intention; discharge status was collected from program records. As expected, TPB attitude and control components independently predicted intention (model R-squared=.56), and intention was positively associated with treatment completion even including clinical and demographic covariates (model R-squared=.24). TPB components were generally associated with the alternative readiness scales as expected, and the TPB remained predictive at higher levels of coercion. Meanwhile, none of the standard measures of readiness (e.g., the URICA and TREAT) or treatment coercion were positively associated with treatment participation. Results suggest promise for application of the TPB to treatment completion and support use of the intention component as a screener, though some refinements are suggested. PMID:23953167

  14. 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…

  15. Effects of executive impairments on maladaptive explanatory styles in substance abusers: clinical implications.

    PubMed

    García, Antonio Verdejo; Torrecillas, Francisca López; de Arcos, Francisco Aguilar; García, Miguel Pérez

    2005-01-01

    Our study examined the relation between neuropsychological impairment of executive functions and explanatory styles, according to the Abramson model of learned helplessness in humans, in a sample of substance abusers. Thirty-eight polysubstance abusers were assessed during an abstinence period using a selective neuropsychological battery for the evaluation of the executive functions, as well as the Attributional Style Questionnaire (ASQ) for the assessment of the three dimensions of explanatory style: Internality-Externality, Stability-Instability and Globality-Specificity. Multiple regression analyses showed significant relationships among performance on different neuropsychological tasks sensitive to executive functions and characteristic cognitive styles. The results showed the performance on cognitive flexibility and response inhibition tasks is directly related to making more internal attributions for positive situations, and inversely related to the appearance of more stable attributions for negative events. Likewise, adequate performance on working memory tasks was related to development of more global attributions for failures. These results are partially congruent with the learned helplessness model and particularly relevant for the clinical management of substance abusers and the success on the treatment and rehabilitation of these subjects. PMID:15620814

  16. Victimization among African-American adolescents in substance abuse treatment.

    PubMed

    Perron, Brian E; Gotham, Heather J; Cho, Dong

    2008-03-01

    Victimization is regarded as a significant public health issue, especially among adolescents in urban areas. Although victimization is linked to substance use, the research on victimization among adolescents in treatment is underdeveloped. Given the high rate of victimization among African-American adolescents, further research on the prevalence and correlates of victimization for this population is needed. This knowledge can guide the development of effective treatment and prevention strategies. This study contributed to the research by examining the rate and different types of victimization among a sample of African-American adolescents in an urban substance abuse treatment program, testing whether victimization is associated with increased levels of psychopathology and high-risk behaviors; and comparing the rates and associations with existing studies of adolescent victimization. It reports on a sample of 259 African-American adolescents receiving substance abuse treatment in an inner-city program. Fifty-four percent of the subjects reported lifetime victimization. Severity of victimization was associated with depression, generalized anxiety disorder, traumatic stress disorder, and conduct disorder, although the effect sizes were relatively small. Lifetime victimization exhibited a relationship of small to moderate strength with high-risk behaviors (i.e., illegal activity, gang membership, multiple sex partners and unprotected sex). Service implications and recommendations for future research are provided. PMID:18472666

  17. The Role of Mental Health Professionals in the Prevention and Treatment of Child Abuse and Neglect. The User Manual Series.

    ERIC Educational Resources Information Center

    Peterson, Marilyn Strachan; Urquiza, Anthony J.

    This manual is intended to provide mental health professionals with the information needed in the evaluation and treatment of maltreated children and their families. An introductory chapter briefly considers the roles of the various mental health disciplines in child abuse intervention, including psychiatry, psychology, clinical social work,…

  18. Patients Reporting Ritual Abuse in Childhood: A Clinical Syndrome. Report of 37 Cases.

    ERIC Educational Resources Information Center

    Young, Walter C.; And Others

    1991-01-01

    Thirty-seven adult dissociative disorder patients who reported ritual abuse in childhood by satanic cults are described. A clinical syndrome is presented that includes dissociative states with satanic overtones, posttraumatic stress disorder, survivor guilt, unusual fears, and substance abuse. Questions concerning reliability, credibility, and…

  19. Social and Emotional Outcomes of Child Sexual Abuse: A Clinical Sample in Turkey

    ERIC Educational Resources Information Center

    Ozbaran, Burcu; Erermis, Serpil; Bukusoglu, Nagehan; Bildik, Tezan; Tamar, Muge; Ercan, Eyyup Sabri; Aydin, Cahide; Cetin, Saniye Korkmaz

    2009-01-01

    Childhood sexual abuse is a traumatic life event that may cause psychiatric disorders such as posttraumatic stress disorder and depression. During 2003-2004, 20 sexually abused children were referred to the Child and Adolescent Psychiatry Clinic of Ege University in Izmir, Turkey. Two years later, the psychological adjustment of these children (M…

  20. Clinical Characteristics of Adults Reporting Repressed, Recovered, or Continuous Memories of Childhood Sexual Abuse

    ERIC Educational Resources Information Center

    McNally, Richard J.; Perlman, Carol A.; Ristuccia, Carel S.; Clancy, Susan A.

    2006-01-01

    The authors assessed women and men who either reported continuous memories of their childhood sexual abuse (CSA, n = 92), reported recovering memories of CSA (n = 38), reported believing they harbored repressed memories of CSA (n = 42), or reported never having been sexually abused (n = 36). Men and women were indistinguishable on all clinical and…

  1. The Adolescent Substance Abuse Goal Commitment (ASAGC) Questionnaire: An Examination of Clinical Utility and Psychometric Properties.

    PubMed

    Kaminer, Yifrah; Ohannessian, Christine McCauley; McKay, James R; Burke, Rebecca H

    2016-02-01

    Commitment to change is an innovative potential mediator or mechanism of behavior change that has not been examined in adolescents with substance use disorders (SUD). The Adolescent Substance Abuse Goal Commitment (ASAGC) questionnaire is a 16-item measure developed to assess an individual's commitment to his/her stated treatment goal. The objectives of this study are to explore the research and clinical utility of the commitment construct as measured by the ASAGC. During sessions 3 and 9 of a 10-week SUD treatment, therapists completed the ASAGC for 170 13-18 year-old adolescents. An exploratory factor analysis was conducted on the ATAGC items. Concurrent validity with related constructs, self-efficacy and motivation for change, was examined as well. At both sessions, the factor analysis resulted in two scales--Commitment to Recovery and Commitment to Harm Reduction. The ASAGC scales were found to demonstrate a high level of internal consistency (alpha coefficients ranged from .92 to .96 over time). In contrast to the Commitment to Harm Reduction scale, the Commitment to Recovery scale consistently correlated with scales from the Situational Confidence Questionnaire assessing self-efficacy, evidencing concurrent validity. Similarly, the Commitment to Recovery scale was related to the Problem Recognition Questionnaire, providing further evidence of the validity of the ASAGC. The ASAGC is a reliable and valid clinical research instrument for the assessment of adolescents' commitment to their substance abuse treatment goal. Clinical researchers may take advantage of the clinical utility of the ASAGC including its ability to differentiate between commitment to abstinence versus commitment to harm reduction. PMID:26531893

  2. Research design considerations for clinical studies of abuse-deterrent opioid analgesics: IMMPACT recommendations

    PubMed Central

    Turk, Dennis C.; O’Connor, Alec B.; Dworkin, Robert H.; Chaudhry, Amina; Katz, Nathaniel P.; Adams, Edgar H.; Brownstein, John S.; Comer, Sandra D.; Dart, Richard; Dasgupta, Nabarun; Denisco, Richard A.; Klein, Michael; Leiderman, Deborah B.; Lubran, Robert; Rappaport, Bob A.; Zacny, James P.; Ahdieh, Harry; Burke, Laurie B.; Cowan, Penney; Jacobs, Petra; Malamut, Richard; Markman, John; Michna, Edward; Palmer, Pamela; Peirce-Sandner, Sarah; Potter, Jennifer S.; Raja, Srinivasa N.; Rauschkolb, Christine; Roland, Carl L.; Webster, Lynn R.; Weiss, Roger D.; Wolf, Kerry

    2013-01-01

    Opioids are essential to the management of pain in many patients, but they also are associated with potential risks for abuse, overdose, and diversion. A number of efforts have been devoted to the development of abuse-deterrent formulations of opioids to reduce these risks. This article summarizes a consensus meeting that was organized to propose recommendations for the types of clinical studies that can be used to assess the abuse deterrence of different opioid formulations. Due to the many types of individuals who may be exposed to opioids, an opioid formulation will need to be studied in several populations using various study designs in order to determine its abuse-deterrent capabilities. It is recommended that the research conducted to evaluate abuse deterrence should include studies assessing: (1) abuse liability; (2) the likelihood that opioid abusers will find methods to circumvent the deterrent properties of the formulation; (3) measures of misuse and abuse in randomized clinical trials involving pain patients with both low risk and high risk of abuse; and (4) post-marketing epidemiological studies. PMID:22770841

  3. Research design considerations for clinical studies of abuse-deterrent opioid analgesics: IMMPACT recommendations.

    PubMed

    Turk, Dennis C; O'Connor, Alec B; Dworkin, Robert H; Chaudhry, Amina; Katz, Nathaniel P; Adams, Edgar H; Brownstein, John S; Comer, Sandra D; Dart, Richard; Dasgupta, Nabarun; Denisco, Richard A; Klein, Michael; Leiderman, Deborah B; Lubran, Robert; Rappaport, Bob A; Zacny, James P; Ahdieh, Harry; Burke, Laurie B; Cowan, Penney; Jacobs, Petra; Malamut, Richard; Markman, John; Michna, Edward; Palmer, Pamela; Peirce-Sandner, Sarah; Potter, Jennifer S; Raja, Srinivasa N; Rauschkolb, Christine; Roland, Carl L; Webster, Lynn R; Weiss, Roger D; Wolf, Kerry

    2012-10-01

    Opioids are essential to the management of pain in many patients, but they also are associated with potential risks for abuse, overdose, and diversion. A number of efforts have been devoted to the development of abuse-deterrent formulations of opioids to reduce these risks. This article summarizes a consensus meeting that was organized to propose recommendations for the types of clinical studies that can be used to assess the abuse deterrence of different opioid formulations. Because of the many types of individuals who may be exposed to opioids, an opioid formulation will need to be studied in several populations using various study designs to determine its abuse-deterrent capabilities. It is recommended that the research conducted to evaluate abuse deterrence should include studies assessing: (1) abuse liability, (2) the likelihood that opioid abusers will find methods to circumvent the deterrent properties of the formulation, (3) measures of misuse and abuse in randomized clinical trials involving pain patients with both low risk and high risk of abuse, and (4) postmarketing epidemiological studies. PMID:22770841

  4. A Program for Engaging Treatment-Refusing Substance Abusers into Treatment: CRAFT

    ERIC Educational Resources Information Center

    Meyers, Robert J.; Smith, Jane Ellen; Lash, Denise N.

    2005-01-01

    Community Reinforcement and Family Training (CRAFT) is a scientifically-supported program for family members who are desperate to get a treatment-refusing substance abuser to enter treatment (Meyers & Wolfe, 2004; Sisson & Azrin, 1986; Smith & Meyers, 2004). CRAFT teaches these family members how to apply behavioral principles at home so that…

  5. Association of perpetrator relationship to abusive head trauma clinical outcomes.

    PubMed

    Scribano, Philip V; Makoroff, Kathi L; Feldman, Kenneth W; Berger, Rachel P

    2013-10-01

    The diagnosis of abusive head trauma (AHT) remains a significant public health problem with limited prevention success. Providing protection from further harm is often challenged by the difficulty in identifying the alleged perpetrator (AP) responsible for this pediatric trauma. The objective of this study was to evaluate demographic and clinical characteristics of children with AHT and the relationship between APs and their victims in a large, multi-site sample. Understanding the AHT risks from various caregivers may help to inform current prevention strategies. A retrospective review of all cases of AHT diagnosed by child protection teams (CPT) from 1/1/04 to 6/30/09 at four children's hospitals was conducted. Clinical characteristics of children with AHT injured by non-parental perpetrators (NPP) were compared to parental perpetrators (PP). There were 459 children with AHT; 313 (68%) had an identified AP. The majority of the 313 children were <1 year of age (76%), Caucasian (63%), male (58%), receiving public assistance (80%), and presented without a history of trauma (62%); mortality was 19%. Overall, APs were: father (53%), parent partner (22%), mother (8%), babysitter (8%), other adult caregiver (5%); NPP accounted for 39% of APs. NPPs were more likely to cause AHT in children ≥ 1 year (77% vs. 23%, p<0.001) compared to PP. Independent associations to NPP included: older child, absence of a history of trauma, retinal hemorrhages, and male perpetrator gender. While fathers were the most common AP in AHT victims, there is a significant association for increased risk of AHT by NPPs in the older child, who presents with retinal hemorrhages, in the hands of a male AP. Further enhancement of current prevention strategies to address AHT risks of non-parental adults who provide care to children, especially in the post-infancy age seems warranted. PMID:23735871

  6. 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

  7. Estimating Determinants of Multiple Treatment Episodes for Substance Abusers.

    PubMed

    Goodman, Allen C.; Hankin, Janet R.; Kalist, David E.; Peng, Yingwei; Spurr, Stephen J.

    2001-06-01

    BACKGROUND: Health services researchers have increasingly used hazard functions to examine illness or treatment episode lengths and related treatment utilization and treatment costs. There has been little systematic hazard analysis, however, of mental health/substance abuse (MH/SA) treatment episodes. AIMS OF THE STUDY: This article uses proportional hazard functions to characterize multiple treatment episodes for a sample of insured clients with at least one alcohol or drug treatment diagnosis over a three-year period. It addresses the lengths and timing of treatment episodes, and the relationships of episode lengths to the types and locations of earlier episodes. It also identifies a problem that occurs when a portion of the sample observations is ǣpossibly censored. Failure to account for sample censoring will generate biased hazard function estimates, but treating all potentially censored observations as censored will overcompensate for the censoring bias. METHODS: Using insurance claims data, the analysis defines health care treatment episodes as all events that follow the initial event irrespective of diagnosis, so long as the events are not separated by more than 30 days. The distribution of observations ranges from 1 day to 3 years, and individuals have up to 10 episodes. Due to the data collection process, observations may be right censored if the episode is either ongoing at the time that data collection starts, or when the data collection effort ends. The Andersen-Gill (AG) and Wei-Lin-Weissfeld (WLW) estimation methods are used to address relationships among individuals multiple episodes. These methods are then augmented by a probit censoring model that estimates censoring probability and adjusts estimated behavioral coefficients and related treatment utilization and treatment costs. There has been little systematic hazard analysis, however, of mental health/substance abuse (MH/SA) treatment episodes. RESULTS: Five sets of variables explain episode

  8. 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…

  9. 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…

  10. Program characteristics for successful treatment of adolescent drug abuse.

    PubMed

    Friedman, A S; Glickman, N W

    1986-11-01

    The relationship to treatment outcome, as measured by reduction in drug use, of specific characteristics and elements of 30 drug-free outpatient programs for adolescents is reported. Admission and discharge data were obtained from National Institute on Drug Abuse-Client Oriented Data Acquisition Process on 5789 adolescents in the 30 programs. A partial cross-validation study was conducted by analyzing separately for two annual client subsamples. The program, not the individual clients, was the unit of analysis. While controlling for differences between programs on their client populations, multiple regression analysis indicated that the following characteristics of programs were found to predict the outcome criterion variable, to a statistically significant degree: treat a large number of adolescent clients; have a special school for school dropouts; have a relatively large budget; employ counselors or therapists who have at least 2 years' experience in working with adolescent drug abusers; provide special services such as vocational counseling, recreational services, and birth control services; use such therapy methods as crisis intervention, gestalt therapy, music/art therapy, and group confrontation; and be perceived by the clients as allowing and encouraging free expression and spontaneous action by clients. There was a high degree of replication of these findings across the two annual subsamples of clients; and the amount of variance in the treatment outcome criterion variable accounted for by the above-listed program characteristics was quite impressive. PMID:3772356

  11. Cocaine abuse among opioid addicts: demographic and diagnostic factors in treatment.

    PubMed

    Kosten, T R; Gawin, F H; Rounsaville, B J; Kleber, H D

    1986-01-01

    Cocaine is becoming a major drug of abuse among the general population and among opiate addicts. Reports from the early 1970s found that most abusers were older Black males with some antisocial characteristics. Cocaine abuse at that time was reported by about 17% of opiate addicts seeking treatment and by 7 to 11% of ex-addicts on methadone maintenance. However, that rate increased dramatically during the 1970s, and in our 1980 study of 533 addicts we found that 74% of opiate addicts applying for treatment used cocaine. It was the second most abused nonopioid drug after marijuana, surpassing alcohol intoxication. Although the mean number of days of abuse over the previous 30 days was substantially lower among the addicts on our methadone maintenance program (mean = 1.4 days, n = 120) than among the addicts applying for treatment (mean = 9 days, n = 204), the following associations with cocaine abuse were consistent in both subsamples. Cocaine abuse was more frequent among Blacks. It was associated with a variety of antisocial indices including Research Diagnostic Criteria antisocial personality disorder, number of arrests, and legal, family, employment, and drug abuse problems as assessed by the Addiction Severity Index and the Social Adjustment Scale. Several differences emerged between Black and White cocaine-abusing addicts, the most interesting being an increased rate of anxiety disorders among White cocaine abusers. Based on these associations, we offer several guidelines for treating cocaine abuse in opiate addicts. PMID:3788892

  12. Utilization of mental health services among adolescents in community-based substance abuse outpatient clinics.

    PubMed

    Chan, Ya-Fen; Godley, Mark D; Godley, Susan H; Dennis, Michael L

    2009-01-01

    This study examined the rates and correlates of self-reported receipt for mental health services among 1,190 adolescents, aged 12-19, who were admitted to community-based substance abuse outpatient clinics and had a co-occurring mental health problem. Utilization of mental health service was ascertained 3 months post-intake. About one third (35%) of adolescents with a co-occurring mental health problem identified at intake received mental health service in the 3 months after treatment entry. After holding other correlates constant, history of mental health treatment, suicidal behavior, family history of mental disorder and insurance coverage at intake were associated with mental health service utilization at the 3-month follow up. Predictors of service utilization varied by gender and racial/ethnic status. Implications for integrated substance use and mental health services are discussed. PMID:18157641

  13. National and State Estimates of the Drug Abuse Treatment Gap: 2000 National Household Survey on Drug Abuse.

    ERIC Educational Resources Information Center

    Research Triangle Inst., Research Triangle Park, NC.

    This report presents information from the 2000 National Household Survey on Drug Abuse (NHSDA) on the number and percentage of the population in the nation and in each state who need but did not receive treatment for an illicit drug use problem, referred to as the treatment gap. Following the introduction, chapter 2 presents national estimates of…

  14. Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. Treatment Improvement Protocol (TIP) Series 40

    ERIC Educational Resources Information Center

    Boone, Margaret; Brown, Nancy J.; Moon, Mary A.; Schuman, Deborah J.; Thomas, Josephine; Wright, Denise L.

    2004-01-01

    This Treatment Improvement Protocol (TIP) addresses the clinical use of buprenorphine in the treatment of opioid addiction. 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…

  15. Principles of laboratory assessment of drug abuse liability and implications for clinical development

    PubMed Central

    Carter, Lawrence P.; Griffiths, Roland R.

    2009-01-01

    Abuse liability testing plays an important role in informing drug development, regulatory processes, and clinical practice. This paper describes the current “gold standard” methodologies that are used for laboratory assessments of abuse liability in non-human and human subjects. Particular emphasis is given to procedures such as non-human drug discrimination, self-administration, and physical dependence testing, and human dose effect abuse liability studies that are commonly used in regulatory submissions to governmental agencies. The potential benefits and risks associated with the inclusion of measures of abuse liability in industry-sponsored clinical trials is discussed. Lastly, it is noted that many factors contribute to patterns of drug abuse and dependence outside of the laboratory setting and positive or negative signals in abuse liability studies do not always translate to high or low levels of actual abuse or dependence. Well-designed patient and physician education, pharmacovigilance, and postmarketing surveillance can reduce the diversion and misuse of drugs with abuse liability and can effectively foster the protection and promotion of public health. PMID:19443137

  16. Clinical case management: a strategy to coordinate detection, reporting, and prosecution of elder abuse.

    PubMed

    Luu, Arlene D; Liang, Bryan A

    2005-01-01

    Despite civil and criminal sanctions, elder abuse is a prevalent, underreported, and underprosecuted event in the United States. Traditional reporting legislation and common law remedies have had minimal effect on the incidence and prevalence of elder abuse. The epidemic nature of elder abuse is projected to increase exponentially as the elderly population grows disproportionately over the next several decades. The fragmented system of detecting, reporting, and prosecuting this abuse across a wide range of medical and legal settings creates a poor structure to effectively allow a potentially abused patient to have his/her abuse circumstance communicated to the relevant parties to protect the patient, have his/her situation reported and investigated, and, if necessary, have the perpetrator brought to justice. Emergency rooms and other facilities where elders present for care should be staffed by clinically trained persons who have familiarity interacting with patients and providers across settings of care, and who are trained to detect and report abuse. Nursing case managers fill this role well because they are able to coordinate efforts among acute and long-term care facilities while also being able to supply patients with legal and clinical information about elder abuse. In addition they may support prosecution efforts through their clinical observations and expertise. Hence, clinical case managers are able to coordinate efforts lacking in the current system to effectively evaluate, report, protect, and arrange for relevant services for the patient. Through clinical and special training in elder abuse, nursing case managers can provide support to prosecution efforts against the perpetrators of this most egregious crime. PMID:16838454

  17. Psychoanalytic Treatment of Psychological Addiction to Alcohol (Alcohol Abuse)

    PubMed Central

    Johnson, Brian

    2011-01-01

    The DSM-V Committee plans to abolish the distinction between Alcohol Abuse and Alcohol Dependence (dsm5.org). The author presents a case report as a proof of concept that this distinction should be retained. The author has asserted that Alcohol Abuse is a purely psychological addiction, while Alcohol Dependence involves capture of the ventral tegmental dopaminergic SEEKING system (Johnson, 2003). In psychological addiction the brain can be assumed to function normally, and ordinary psychoanalytic technique can be followed. For the patient described, transference interpretation was the fundamental key to recovery. Alcoholic drinking functioned to prevent this man from remembering overwhelming childhood events; events that were also lived out in his current relationships. Murders that occurred when he was a child were hidden in a screen memory. The patient had an obsessional style of relating where almost all feeling was left out of his associations. After he stopped drinking compulsively, he continued to work compulsively. The maternal transference had to be enacted and then interpreted in order for overwhelming memories to be allowed into conscious thought. After psychoanalysis, the patient resumed drinking and worked a normal schedule that allowed more fulfilling relationships. He had no further symptoms of distress from drinking over a 9-year followup. This case illustrates that Alcohol Abuse is a purely psychological illness, that it does not have the brain changes typical of Alcohol Dependence. Combining epidemiological, neurobiological, longitudinal, and psychoanalytic observations would allow multiple sources of information to be used in creating diagnostic categories. Losing details of human behavior by relying only on epidemiological studies is likely to cause errors in categorization of disorders. In turn, having faulty categories as the basis of further research is likely to impair identification of specific effective treatments. PMID:22144975

  18. Perspectives on Adolescent Residential Substance Abuse Treatment: When Are Adolescents Done?

    PubMed Central

    Wisdom, Jennifer P.; Gogel, Leah P.

    2013-01-01

    Objectives The study evaluated responses from adolescents in substance abuse treatment, their parents, and treatment staff to the question of what constitutes treatment success. Methods Semistructured interviews were conducted with 28 adolescents, 30 parents, and 29 staff at three residential substance abuse treatment programs in two states. Data were coded and organized into themes by respondent type. Results Respondents reported knowing when treatment was no longer needed based on changes in adolescents’ substance use, treatment-related and other behaviors, and attitudes and character. A fourth category of responses indicated respondents’ ambiguity regarding successful completion of substance abuse treatment. Little concurrence was found among adolescents, parents, and treatment center staff to indicate criteria suggesting that discharge is appropriate. Conclusions Substance abuse treatment programs and their clients may benefit from ensuring that staff, parents, and adolescents are aware of treatment goals to promote more effective treatment and improve collaboration toward the adolescent’s recovery. PMID:20675841

  19. Improving linkage with substance abuse treatment using brief case management and motivational interviewing

    PubMed Central

    Rapp, Richard C.; Otto, Amy L.; Lane, D. Timothy; Redko, Cristina; McGatha, Sue; Carlson, Robert G.

    2008-01-01

    Background Poor linkage with substance abuse treatment remains a problem, negating the benefits that can accrue to both substance abusers and the larger society. Numerous behavioral interventions have been tested to determine their potential role in improving linkage. Methods A randomized clinical trial of 678 substance abusers compared the linkage effect of two brief interventions with the referral standard of care (SOC) at a centralized intake unit (CIU). Interventions included five sessions of strengths-based case management (SBCM) or one session of motivational interviewing (MI). A priori hypotheses predicted that both interventions would be better than the standard of care in predicting linkage and that SBCM would be more effective than MI. We analyzed the effect of the two interventions on overall treatment linkage rates and by treatment modality. Logistic regression analysis examined predictors of treatment linkage for the sample and each group. Results Two hypotheses were confirmed in that SBCM (n = 222) was effective in improving linkage compared to the SOC (n = 230), 55.0% vs. 38.7% (p < .01). SBCM improved linkage more than MI (55.0% vs. 44.7%, p < .05). Motivational interviewing (n = 226) was not significantly more effective in improving linkage than the standard of care (44.7% vs. 38.7%; p > .05). The three trial groups differed only slightly on the client characteristics that predicted linkage with treatment. Conclusions The results of this study confirm a body of literature that supports the effectiveness of case management in improving linkage with treatment. The role of motivational interviewing in improving linkage was not supported. Results are discussed in the context of other case management and motivational interviewing linkage studies. PMID:18242883

  20. Sexual Abuse in Nine North American Cultures: Treatment and Prevention.

    ERIC Educational Resources Information Center

    Fontes, Lisa Aronson, Ed.

    Due to cultural and linguistic misunderstandings, racism, and even homophobia, sexual abuse is frequently mishandled by professionals working with minority populations. Research and multiculturalism have led to advances in understanding sexual abuse in its various contexts. The complicated issues which surround such abuse, in nine different…

  1. The Urgency Of Providing Comprehensive And Integrated Treatment For Substance Abusers With HIV

    PubMed Central

    Volkow, Nora D.; Montaner, Julio

    2011-01-01

    Substance abuse is linked to many new cases of HIV infection. Barriers such as the myth that drug users cannot adhere to HIV/AIDS treatment block progress in curbing the spread of HIV in that population. In this article we explain the need to aggressively seek out high-risk, hard-to-reach substance abusers and to offer them HIV testing, access to treatment, and the necessary support to remain in treatment—both for HIV and for substance abuse. We summarize evidence showing that injection drug users can successfully undergo HIV treatment; that many substance abusers adhere to antiretroviral therapy as well as do people who don’t inject drugs; and that injection drug users who undergo substance abuse treatment are more likely to obtain and stay in treatment for their HIV infection. This evidence makes a strong case for integrating substance abuse treatment with HIV treatment programs and providing substance abusers with universal access to HIV treatment. But an integrated strategy will require changes in the health care system to overcome lingering obstacles that inhibit the merging of substance abuse treatment with HIV programs. PMID:21821558

  2. 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

  3. The Impulsive Lifestyle Counseling Program for Antisocial Behavior in Outpatient Substance Abuse Treatment.

    PubMed

    Thylstrup, Birgitte; Hesse, Morten

    2016-06-01

    Antisocial behavior is associated with low quality of life for the patient and with adverse effects on society and those close to the antisocial patient. However, most patients with antisocial behavior are not seen in treatment settings that focus on their personality but rather in criminal justice settings, substance-abuse treatment, and social welfare settings. This article describes the adaptation and implementation of a highly structured manualized treatment, Impulsive Lifestyle Counseling (ILC), based on the Lifestyle Issues program, a 10-week psychoeducation program studied in prison settings. ILC consists of four sessions over 4 weeks and a booster session 8 weeks later. The goal of treatment is described to patients as "to help people identify their impulsive thoughts and lifestyle leading to problems with drug use, other people, and the police." Two clinical examples and reflections on our experiences with the training and implementation of the ILC program are presented. PMID:21862528

  4. Hospitalized youth and child abuse: a systematic examination of psychiatric morbidity and clinical severity.

    PubMed

    Keeshin, Brooks R; Strawn, Jeffrey R; Luebbe, Aaron M; Saldaña, Shannon N; Wehry, Anna M; DelBello, Melissa P; Putnam, Frank W

    2014-01-01

    Many children and adolescents who require psychiatric hospitalization have been physically or sexually abused, yet the association between reported histories of abuse and the complexity and severity of mental illness among psychiatrically hospitalized youth is poorly described with regard to current inpatient psychiatric practice. We sought to determine the association between histories of abuse and psychiatric complexity and severity in psychiatrically hospitalized youth including comorbidity patterns, psychotropic medication use, reason for admission and length of hospitalization. A systematic chart review was performed on 1433 consecutive psychiatric hospitalizations of children and adolescents that occurred over a 10-month period. Children with a history of abuse were more likely to be diagnosed with multiple DSM-IV-TR disorders than non-traumatized children. A history of sexual abuse was associated with more medication use than in their non-traumatized peers and a higher likelihood of treatment with antipsychotic medications, both at admission and discharge. Physical and sexual abuse were independently associated with increased length of stays, with exposure to both physical and sexual abuse associated with a 2-day increase in duration of hospitalization compared to non-traumatized patients. The findings from this study draw attention to the adverse impact of abuse on psychiatric morbidity and complexity and suggest the need for trauma-informed treatment in psychiatric hospital settings. PMID:24041456

  5. 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…

  6. 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…

  7. 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…

  8. Adoption of Evidence-Based Practices among Substance Abuse Treatment Providers

    ERIC Educational Resources Information Center

    Haug, Nancy A.; Shopshire, Michael; Tajima, Barbara; Gruber, Valerie; Guydish, Joseph

    2008-01-01

    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…

  9. The Use of Family Therapy in Drug Abuse Treatment: A National Survey. Services Research Report.

    ERIC Educational Resources Information Center

    George Washington Univ. Medical Center, Washington, DC.

    A survey sought to determine the nature and extent of family therapy practiced in treatment and rehabilitation agencies serving drug abuse clients. Questionnaire responses to a three-phase study were on a voluntary basis. Phase I, with a 60% response rate, gathered information on the number of drug abuse treatment agencies providing family…

  10. Guidelines for the treatment of adults abused or possibly abused as children (with attention to issues of delayed/recovered memory). NATO Advanced Study Institute.

    PubMed

    Courtois, C A

    1997-01-01

    These guidelines provide practicing clinicians with information regarding psychotherapy with adults who (1) disclose an abuse history (physical, sexual, emotional) at the beginning of therapy; (2) do not disclose abuse despite having knowledge and memory about such events in their past; (3) report new (delayed or recovered) memories of abuse during the course of therapy; and/or (4) suspect past abuse but have no clear memories of having been abused. The more common clinical scenario involves an individual who has retained memory for past abuse but recalls additional events or details during therapy. The less common scenario is for an individual to have totally absent memory of abuse and to later develop highly detailed memory. Practitioners should expect a range of memory presentations and must work to neither suggest nor suppress abuse-related issues that arise in the course of therapy. PMID:9470957

  11. Prescription Opioid Abuse: A Literature Review of the Clinical and Economic Burden in the United States

    PubMed Central

    Patel, Anisha M.; Rattana, Stacy K.; Quock, Tiffany P.; Mody, Samir H.

    2014-01-01

    Abstract Between 2002 and 2007, the nonmedical use of prescription pain relievers grew from 11.0 million to 12.5 million people in the United States. Societal costs attributable to prescription opioid abuse were estimated at $55.7 billion in 2007. The purpose of this study was to comprehensively review the recent clinical and economic evaluations of prescription opioid abuse. A comprehensive literature search was conducted for studies published from 2002 to 2012. Articles were included if they were original research studies in English that reported the clinical and economic burden associated with prescription opioid abuse. A total of 23 studies (183 unique citations identified, 54 articles subjected to full text review) were included in this review and analysis. Findings from the review demonstrated that rates of opioid overdose-related deaths ranged from 5528 deaths in 2002 to 14,800 in 2008. Furthermore, overdose reportedly results in 830,652 years of potential life lost before age 65. Opioid abusers were generally more likely to utilize medical services, such as emergency department, physician outpatient visits, and inpatient hospital stays, relative to non-abusers. When compared to a matched control group (non-abusers), mean annual excess health care costs for opioid abusers with private insurance ranged from $14,054 to $20,546. Similarly, the mean annual excess health care costs for opioid abusers with Medicaid ranged from $5874 to $15,183. The issue of opioid abuse has significant clinical and economic consequences for patients, health care providers, commercial and government payers, and society as a whole. (Population Health Management 2014;17:372–387) PMID:25075734

  12. Prescription opioid abuse: a literature review of the clinical and economic burden in the United States.

    PubMed

    Meyer, Roxanne; Patel, Anisha M; Rattana, Stacy K; Quock, Tiffany P; Mody, Samir H

    2014-12-01

    Between 2002 and 2007, the nonmedical use of prescription pain relievers grew from 11.0 million to 12.5 million people in the United States. Societal costs attributable to prescription opioid abuse were estimated at $55.7 billion in 2007. The purpose of this study was to comprehensively review the recent clinical and economic evaluations of prescription opioid abuse. A comprehensive literature search was conducted for studies published from 2002 to 2012. Articles were included if they were original research studies in English that reported the clinical and economic burden associated with prescription opioid abuse. A total of 23 studies (183 unique citations identified, 54 articles subjected to full text review) were included in this review and analysis. Findings from the review demonstrated that rates of opioid overdose-related deaths ranged from 5528 deaths in 2002 to 14,800 in 2008. Furthermore, overdose reportedly results in 830,652 years of potential life lost before age 65. Opioid abusers were generally more likely to utilize medical services, such as emergency department, physician outpatient visits, and inpatient hospital stays, relative to non-abusers. When compared to a matched control group (non-abusers), mean annual excess health care costs for opioid abusers with private insurance ranged from $14,054 to $20,546. Similarly, the mean annual excess health care costs for opioid abusers with Medicaid ranged from $5874 to $15,183. The issue of opioid abuse has significant clinical and economic consequences for patients, health care providers, commercial and government payers, and society as a whole. PMID:25075734

  13. 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…

  14. Prevalence and predictors of Axis I disorders in a large sample of treatment-seeking victims of sexual abuse and incest

    PubMed Central

    McElroy, Eoin; Shevlin, Mark; Elklit, Ask; Hyland, Philip; Murphy, Siobhan; Murphy, Jamie

    2016-01-01

    Background Childhood sexual abuse (CSA) is a common occurrence and a robust, yet non-specific, predictor of adult psychopathology. While many demographic and abuse factors have been shown to impact this relationship, their common and specific effects remain poorly understood. Objective This study sought to assess the prevalence of Axis I disorders in a large sample of help-seeking victims of sexual trauma, and to examine the common and specific effects of demographic and abuse characteristics across these different diagnoses. Method The participants were attendees at four treatment centres in Denmark that provide psychological therapy for victims of CSA (N=434). Axis I disorders were assessed using the Millon Clinical Multiaxial Inventory-III (MCMI-III). Multivariate logistic regression analysis was used to examine the associations between CSA characteristics (age of onset, duration, number of abusers, number of abusive acts) and 10 adult clinical syndromes. Results There was significant variation in the prevalence of disorders and the abuse characteristics were differentially associated with the outcome variables. Having experienced sexual abuse from more than one perpetrator was the strongest predictor of psychopathology. Conclusions The relationship between CSA and adult psychopathology is complex. Abuse characteristics have both unique and shared effects across different diagnoses. Highlights of the article The prevalence of Axis I disorders were assessed in a large sample of sexual abuse and incest survivors. The impact of demographic and abuse characteristics were also examined. There was significant variation in the prevalence of disorders. Abuse characteristics were differentially associated with the disorders. Abuse from multiple perpetrators was the strongest overall predictor of psychopathology. PMID:27064976

  15. Adoption of medications in substance abuse treatment: priorities and strategies of single state authorities.

    PubMed

    Rieckmann, Traci; Kovas, Anne E; Rutkowski, Beth A

    2010-09-01

    Research has confirmed the effectiveness of medications, when used in conjunction with ongoing counseling, to treat substance abuse disorders. This article describes a national, mixed-methods research project designed to investigate single state authorities' (SSAs) perceptions of adoption of evidence-based practices in substance abuse treatment. Results are focused specifically on medication-assisted treatment, one of five evidence-based practices defined by the National Quality Forum. Medication-assisted treatment (MAT) is an important and effective part of comprehensive care options available to clients who are chronically ill with alcohol and other drug disorders. Despite mounting clinical evidence and increased availability, overall rates of implementation and sustained adoption of medications to treat addiction remain limited. The results illustrate that the SSA representatives who fund public treatment programs believe MAT is a priority and worthy of system-wide implementation. Current strategies utilized by SSAs to support the adoption of MAT are detailed, as are barriers to adoption and implementation. PMID:21138199

  16. Trends in Substances of Abuse among Pregnant Women and Women of Childbearing Age in Treatment

    MedlinePlus

    ... 1 According to data from the Treatment Episode Data Set (TEDS), the proportion of female substance abuse treatment ... at time of admission is a TEDS Supplemental Data Set item. Thirty-four States and jurisdictions—AZ, CA, ...

  17. 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)

  18. Family Treatment for Bipolar Disorder and Substance Abuse in Late Adolescence

    PubMed Central

    Miklowitz, David J.

    2013-01-01

    The initial onset of bipolar disorder occurs in childhood or adolescence in about 50% of patients. Early-onset forms of the disorder have a poorer prognosis than adult-onset forms and are frequently characterized by comorbid substance abuse. Clinical trials research suggests that family psychoeducational approaches are effective adjuncts to medication in stabilizing the symptoms of bipolar disorder in adults and youth, although their efficacy in patients with comorbid substance use disorders has not been systematically investigated. This article describes the family-focused treatment (FFT) of a late adolescent with bipolar disorder and polysubstance dependence. The treatment of this patient and family required adapting FFT to consider the family’s structure, dysfunctional alliance patterns, and unresolved conflicts from early in the family’s history. The case illustrates the importance of conducting manual-based behavioral family treatments with a psychotherapeutic attitude, including addressing unstated emotional conflicts and resistances that may impede progress. PMID:22504610

  19. [Natural recovery and treatment recovery from drug and alcohol abuse].

    PubMed

    Pérez Gómez, Augusto; Sierra Acuña, Diana Raquel

    2007-01-01

    This study examines the concept of natural recovery (without formal treatment) from problems associated with alcohol, marijuana, cocaine and heroin abuse, each one alone or in any combination. Two groups of males (40 Ss between 18 and 60 years of age) and two groups of females (19 Ss between 18 and 55 years of age) with at least one year of abstinence were studied. The main issues considered were: reason for attending treatment or ceasing the use of substances, factors related to maintenance of abstinence, and difficulties and threats associated with abstinence. Several significant differences were found between groups with and without treatment, as well as between males and females, particularly regarding factors related to the maintenance of abstinence. In both cases family and affective links appear as the most relevant factors in the decision to stop using substances. On the other hand, commitment to one's goals and life project are the principal motives for maintaining abstinence or moderate consumption. This reflects the progressive transition from cognitive and emotional processes with external referents to processes with internal referents, associated with personal achievement. PMID:18173103

  20. Differences between adolescents who complete and fail to complete residential substance abuse treatment

    PubMed Central

    Neumann, Anne; Ojong, Tambetta N.; Yanes, Paula K.; Tumiel-Berhalter, Laurene; Daigler, Gerald E.; Blondell, Richard D.

    2010-01-01

    This study examined the admission characteristics associated with failure to complete residential substance abuse treatment among male adolescents. Of 160 admissions, 48 (30%) completed treatment. Having commercial health insurance (P = 0.005), having a family history of a substance use disorder (P = 0.05), and living with only one biological parent (P = 0.015) were admission characteristics associated with non-completion. Those reporting a history of physical or sexual abuse also appeared to be at risk for non-completion (P = 0.014); none of these patients completed the treatment. Interventions that improve residential substance abuse treatment retention for adolescents are needed. PMID:20924878

  1. Clinical Supervision in Alcohol and Drug Abuse Counseling: Principles, Models, Methods.

    ERIC Educational Resources Information Center

    Powell, David J.

    A case is made for professionalism in clinical training as substance abuse counseling becomes a unique field. Part 1, "Principles," includes: (1) "A Historical Review of Supervision"; (2) "A Working Definition of Supervision"; (3) "Leadership Principles for Supervisors" and; (4) "Traits of an Effective Clinical Supervisor." Part 2, "Models,"…

  2. The Effects of Childhood Abuse on Relationship Quality: Gender Differences and Clinical Implications

    ERIC Educational Resources Information Center

    Larsen, Carly D.; Sandberg, Jonathan G.; Harper, James M.; Bean, Roy

    2011-01-01

    This study examined the relationship between self-reported childhood physical and sexual abuse, romantic relationship quality, possible gender differences, and clinical implications. Three hundred thirty-eight women and 296 men who sought services at a university mental health clinic in the northeast region of the United States completed a…

  3. Cultural considerations in the treatment of mental illness among sexually abused children and adolescents: the case of Bali, Indonesia.

    PubMed

    Lesmana, Cokorda Bagus J; Suryani, Luh Ketut; Tiliopoulos, Niko

    2015-01-01

    Childhood and adolescence sexual abuse can have long-lasting and devastating effects on personal and interpersonal growth and development. Sexually abused children tend to exhibit higher rates of poor school performance, aggressive behavior, PTSD (posttraumatic stress disorder), or depressive symptomatology, as well as social and relational deficits (e.g., age-inappropriate sexual behaviors). The trauma following such abuse can further affect neurodevelopment and physiology, aggravating mental or physical problems in adulthood. Early symptom recognition and appropriate interventional applications are important factors in successfully treating or even preventing the development of mental disorders in such cohorts. A central element of effective treatment is the selection of treatment targets. Cultural considerations are rarely or peripherally considered in sexual abuse treatment strategies. Western-trained psychiatrists and clinical psychologists tend to overlook or underestimate such factors in cross-cultural settings, resulting in interventional efforts that may interfere with traditional approaches to healing, and potentially contributing to a transgenerational cycle of trauma. By using Bali (Indonesia) as a focal culture, in this article we discuss the effects of cultural elements and showcase their potential contribution and systematic implementation into a holistic and sensitive interventional model for the treatment of mental illness in childhood and adolescence sexual traumatization. PMID:25732022

  4. A centralized informatics infrastructure for the National Institute on Drug Abuse Clinical Trials Network

    PubMed Central

    Pan, Jeng-Jong; Nahm, Meredith; Wakim, Paul; Cushing, Carol; Poole, Lori; Tai, Betty; Pieper, Carl F.

    2009-01-01

    Background Clinical trial networks were created to provide a sustaining infrastructure for the conduct of multisite clinical trials. As such, they must withstand changes in membership. Centralization of infrastructure including knowledge management, portfolio management, information management, process automation, work policies, and procedures in clinical research networks facilitates consistency and ultimately research. Purpose In 2005, the National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN) transitioned from a distributed data management model to a centralized informatics infrastructure to support the network’s trial activities and administration. We describe the centralized informatics infrastructure and discuss our challenges to inform others considering such an endeavor. Methods During the migration of a clinical trial network from a decentralized to a centralized data center model, descriptive data were captured and are presented here to assess the impact of centralization. Results We present the framework for the informatics infrastructure and evaluative metrics. The network has decreased the time from last patient-last visit to database lock from an average of 7.6 months to 2.8 months. The average database error rate decreased from 0.8% to 0.2%, with a corresponding decrease in the interquartile range from 0.04%–1.0% before centralization to 0.01%–0.27% after centralization. Centralization has provided the CTN with integrated trial status reporting and the first standards-based public data share. A preliminary cost-benefit analysis showed a 50% reduction in data management cost per study participant over the life of a trial. Limitations A single clinical trial network comprising addiction researchers and community treatment programs was assessed. The findings may not be applicable to other research settings. Conclusions The identified informatics components provide the information and infrastructure needed for our clinical trial

  5. Improving the retention rate for residential treatment of substance abuse by sequential intervention for social anxiety

    PubMed Central

    2014-01-01

    Background Residential drug rehabilitation is often seen as a treatment of last resort for people with severe substance abuse issues. These clients present with more severe symptoms, and frequent psychiatric comorbidities relative to outpatients. Given the complex nature of this client group, a high proportion of clients seeking treatment often do not enter treatment, and of those who do, many exit prematurely. Given the highly social nature of residential drug rehabilitation services, it has been argued that social anxieties might decrease the likelihood of an individual entering treatment, or increase the likelihood of them prematurely exiting treatment. The current paper reports on the protocol of a Randomised Control Trial which examined whether treatment of social anxiety prior to entry to treatment improves entry rates and retention in residential drug rehabilitation. Method/design A Randomised Control Trial comparing a social skills treatment with a treatment as usual control group was employed. The social skills training program was based on the principles of Cognitive Behaviour Therapy, and was adapted from Ron Rapee’s social skills training program. A permutated block randomisation procedure was utilised. Participants are followed up at the completion of the program (or baseline plus six weeks for controls) and at three months following entry into residential rehabilitation (or six months post-baseline for participants who do not enter treatment). Discussion The current study could potentially have implications for addressing social anxiety within residential drug treatment services in order to improve entry and retention in treatment. The results might suggest that the use of additional screening tools in intake assessments, a focus on coping with social anxieties in support groups for clients waiting to enter treatment, and greater awareness of social anxiety issues is warranted. Australian New Zealand clinical trials registry Australian New Zealand

  6. Treatment of schizophrenia and comorbid substance abuse: pharmacologic approaches.

    PubMed

    Green, Alan I

    2006-01-01

    Co-occurring substance use disorder is common among patients with schizophrenia, and its presence greatly worsens the course of schizophrenia. A number of theories have been introduced to explain the increased rate of substance use disorder in these patients. These theories include the notion that substance use could trigger psychotic symptoms in vulnerable individuals and the idea that the substances are used to self-medicate symptoms of schizophrenia. Our group and others have advanced a neurobiological hypothesis to explain this comorbidity-that a mesocorticolimbic brain reward circuit underlies the substance use disorder in patients with schizophrenia. Treatment of substance use disorder in these patients is best done with integrated treatment programs that combine psychosocial interventions with pharmacotherapy. Recent data suggest that the atypical antipsychotic clozapine and perhaps other atypical agents may lessen substance use in patients with schizophrenia. My colleagues and I have proposed that clozapine's effect in these patients may be related to its ability to decrease the brain reward circuit dysfunction. Research is continuing on the use of atypical antipsychotics in patients with schizophrenia and comorbid substance abuse. The adjunctive use of naltrexone or other agents also may be helpful. Further research on the optimal pharmacologic approach to patients with dual diagnosis is needed. PMID:16961422

  7. 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... RDAP, they must participate in TDAT in the community. If inmates refuse or fail to complete TDAT,...

  8. 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... RDAP, they must participate in TDAT in the community. If inmates refuse or fail to complete TDAT,...

  9. 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... RDAP, they must participate in TDAT in the community. If inmates refuse or fail to complete TDAT,...

  10. 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... RDAP, they must participate in TDAT in the community. If inmates refuse or fail to complete TDAT,...

  11. The Educator's Role in the Prevention and Treatment of Child Abuse and Neglect.

    ERIC Educational Resources Information Center

    Broadhurst, Diane D.

    The manual delineates the roles of the educator in child abuse and neglect identification, treatment, and prevention. Chapter I addresses the nature, extent, causes, and effects of child abuse and neglect. Chapter II explains why educators should be involved with discussion of legal and ethical issues relating to the problem. A third chapter…

  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. Relapse Among Adolescent Drug Abusers Following Treatment: The Role of Probable ADHD Status

    ERIC Educational Resources Information Center

    Latimer, William W.; Ernst, Jenna; Hennessey, Jodi; Stinchfield, Randy D.; Winters, Ken C.

    2004-01-01

    This is a report on a sample of adolescent drug abusers in treatment (N = 220) to estimate the degree to which probable ADHD status increases the odds of posttreatment alcohol, marijuana, and other drug relapse during the initial 6 months following discharge. Drug abusing youth with probable ADHD status exhibited 2.5 times the risk of…

  14. 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…

  15. State Part C Agency Practices and the Child Abuse Prevention and Treatment Act (CAPTA)

    ERIC Educational Resources Information Center

    Stahmer, Aubyn C.; Sutton, Danielle Thorp; Fox, Lise; Leslie, Laurel K.

    2008-01-01

    Each year nearly 900,000 cases of child abuse and neglect are substantiated in the United States, with the highest rates of maltreatment occurring among infants and toddlers. Children exposed to maltreatment are at increased risk of developmental delay. The Child Abuse Prevention and Treatment Act specifies that children under age 3 with…

  16. Residential Substance Abuse Treatment for State Prisoners: Breaking the Drug-Crime Cycle among Parole Violators.

    ERIC Educational Resources Information Center

    Stohr, Mary K.; Hemmens, Craig; Baune, Diane; Dayley, Jed; Gornik, Mark; Kjaer, Kirstin; Noon, Cindy

    This Research for Practice examines the Residential Substance Abuse Treatment (RSAT) program at the South Idaho Correctional Institution. The program targets parole-violating inmates with substance abuse problems in an effort to reduce recidivism. Researchers conducted a 15-month evaluation of the program's process to identify strengths and…

  17. 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…

  18. 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.

  19. Family and Group Treatment for Sexually-Abused Children: A Review.

    ERIC Educational Resources Information Center

    Silovsky, Jane F.; Hembree-Kigin, Toni L.

    1994-01-01

    Provides a critical discussion of current research on the efficacy of family and group interventions for child sexual abuse victims. Treatment goals and components are described, followed by a review of relevant empirical studies. Suggestions are presented for improving the methodology of future sexual abuse intervention research. (JPS)

  20. Risk Factors in Adolescent Substance Abuse: Treatment and Management Implications.

    ERIC Educational Resources Information Center

    Thomas, Connie S.; Schandler, Steven L.

    1996-01-01

    Discusses research on adolescent substance abuse risk factors and their role in the management of adolescent substance abuse disorders. A selective literature review suggests specific intervention strategies; no generic approach fits all adolescent substance-use clients. Effective techniques require individual assessments, including the context in…

  1. Alcohol and Drug Abusers Entering Treatment: How Different Are They?

    ERIC Educational Resources Information Center

    Seraganian, Peter; And Others

    A major shift in drug abuse epidemiology has been witnessed in North America over the past decade. Although alcohol continues to be widely abused, usage of other substances has proliferated. While addicted individuals share some attributes, certain demographic, psychological, and cognitive characteristics may distinguish alcoholics from those who…

  2. The Fallacy of Victimization in the Treatment of Sexual Abuse.

    ERIC Educational Resources Information Center

    Seligson, Anne Glinert

    Object relations theory offers the most viable explanation of the dynamics of sexually abused individuals by allowing for the conceptualization of an individual, whose earlier object relations left him barren, lonely, or neglected, as having a predisposition or vulnerability to abuse. Children with adequate nurturing experiences react negatively…

  3. Clinical characteristics of adults reporting repressed, recovered, or continuous memories of childhood sexual abuse.

    PubMed

    McNally, Richard J; Perlman, Carol A; Ristuccia, Carel S; Clancy, Susan A

    2006-04-01

    The authors assessed women and men who either reported continuous memories of their childhood sexual abuse (CSA, n = 92), reported recovering memories of CSA (n = 38), reported believing they harbored repressed memories of CSA (n = 42), or reported never having been sexually abused (n = 36). Men and women were indistinguishable on all clinical and psychometric measures. The 3 groups that reported abuse scored similarly on measures of anxiety, depression, dissociation, and absorption. These groups also scored higher than the control group. Inconsistent with betrayal trauma theory, recovered memory participants were not more likely to report abuse by a parent or stepparent than were continuous memory participants. Rates of depression and posttraumatic stress disorder did not differ between the continuous and recovered memory groups. PMID:16649868

  4. Cultural accommodation of group substance abuse treatment for Latino adolescents: Results of an RCT.

    PubMed

    Burrow-Sánchez, Jason J; Minami, Takuya; Hops, Hyman

    2015-10-01

    Comparative studies examining the difference between empirically supported substance abuse treatments versus their culturally accommodated counterparts with participants from a single ethnic minority group are frequently called for in the literature but infrequently conducted in practice. This randomized clinical trial was conducted to compare the efficacy of an empirically supported standard version of a group-based cognitive-behavioral treatment (S-CBT) to a culturally accommodated version (A-CBT) with a sample of Latino adolescents primarily recruited from the juvenile justice system. Development of the culturally accommodated treatment and testing was guided by the Cultural Accommodation Model for Substance Abuse Treatment (CAM-SAT). Seventy Latino adolescents (mean age = 15.2; 90% male) were randomly assigned to 1 of 2 group-based treatment conditions (S-CBT = 36; A-CBT = 34) with assessments conducted at pretreatment, posttreatment, and 3-month follow-up. Longitudinal Poisson mixed models for count data were used to conduct the major analyses. The primary outcome variable in the analytic models was the number of days any substance was used (including alcohol, except tobacco) in the past 90 days. In addition, the variables ethnic identity, familism, and acculturation were included as cultural moderators in the analysis. Although both conditions produced significant decreases in substance use, the results did not support a time by treatment condition interaction; however, outcomes were moderated by ethnic identity and familism. The findings are discussed with implications for research and practice within the context of providing culturally relevant treatment for Latino adolescents with substance use disorders. PMID:25602465

  5. Retention of Under-represented Minorities in Drug Abuse Treatment Studies

    PubMed Central

    Magruder, Kathryn M; Ouyang, Bichun; Miller, Scott; Tilley, Barbara C

    2009-01-01

    Background Differential attrition by minority participants can be as limiting to interpreting final results as poor initial recruitment of minority participants. This is especially important in drug abuse treatment studies, as minorities are over-represented in substance abuse clinical treatment programs. Purpose The specific aims of this secondary data analysis were to: (1) determine if there are differences in study retention rates by race/ethnicity and age, and (2) explore other client characteristics, as well as protocol and treatment program factors, that could account for differential retention rates. Methods We conducted a secondary analysis using data from 1737 participants in the first six clinical trials whose databases were locked in the NIDA Clinical Trials Network. Protocol level characteristics were also abstracted from these studies, and we used data from a study which assessed characteristics of community treatment programs that participated in these studies. Logistic regression was used to study the effect on retention of: client, protocol, and program characteristics. Results In the model of client characteristics, a significant age by race/ethnicity interaction term was detected based on a threshold of 0.1, with younger African Americans having the lowest odds of retention. Primary drug of abuse was also a significant factor in determining study retention, with heroin, methadone, and opiate users having the greatest odds of retention and polydrug users the lowest. Similar analyses testing treatment program characteristics found that only the presence of HIV risk screening and decreasing levels of female admissions (as a percent of total admissions) were related to study retention. In our final model, there was an effect of age, but not race/ethnicity, with younger participants having lower odds of retention. A multivariable model including protocol variables could not be developed due to the high correlation among protocol variables. Limitations

  6. Customizing Monoclonal Antibodies for the Treatment of Methamphetamine Abuse: Current and Future Applications

    PubMed Central

    Peterson, Eric C.; Gentry, W. Brooks

    2015-01-01

    Monoclonal antibody-based medications designed to bind (+)-methamphetamine (METH) with high affinity are among the newest approaches to the treatment of METH abuse, and the associated medical complications. The potential clinical indications for these medications include treatment of overdose, reduction of drug dependence, and protection of vulnerable populations from METH-related complications. Research designed to discover and conduct preclinical and clinical testing of these antibodies suggest a scientific vision for how intact mAb (singular and plural) or small antigen binding fragments of mAb could be engineered to optimize the proteins for specific therapeutic applications. In this review we discuss keys to success in this development process including choosing predictors of specificity, efficacy, duration of action, and safety of the medications in disease models of acute and chronic drug abuse. We consider important aspects of METH-like hapten design and how hapten structural features influence specificity and affinity, with an example of a high-resolution x-ray crystal structure of a high affinity antibody to demonstrate this structural relationship. Additionally, several prototype anti-METH mAb forms such as antigen binding fragments (Fab) and single chain variable fragments (scFv) are under development. Unique, customizable aspects of these fragments are presented with specific possible clinical indications. Finally, we discuss clinical trial progress of the first in kind anti-METH mAb, for which the METH is the disease target instead of vulnerable central nervous system networks of receptors, binding sites and neuronal connections. PMID:24484976

  7. The Effect of Substance Abuse Treatment on High Risk Behaviors in the National Treatment Improvement Evaluation Study (NTIES).

    ERIC Educational Resources Information Center

    Greenfield, Lawrence; Finkbiner, Richard; Bishop, Sharon

    Substance abusers are at particular risk for becoming infected with, and for spreading, a number of serious communicable diseases. The value of substance abuse treatment in helping to reduce the associated risk behaviors for these diseases is the focus of this technical report. This analysis examines the risk behaviors of injection drug use and…

  8. Causes, Consequences, and Prevention of Burnout among Substance Abuse Treatment Counselors: A Rural versus Urban Comparison

    PubMed Central

    Oser, Carrie B.; Biebel, Elizabeth P.; Pullen, Erin; Harp, Kathi LH

    2012-01-01

    Substance abuse counselors are vulnerable to burnout, which has negative repercussions for the counselor, employing organization, and clients. However, little is known about differences in counselor burnout from the counselors’ perspective in rural versus urban treatment centers. In 2008, focus group data from 28 rural and urban counselors in a southern state was analyzed, revealing three burnout themes across all counselors: causes, consequences, and prevention. However, there were various differences between rural and urban counselors in sub-themes with only rural counselors citing office politics and low occupational prestige as causes of burnout. Only urban counselors reported responses endorsing the sub-themes of role reversal, clients trying to choose their counselors, and changing jobs as consequences of burnout. All counselors cited co-worker support, clinical supervision, and self-care as important strategies for managing burnout. In sum, context clearly matters as rural counselors cited more causes of burnout; yet, the implications of burnout are universal in that they often lead to poor quality clinical care. There is a continued need for greater understanding of addiction as a disease, which would reduce stigma, especially in rural areas, as well as increase the prestige and earning potential of the substance abuse counseling occupation. PMID:23662328

  9. Hepatitis Infection in the Treatment of Opioid Dependence and Abuse

    PubMed Central

    Kresina, Thomas F; Sylvestre, Diana; Seeff, Leonard; Litwin, Alain H; Hoffman, Kenneth; Lubran, Robert; Clark, H Westley

    2008-01-01

    Many new and existing cases of viral hepatitis infections are related to injection drug use. Transmission of these infections can result directly from the use of injection equipment that is contaminated with blood containing the hepatitis B or C virus or through sexual contact with an infected individual. In the latter case, drug use can indirectly contribute to hepatitis transmission through the dis-inhibited at-risk behavior, that is, unprotected sex with an infected partner. Individuals who inject drugs are at-risk for infection from different hepatitis viruses, hepatitis A, B, or C. Those with chronic hepatitis B virus infection also face additional risk should they become co-infected with hepatitis D virus. Protection from the transmission of hepatitis viruses A and B is best achieved by vaccination. For those with a history of or who currently inject drugs, the medical management of viral hepatitis infection comprising screening, testing, counseling and providing care and treatment is evolving. Components of the medical management of hepatitis infection, for persons considering, initiating, or receiving pharmacologic therapy for opioid addiction include: testing for hepatitis B and C infections; education and counseling regarding at-risk behavior and hepatitis transmission, acute and chronic hepatitis infection, liver disease and its care and treatment; vaccination against hepatitis A and B infection; and integrative primary care as part of the comprehensive treatment approach for recovery from opioid abuse and dependence. In addition, participation in a peer support group as part of integrated medical care enhances treatment outcomes. Liver disease is highly prevalent in patient populations seeking recovery from opioid addiction or who are currently receiving pharmacotherapy for opioid addiction. Pharmacotherapy for opioid addiction is not a contraindication to evaluation, care, or treatment of liver disease due to hepatitis virus infection. Successful

  10. Studies of the Effectiveness of Treatments for Drug Abuse, Based on the Drug Abuse Reporting Program (DARP): 1974. IBR Report 74-26.

    ERIC Educational Resources Information Center

    Texas Christian Univ., Fort Worth. Inst. of Behavioral Research.

    The papers included in this volume are part of a programmatic investigation involving the evaluation of treatments for drug abuse. The studies are based on treatment outcome criteria for the patient sample representing all admissions during year 3 (June 1, 1971 to May 31, 1972) of the Drug Abuse Reporting Program (DARP). The overall strategy of…

  11. Toxic keratopathy associated with abuse of topical anesthetics and amniotic membrane transplantation for treatment

    PubMed Central

    Tok, Ozlem Yalcin; Tok, Levent; Atay, Inci Meltem; Argun, Tugba Cakmak; Demirci, Nazire; Gunes, Alime

    2015-01-01

    AIM To evaluate the clinical findings of toxic keratopathy associated with abuse of topical anesthetics and the treatment efficacy of amniotic membrane transplantation (AMT). METHODS Fifteen eyes of 10 patients with abuse of topical anesthetics were included in this study. The data collected included patients' demographic information, initial best corrected visual acuity (BCVA), clinical findings, time to AMT, duration of epithelization, additional treatments, posttreatment BCVA, and the results of psychiatric examination. RESULTS All patients were male, with the mean age of 37.9±5.4y. The patients had received 0.5% proparacaine hydrochloride due to pain resulting from foreign bodies, such as welding flash burns and car battery explosions, for a mean of 18.2±12.4d. The mean initial BCVA of the patients was 0.069±0.100. All patients had persistent epithelial defects, stromal infiltration, ring ulcer, and corneal edema. Initially, medical treatment was attempted in all cases. Because of severe pain, persistent epithelial defects and progressing stromal thinning did not improve with medical treatment, thus, the patients underwent AMT. The mean posttreatment BCVA of the patients was 0.33±0.27. All of them, except for two patients, showed improved visual acuity. One patient underwent evisceration for corneal melting and endophthalmitis in another center, and one patient underwent evisceration for severe pain of unknown origin. All 5 patients who consented to a psychiatric examination had depression, had personality disorder, and used tobacco. CONCLUSION AMT appears to be an effective method for pain relief, rapid epithelial and stromal healing; however, visual prognosis is still poor despite medical and surgical interventions. PMID:26558205

  12. Criminal typology of veterans entering substance abuse treatment.

    PubMed

    Schultz, Nicole R; Blonigen, Daniel; Finlay, Andrea; Timko, Christine

    2015-07-01

    Criminal justice involvement among veterans is a critical and timely concern, yet little is known about criminal histories and clinical characteristics among veterans seeking treatment for substance use disorders (SUDs). The present study examined criminal typology, clinical characteristics, treatment utilization, and 12-step mutual-help group (MHG) participation among veterans (N = 332) at intake to SUD treatment at the Department of Veterans Affairs (VA), and 6 months and 1 year post-intake. Cluster analysis yielded three types of criminal histories mild-(78.9%), moderate (13.6%), and severe (7.5%)-distinguished by type of offense, number of convictions, and number of months incarcerated. At intake, participants with mild criminal histories reported more alcohol problems and fewer legal and employment problems than participants with moderate and severe criminal histories. Participants with severe criminal histories were most likely to attend a 12-step MHG meeting in the year post-intake, but all groups had high attendance. When only participants who had attended at least one meeting in the year post-intake were compared, participants with mild criminal histories worked more steps and were more involved in 12-step practices. All groups improved between baseline and follow-up and did not differ at follow-ups on substance use or other clinical outcomes. Multiple regressions identified treatment utilization and MHG attendance, but not baseline criminal history, as significant predictors of improved substance use problem severity at follow-up. Outpatient treatment and 12-step MHG attendance appear to be important components of recovery for veterans with varying criminal histories. Clinicians in SUD treatment programs should screen for criminal histories at treatment intake to ensure appropriate treatment planning. PMID:25661518

  13. Oxazepam for the Treatment of Substance Abuse and Depression: Is it Appropriate?

    PubMed

    Howland, Robert H

    2016-05-01

    Distinguishing itself from other benzodiazepine drugs, oxazepam has an interesting pharmacological and clinical profile, including binding effects on the translocator protein (TSPO) and a relatively favorable safety and abuse liability profile. TSPO is found in the brain (where it is involved in neurosteroid synthesis), but is also expressed in the heart and other peripheral tissues. Oxazepam is potentially useful in the treatment of substance abuse, especially in conjunction with the cortisol synthesis inhibitor metyrapone, and can be considered an appropriate medication to use in the treatment of depression. The oxazepam/metyrapone combination has been piloted in cocaine-dependent patients and should be investigated in patients with depression. Expression of cardiac TSPO is altered by different stress conditions, and drugs binding to TSPO may have cardioprotective effects. The possibility of oxazepam, alone or together with antidepressant drugs, having a positive effect on cardiac function in patients with depression should also be studied. [Journal of Psychosocial Nursing and Mental Health Services, 54(5), 21-24.]. PMID:27135891

  14. 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. PMID:22139045

  15. Toward a Treatment-Relevant Typology of Child Abuse Families.

    ERIC Educational Resources Information Center

    Bowdry, Carole

    1990-01-01

    Discusses criteria for identification of six types of physical maltreatment of children. The typology represents a broad framework which is used to differentiate between milder and more severe forms of physical child abuse. (NH)

  16. "Shadows of the heart": a dramatic video for the treatment resistance of spouse abusers.

    PubMed

    Stosny, S

    1994-11-01

    Successful intervention with spouse abusers, most of whom are ordered into treatment by the courts, must overcome formidable anger and resistance, often expressed by high attrition and scant participation in the group treatment process. The dramatic video "Shadows of the Heart" dissipates client resistance by providing internal motivation to control violent behavior. The video dramatizes spouse abuse from the viewpoint of a young boy, who as a man has become a spouse abuser. As clients experience compassion for the child witness to family violence, they learn to convert their habitual anger response into nonviolent actions. Developed to combat treatment resistance, the video presentation was tested in a randomized experiment with 106 male spouse abusers drawn from seven public and private agencies. Results indicate that the video presentation significantly increased attendance and participation in the group treatment process. PMID:7992138

  17. Monoamine transporter inhibitors and substrates as treatments for stimulant abuse.

    PubMed

    Howell, Leonard L; Negus, S Stevens

    2014-01-01

    The acute and chronic effects of abused psychostimulants on monoamine transporters and associated neurobiology have encouraged development of candidate medications that target these transporters. Monoamine transporters, in general, and dopamine transporters, in particular, are critical molecular targets that mediate abuse-related effects of psychostimulants such as cocaine and amphetamine. Moreover, chronic administration of psychostimulants can cause enduring changes in neurobiology reflected in dysregulation of monoamine neurochemistry and behavior. The current review will evaluate evidence for the efficacy of monoamine transporter inhibitors and substrates to reduce abuse-related effects of stimulants in preclinical assays of stimulant self-administration, drug discrimination, and reinstatement. In considering deployment of monoamine transport inhibitors and substrates as agonist-type medications to treat stimulant abuse, the safety and abuse liability of the medications are an obvious concern, and this will also be addressed. Future directions in drug discovery should identify novel medications that retain efficacy to decrease stimulant use but possess lower abuse liability and evaluate the degree to which efficacious medications can attenuate or reverse neurobiological effects of chronic stimulant use. PMID:24484977

  18. Monoamine Transporter Inhibitors and Substrates as Treatments for Stimulant Abuse

    PubMed Central

    Howell, Leonard L.; Negus, S. Stevens

    2015-01-01

    The acute and chronic effects of abused psychostimulants on monoamine transporters and associated neurobiology have encouraged development of candidate medications that target these transporters. Monoamine transporters in general, and dopamine transporters in particular, are critical molecular targets that mediate abuse-related effects of psychostimulants such as cocaine and amphetamine. Moreover, chronic administration of psychostimulants can cause enduring changes in neurobiology reflected in dysregulation of monoamine neurochemistry and behavior. The current review will evaluate evidence for the efficacy of monoamine transporter inhibitors and substrates to reduce abuse-related effects of stimulants in preclinical assays of stimulant self-administration, drug discrimination and reinstatement. In considering deployment of monoamine transport inhibitors and substrates as agonist-type medications to treat stimulant abuse, the safety and abuse liability of the medications are an obvious concern, and this will also be addressed. Future directions in drug discovery should identify novel medications that retain efficacy to decrease stimulant use but possess lower abuse liability, and evaluate the degree to which efficacious medications can attenuate or reverse neurobiological effects of chronic stimulant use. PMID:24484977

  19. Personality Disorders in Substance Abusers: A Comparison of Patients Treated in a Prison Unit and Patients Treated in Inpatient Treatment

    ERIC Educational Resources Information Center

    Stefansson, Ragnar; Hesse, Morten

    2008-01-01

    A large body of literature has shown a high prevalence of personality disorders in substance abusers. We compared a sample of substance abusers treated in a prison setting with substance abusers treated in a non-prison inpatient setting rated with the Millon Clinical Multiaxial Inventory-III. Base-rate scores indicated a prevalence of 95% of…

  20. Site Matters: Multisite Randomized Trial of Motivational Enhancement Therapy in Community Drug Abuse Clinics

    ERIC Educational Resources Information Center

    Ball, Samuel A.; Martino, Steve; Nich, Charla; Frankforter, Tami L.; Van Horn, Deborah; Crits-Christoph, Paul; Woody, George E.; Obert, Jeanne L.; Farentinos, Christiane; Carroll, Kathleen M.

    2007-01-01

    The effectiveness of motivational enhancement therapy (MET) in comparison with counseling as usual (CAU) for increasing retention and reducing substance use was evaluated in a multisite randomized clinical trial. Participants were 461 outpatients treated by 31 therapists within 1 of 5 outpatient substance abuse programs. There were no retention…

  1. Behavioral and Psychological Assessment of Child Sexual Abuse in Clinical Practice

    ERIC Educational Resources Information Center

    Malhotra, Savita; Biswas, Parthasarathy

    2006-01-01

    This paper discusses the behavioral and psychological assessment of Child Sexual Abuse (CSA) in clinical practice. Following a brief introduction regarding definition and etiology of CSA and discussion on issues of behavioral/psychological consequences of CSA, the paper reviews the various approaches towards behavioral/psychological assessment in…

  2. Maternal Drug Abuse History, Maltreatment, and Functioning in a Clinical Sample of Urban Children

    ERIC Educational Resources Information Center

    Onigu-Otite, Edore C.; Belcher, Harolyn M. E.

    2012-01-01

    Objective: This study examined the association between maternal drug abuse history, maltreatment exposure, and functioning, in a clinical sample of young children seeking therapy for maltreatment. Methods: Data were collected on 91 children, mean age 5.3 years (SD 1.0). The Preschool and Early Childhood Functional Assessment Scales (PECFAS) was…

  3. Clinical Correlates and Repetition of Self-Harming Behaviors among Female Adolescent Victims of Sexual Abuse

    ERIC Educational Resources Information Center

    Cyr, Mireille; McDuff, Pierre; Wright, John; Theriault, Chantal; Cinq-Mars, Caroline

    2005-01-01

    This study investigated self-harming behaviors in 149 female adolescent victims of sexual abuse, first, by determining the rates of nine types of self-mutilating behavior at intake and nine months later and, second, by investigating comorbidity of clinical correlates associated with these behaviors. The adolescents were divided into three groups…

  4. The Clinical-Forensic Dichotomy in Sexual Abuse Evaluations: Moving toward an Integrative Model

    ERIC Educational Resources Information Center

    Tishelman, Amy C.; Meyer, Susanne K.; Haney, Penny; McLeod, Sara K.

    2010-01-01

    We propose the use of an approach to evaluation that can be undertaken in a clinical setting when concerns regarding child sexual abuse are unclear or ambiguous and other systems are not involved, thus providing an option for the nondisclosing child often discussed in the "delayed disclosure" literature. This approach can also be appropriate for a…

  5. Evaluating Faculty Development and Clinical Training Programs in Substance Abuse: A Guide Book.

    ERIC Educational Resources Information Center

    Klitzner, Michael; Stewart, Kathryn

    Intended to provide an overview of program evaluation as it applies to the evaluation of faculty development and clinical training programs in substance abuse for health and mental health professional schools, this guide enables program developers and other faculty to work as partners with evaluators in the development of evaluation designs that…

  6. Arab Parents' Reactions to Child Sexual Abuse: A Review of Clinical Records

    ERIC Educational Resources Information Center

    Abu-Baker, Khawla

    2013-01-01

    This paper addresses parents' reactions to sexual abuse cases in their families. The study analyzed the clinical records of individual and family therapy sessions with 35 cases of Arab Palestinian clients, citizens of Israel (27 individuals and 8 families). Families were categorized as either functional or dysfunctional. It was concluded that…

  7. Counselors' Role in Preventing Abuse of Older Adults: Clinical, Ethical, and Legal Considerations

    ERIC Educational Resources Information Center

    Forman, Julia M.; McBride, Rebecca G.

    2010-01-01

    Mistreatment of older adults is commonplace. These individuals are subjected to abuse, financial exploitation, and neglect. The authors present an overview of the literature concerning mistreatment, with an emphasis on clinical, ethical, and legal considerations. Methods are proposed for prevention, including counselor education, advocacy, and…

  8. Social and Demographic Factors Affecting Psychopathology and Substance Abuse in a Spanish Family Clinic Population.

    ERIC Educational Resources Information Center

    Ladner, Robert A.

    This report presents findings on the social and demographic factors associated with drug abuse, alcoholism, and major psychological impairment in a population of Cuban American patients presenting at the Spanish Family Guidance Clinic (Miami, Florida) in 1974-75. The analysis indicates a number of factors operating to increase the likelihood of…

  9. Satanism as a response to abuse: the dynamics and treatment of satanic involvement in male youths.

    PubMed

    Belitz, J; Schacht, A

    1992-01-01

    Male youths from abusive family environments may be particularly vulnerable to recruitment into satanic cults. Families that are abusive, devalue or invalidate the abused child's feelings, blame the child for the family's problems, and view the world in rigidly moralistic terms create environments in which the youths are likely to identify with the aggressor and label themselves as evil. These youths, who may have poor social skills and feelings of anger, low self-esteem, self-blame, depression, powerlessness, and isolation as a result of the abuse, may use satanic involvement as a means of legitimizing their experience and differentiating from a negatively enmeshed and/or abusive family system. In this paper, the etiological factors and treatment approaches of ten hospitalized boys who had voluntarily involved themselves in repeated group satanic activities during their adolescence are described, and two case illustrations are given. Recommendations for understanding and treating such cases are provided. PMID:1471565

  10. The impact of 9/11 on New York City's substance abuse treatment programs: a study of program administrators.

    PubMed

    Frank, Blanche; Dewart, Tracey; Schmeidler, James; Demirjian, Arlene

    2006-01-01

    Given the far-reaching effects of the terrorist attacks on September 11, 2001, a study was conducted under the supervision of the New York State Office of Alcoholism and Substance Abuse Services to assess the impact on New York City's substance abuse treatment programs. A stratified, random sample of 15 treatment programs was selected to represent the system's major modalities. Administrators representing these programs were interviewed face-to- face using a structured interview schedule. The questions mainly probed the problems experienced on 9/11 and afterwards, patient issues and the lessons learned. The findings show major concerns for the mental health of both staff members and patients, the failure of the telephone communication system, the particular sensitivity of drug-free outpatient clinics, the challenges experienced by methadone programs, and the need to update disaster planning. A host of problems came to the fore now requiring another level of thinking. PMID:16597568

  11. Integration of Substance Abuse Treatment Organizations into Accountable Care Organizations: Results from a National Survey

    PubMed Central

    D’Aunno, Thomas; Friedmann, Peter D.; Chen, Qixuan; Wilson, Donna M.

    2016-01-01

    To meet their aims of managing population health to improve the quality and cost of health care in the United States, accountable care organizations (ACOs) will need to focus on coordinating care for individuals with substance abuse disorders. The prevalence of these disorders is high, and these individuals often suffer from comorbid chronic medical and social conditions. This article examines the extent to which the nation’s fourteen thousand specialty substance abuse treatment (SAT) organizations, which have a daily census of more than 1 million patients, are contracting with ACOs across the country; we also examine factors associated with SAT organization involvement with ACOs. We draw on data from a recent (2014) nationally representative survey of executive directors and clinical supervisors from 635 SAT organizations. Results show that only 15 percent of these organizations had signed contracts with ACOs. Results from multivariate analyses show that directors’ perceptions of market competition, organizational ownership, and geographic location are significantly related to SATinvolvement with ACOs. We discuss implications for integrating the SAT specialty system with the mainstream health care system. PMID:26124307

  12. An HIV Prevention Intervention for Ethnically Diverse Men in Substance Abuse Treatment: Pilot Study Findings

    PubMed Central

    Burlew, A. Kathleen; Hatch-Maillette, Mary A.; Beadnell, Blair; Wright, Lynette; Wilson, Jerika

    2013-01-01

    Objectives. We determined the acceptability, participants' receptivity, and effectiveness of a culturally adapted version of Real Men Are Safe (REMAS-CA), an HIV prevention intervention for men in substance abuse treatment. Methods. In 2010 and 2011, we compared participants who attended at least 1 (of 5) REMAS-CA session (n = 66) with participants in the original REMAS study (n = 136). Participants completed an assessment battery at baseline and at 3-month follow-up with measures of substance abuse, HIV risk behaviors, perceived condom barriers, and demographics. We conducted postintervention focus groups at each clinic. Results. Minority REMAS-CA participants were more likely to have attended 3 or more sessions (87.0%), meeting our definition of intervention completion, than were minority participants in the REMAS study (75.1%; odds ratio = 2.1). For REMAS-CA participants with casual partners (n = 25), the number of unprotected sexual occasions in the past 90 days declined (6.2 vs 1.6). Among minority men in the REMAS study (n = 36), the number of unprotected sexual occasions with casual partners changed little (9.4 vs 8.4; relative risk = 4.56). Conclusions. REMAS-CA was effective across ethnic groups, a benefit for HIV risk reduction programs that serve a diverse clientele. PMID:23488494

  13. The effects of childhood abuse on symptom complexity in a clinical sample: mediating effects of emotion regulation difficulties.

    PubMed

    Choi, Ji Young; Choi, Young Min; Gim, Min Sook; Park, Jun Hyun; Park, Soo Hyun

    2014-08-01

    The purpose of the present study was to first examine whether childhood abuse predicts symptom complexity, as indicated by the number of clinically elevated scales on the MMPI-2 in an adult clinical sample. Secondly, we investigated whether emotion regulation difficulties mediated the relationship between childhood abuse and symptom complexity. A total of 162 adult outpatients not presenting with psychotic symptoms completed the Korean Childhood Trauma Questionnaire (K-CTQ), Life Events Checklist (LEC), Difficulties in Emotion Regulation Scale (DERS), and Korean Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Partial correlation analysis results indicated that after controlling for the presence of adulthood trauma, childhood abuse was associated with more symptom complexity, or more clinically elevated scales on the MMPI-2. Furthermore, structural equation modeling results showed that emotion regulation difficulties partially mediated the relationship between childhood abuse and symptom complexity. These findings indicate that individuals who had experienced childhood abuse evidence simultaneous presentation of diverse clinical symptoms. PMID:24841063

  14. Physicians in the substance abuse treatment workforce: understanding their employment within publicly funded treatment organizations.

    PubMed

    Knudsen, Hannah K; Oser, Carrie B; Abraham, Amanda J; Roman, Paul M

    2012-09-01

    The employment of physicians by substance abuse treatment organizations is understudied, despite physicians' importance in implementing pharmacotherapy and integrating treatment into the broader system of medical care. Drawing on data collected from 249 publicly funded treatment organizations, this study examined organizational and environmental factors associated with the employment of physicians in these settings. A negative binomial regression model indicated that greater numbers of physicians were employed when organizations offered detoxification services, were embedded in health care settings, and were larger in size. Funding barriers, including the costs of physicians and inadequate reimbursement by funders, were negatively associated with physician employment. Programs unaware that they could use state contract funding to pay for medical staff employed fewer numbers of physicians than programs aware of this type of state policy. Attempts to increase physician employment in substance abuse treatment may require attention to both organizational and environmental factors rather than simply trying to attract individuals to the field. Increasing physician employment may be challenging in the current economic climate. PMID:22301083

  15. Assessment and treatment of mood disorders in the context of substance abuse.

    PubMed

    Tolliver, Bryan K; Anton, Raymond F

    2015-06-01

    Recognition and management of mood symptoms in individuals using alcohol and/or other drugs represent a daily challenge for clinicians in both inpatient and outpatient treatment settings. Diagnosis of underlying mood disorders in the context of ongoing substance abuse requires careful collection of psychiatric history, and is often critical for optimal treatment planning and outcomes. Failure to recognize major depression or bipolar disorders in these patients can result in increased relapse rates, recurrence of mood episodes, and elevated risk of completed suicide. Over the past decade, epidemiologic research has clarified the prevalence of comorbid mood disorders in substance-dependent individuals, overturning previous assumptions that depression in these patients is simply an artifact of intoxication and/or withdrawal, therefore requiring no treatment. However, our understanding of the bidirectional relationships between mood and substance use disorders in terms of their course(s) of illness and prognoses remains limited. Like-wise, strikingly little treatment research exists to guide clinical decision making in co-occurring mood and substance use disorders, given their high prevalence and public health burden. Here we overview what is known and the salient gaps of knowledge where data might enhance diagnosis and treatment of these complicated patients. PMID:26246792

  16. The role of setting for ketamine abuse: clinical and preclinical evidence.

    PubMed

    De Luca, Maria Teresa; Meringolo, Maria; Spagnolo, Primavera Alessandra; Badiani, Aldo

    2012-01-01

    Drug abuse is often seen as a unitary phenomenon, partly as a result of the discovery over the past three decades of shared mechanisms of action for addictive substances. Yet the pattern of drug taking is often very different from drug to drug. This is particularly evident in the case of 'club drugs', such as ketamine. Although the number of ketamine abusers is relatively small in the general population, it is quite substantial in some settings. In particular, ketamine abuse is almost exclusively limited to clubs and large music parties, which suggests a major role of context in modulating the reward effects of this drug. This review focuses on recent preclinical and clinical findings, including previously unpublished data, that provide evidence that, even under controlled conditions, ketamine reward is a function of the setting of drug taking. PMID:23159868

  17. Substance Abuse

    ERIC Educational Resources Information Center

    Rowe, Cynthia L.; Liddle, Howard A.

    2003-01-01

    Liddle and Dakof's (1995) comprehensive review of the status of family-based treatment for drug abuse concluded that this modality offered a "promising, but not definitive" approach to treating drug abuse among adolescents and adults. Less than a decade later, significant progress can be seen in the treatment of drug abuse problems using…

  18. Sexual Abuse Histories of Youth in Child Welfare Residential Treatment Centers: Analysis of the Odyssey Project Population

    ERIC Educational Resources Information Center

    Baker, Amy J. L.; Curtis, Patrick A.; Papa-Lentini, Cynthia

    2006-01-01

    This multi-site examination of sexual abuse histories of youth in residential treatment centers asked, for the sample as a whole and by youth's gender: (a) How many perpetrators did each youth have? (b) What was the gender of the perpetrator? (c) What proportion of youth was abused by family members? (d) What proportion of youth was abused in a…

  19. The Weight-Related Abuse Questionnaire (WRAQ): Reliability, validity, and clinical utility.

    PubMed

    Salwen, Jessica K; Hymowitz, Genna F

    2015-12-01

    Weight-related teasing (WRT)/stigmatization may be distinct from teasing and general abuse and may differentially impact adult outcomes. As WRT increases in severity so do depression and disordered eating. Currently, there are no validated measures designed to assess abuse specific to weight. Thus, we developed the Weight-Related Abuse Questionnaire (WRAQ) and validated it in young adult and clinically obese populations. The WRAQ was administered to 3 samples of participants: 292 undergraduate students, 382 undergraduate students, and 59 individuals seeking bariatric surgery. Concurrent validity was assessed via measures of WRT and general childhood abuse. Convergent validity was assessed with measures of depression and disordered eating. Study 1 data were used to further develop the structure of the WRAQ. Study 2 indicated that the WRAQ had excellent psychometric properties (based on factor analyses and reliability/scale consistency analysis) and strong concurrent and convergent validity, supporting the validity of the questionnaire. 6-month test-retest reliability was also good. In Study 3 responses on the WRAQ converged well with interview responses, showed good psychometric properties, and showed moderate correlations with measures of childhood abuse and psychopathology. The WRAQ has strong psychometric properties and is strongly associated with measures of current psychopathology. Additionally, it fills a gap in the assessment literature and may be a beneficial tool for determining which individuals are at increased risk for psychopathology. PMID:26402044

  20. 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…

  1. National Analysis of Differences among Substance Abuse Treatment Outcomes: College Student and Nonstudent Emerging Adults

    ERIC Educational Resources Information Center

    Sahker, Ethan; Acion, Laura; Arndt, Stephan

    2015-01-01

    Objective: To discover differences between student and nonstudent substance abuse treatment demographics, treatment characteristics, and outcomes. Participants: Conducted February 2014, clients without prior treatment admissions, aged 18-24, not in methadone maintenance therapy, and in nonintensive and ambulatory intensive outpatient treatment…

  2. Treatment for substance abuse in Australia: a comparison of public and private programs.

    PubMed

    McNeese-Smith, Donna K

    2003-09-01

    Alcohol and drug abuse is a major problem in Australia and caused over 4000 deaths in 1998 alone. The national policy for reducing the harmful consequences of drug and alcohol use focuses on decreasing the production and supply of drugs, reducing the demand for drugs including a focus on abstinence in treatment, and minimizing the harm to individuals and communities. This research examines substance abuse treatment in Australia, and identifies similarities and differences in funding, philosophy, purpose, and strategies between public and private treatment programs. Interviews of 21 treatment program directors in Sydney and Melbourne were done, using a valid and reliable semi-structured interview guide. Nine public, not-for-profit programs primarily focused on consultation to medical providers, detoxification, outpatient counseling, and harm minimization including methadone treatment and needle exchange. Rehabilitation, prevention, and/or research were objectives of a limited number. Twelve private, non-governmental programs primarily provided abstinence-based treatment in a variety of settings. Some for-profit programs, funded by insurance, provided three to four weeks inpatient care, usually with outpatient follow-up. Not-for-profit programs provided residential treatment in a therapeutic community over a period of 6 months to 2 years. Still others (both profit and not-for-profit) provided methadone treatment or outpatient treatment. Four were church related and six received funding through government contracts, social security illness benefits, and housing assistance. The general lack of structured rehabilitation programs seemed to be the greatest weakness of the Australian public programs. A low percentage of patients completing detoxification entered counseling, and studies were not available to show the outcomes of detoxification without follow-up. The availability of consultations to hospitals and health care practitioners seemed to be an excellent advantage

  3. Rearrest and Probation Violation Outcomes among Probationers Participating in a Jail-Based Substance-Abuse Treatment Used as an Intermediate Sanction

    ERIC Educational Resources Information Center

    Linhorst, Donald M.; Dirks-Linhorst, P. Ann; Groom, Ralph

    2012-01-01

    This study compares the characteristics of two groups of probationers ordered to jail-based substance-abuse treatment as an intermediate sanction. It further reviews rearrest and probation failure outcomes of the two groups, along with the demographic, clinical, and criminal factors associated with those outcomes. Probationers jailed for probation…

  4. Abuse liability measures for use in analgesic clinical trials in patients with pain: IMMPACT recommendations.

    PubMed

    O'Connor, Alec B; Turk, Dennis C; Dworkin, Robert H; Katz, Nathaniel P; Colucci, Robert; Haythornthwaite, Jennifer A; Klein, Michael; O'Brien, Charles; Posner, Kelly; Rappaport, Bob A; Reisfield, Gary; Adams, Edgar H; Balster, Robert L; Bigelow, George E; Burke, Laurie B; Comer, Sandra D; Cone, Edward; Cowan, Penney; Denisco, Richard A; Farrar, John T; Foltin, Richard W; Haddox, J David; Hertz, Sharon; Jay, Gary W; Junor, Roderick; Kopecky, Ernest A; Leiderman, Deborah B; McDermott, Michael P; Palmer, Pamela P; Raja, Srinivasa N; Rauschkolb, Christine; Rowbotham, Michael C; Sampaio, Cristina; Setnik, Beatrice; Smith, Shannon M; Sokolowska, Marta; Stauffer, Joseph W; Walsh, Sharon L; Zacny, James P

    2013-11-01

    Assessing and mitigating the abuse liability (AL) of analgesics is an urgent clinical and societal problem. Analgesics have traditionally been assessed in randomized clinical trials (RCTs) designed to demonstrate analgesic efficacy relative to placebo or an active comparator. In these trials, rigorous, prospectively designed assessment for AL is generally not performed. The Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) convened a consensus meeting to review the available evidence and discuss methods for improving the assessment of the AL of analgesics in clinical trials in patients with pain. Recommendations for improved assessment include: (1) performing trials that include individuals with diverse risks of abuse; (2) improving the assessment of AL in clinical trials (eg, training study personnel in the principles of abuse and addiction behaviors, designing the trial to assess AL outcomes as primary or secondary outcome measures depending on the trial objectives); (3) performing standardized assessment of outcomes, including targeted observations by study personnel and using structured adverse events query forms that ask all subjects specifically for certain symptoms (such as euphoria and craving); and (4) collecting detailed information about events of potential concern (eg, unexpected urine drug testing results, loss of study medication, and dropping out of the trial). The authors also propose a research agenda for improving the assessment of AL in future trials. PMID:24148704

  5. Prescribed Exercise Behavior in the Treatment of Spouse Abuse.

    ERIC Educational Resources Information Center

    Doyle, William W., Jr.

    This presentation by a practicing marital therapist describes how exercise behavior can be used as a preventive measure against spouse abuse. This crisis intervention approach is intended to help couples develop stopgap techniques to prevent physical violence; it is one segment of a more comprehensive approach which might include contingency…

  6. Elder Abuse and Black Americans: Incidence, Correlates, Treatment and Prevention.

    ERIC Educational Resources Information Center

    Cazenave, Noel A.

    Existing evidence on family violence rates by age and race as well as the available data on race and physical elder abuse incidence rates suggests that because such data are not based on random or representative samples and tend to reflect a "sampling artifact" of the particular client populations served by the professionals surveyed, there are no…

  7. Characteristics of Pregnant Teen Substance Abuse Treatment Admissions

    MedlinePlus

    ... consequences of teen pregnancy (2nd ed.). Washington, DC: Urban Institute Press. 3. Pinto, S. M., Dodd, S., Walkinshaw, S. A., ... Health, 22 (1), 50-55. 6. Office on Child Abuse and Neglect, Children’s Bureau, ICF International. (2009). Protecting ...

  8. 3 R's in the Marital Treatment of Alcohol Abuse.

    ERIC Educational Resources Information Center

    Schlesinger, Stephen E.

    Alcohol abuse imposes financial, social, and emotional burdens on drinkers and their families. Couples suffering from alcohol-related problems who seek therapy often have expectations of retribution, restitution, and refuge. Although thoughts of retribution are difficult to elicit in therapy, non-drinking spouses often expect to inflict pain on…

  9. Child abuse treatment and follow-up: can the pediatrician help improve outcome?

    PubMed

    Fischler, R S

    1984-01-01

    The pediatric role in the management of child abuse and neglect has been largely limited to detecting and reporting cases, with little involvement in long-term treatment and follow-up. A review of published clinical experience indicates that customary protective services' "treatment" strategies are all too often ineffective at preventing reabuse, improving child health and developmental status, and improving family functioning. When foster care is used as a treatment modality, children run the added risk of never returning home, nor being freed for adoption, and they may suffer the emotional harm of repeated foster placements. This situation is likely to worsen, in the light of recent cutbacks in social service programs, at a time of rising reports of maltreatment. The pediatrician is widely recognized as an expert in children's health and development, and he can effectively use his position to influence the management of cases and thereby the outcome, by actively participating in treatment decision making and providing close follow-up in a limited but important way. In order to do this, he must first become acquainted with the effects of maltreatment upon children's health and development and with the general principles and available modalities of treatment. He must be sympathetic and supportive of the difficult role of the protective service worker who must make treatment decisions. His role is to assist the worker by making medical resources available in order to adequately define the child's needs and the capacity of the family to meet those needs. Essential to answering these questions is the availability of a child development clinic and mental health resources.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6541088

  10. The Appalachian Tri-State Node Experiences with the National Institute on Drug Abuse Clinical Trials Network

    PubMed Central

    Kelly, Thomas M; Daley, Dennis C; Byrne, Mimmie; DeMarzo, Larry; Smith, Doris; Madl, Stephanie

    2011-01-01

    The National Institute on Drug Abuse (NIDA)-sponsored Clinical Trial Network (CTN) recently celebrated 10 years of conducting “real world” research into the treatment of addiction. This article reviews the history and results of the most recent CTN studies and describes the experiences of one of the 13 participating research affiliates, the Appalachian Tri-State (ATS) Node. We discuss our “bidirectional” collaboration with multiple community treatment programs (CTPs) on research and dissemination activities and include their experiences as a member of our ATS Node. Results of CTN clinical trials have found unexpectedly that treatment as usual (TAU) is often almost as good as evidence-based interventions such as Motivational Interviewing (MI), possibly due to the difficulty in implementing evidence-based practices most effectively among divergent treatment sites and heterogeneous clinical populations. Some expected findings from the reviewed research are that severity of addiction and comorbidity moderate treatment outcomes and must be accounted for in future CTN-sponsored studies. Notwithstanding these results, much has been learned and recommendations are suggested for changes in CTN research designs that will address methodological limitations and increase treatment effectiveness in future CTN studies. PMID:22102966

  11. [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. PMID:25831947

  12. [Addressing intimate partner violence in substance-abuse treatment programmes: a challenge for the future].

    PubMed

    Fernández-Montalvo, Javier; López-Goñi, José Javier

    2011-01-01

    There is a close relationship between substance abuse (alcohol and other drugs) and intimate partner violence. Studies carried out with male offenders and with addicted patients show a high comorbidity rate between these two phenomena. However, few batterer intervention programmes have been implemented to date in the field of drug addiction. This paper proposes, first, the need to detect cases of intimate partner violence that are camouflaged beneath a drug problem. Thus, it is important to determine the prevalence rate of intimate partner aggressors among users of drug-addiction treatment programmes, as well as identifying the specific characteristics of these patients. Second, once aggressors are identified, it would be possible to develop specific programmes for the simultaneous treatment of the two problems (addiction and intimate partner violence). Some studies have already been carried with joint treatments for addiction and intimate partner violence. The results obtained are encouraging, and show that intervention programs with addictions can be a useful framework for applying also, where necessary, specific treatments for those addicted patients with an associated problem of intimate partner violence. Finally, implications for clinical practice and future research in this field are discussed. PMID:21503558

  13. The many victims of substance abuse.

    PubMed

    Mauro, Tara

    2007-09-01

    Substance abuse is a complicated disorder and has far reaching consequences. The victims of substance abuse extend beyond the unfortunate ones suffering from this disorder and often include family and friends. Treatment options for substance abuse are many; however, positive outcomes are not always guaranteed. Many factors play into the potential for successful treatment. Some of these include the adherence and motivation of the substance abusing patients as well as patients' surrounding environments and support systems. In this article, we present a clinical case of opioid dependence and discuss various treatment options and modalities. We will discuss different variables that may maximize positive treatment outcomes. Also a review of the current literature regarding substance abuse treatment, psychotherapy with the drug abuser, and grief therapy should the substance abusing patient die for the surviving family members will be presented. PMID:20532120

  14. 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,…

  15. Demographic and Clinical Characteristics of People with Intellectual Disabilities with and without Substance Abuse Disorders in a Medicaid Population

    ERIC Educational Resources Information Center

    Slayter, Elspeth Maclean

    2010-01-01

    Little is known about the demographic and clinical characteristics of people with intellectual disabilities and substance abuse problems. Drawing on health care billing claims for people with Medicaid coverage aged 12-99 years, the characteristics of people with intellectual disability and a history of substance abuse (N = 9,484) were explored and…

  16. Recovery among adolescents: models for post-treatment gains in drug abuse treatments.

    PubMed

    Joe, George W; Knight, Danica Kalling; Becan, Jennifer E; Flynn, Patrick M

    2014-03-01

    Recovery among adolescents undergoing substance abuse treatment was modeled in terms of pre-treatment motivation, therapeutic relationships, psychological functioning, treatment retention, legal pressures, DSM diagnoses, and client demographics. To address between program differences, a within-covariance matrix, based on 547 youth, was used. Applicability of the results across treatment modalities was also examined. The data were from the NIDA-sponsored DATOS Adolescent study. Results from structural equation models (estimated using Mplus) indicated that higher pre-treatment motivation predicted stronger counselor and in-treatment peer relationships, better counselor relationships and retention predicted less illegal drug use at follow-up, and DSM diagnosis was important in the treatment process. Overall, illegal drug use at follow-up was associated with post-treatment alcohol consumption, cigarette use, condom nonuse, psychological distress, criminality, and school non-attendance. The results document the importance of motivation and therapeutic relationships on recovery, even when taking into account the relative effects of legal pressures, DSM diagnoses, and demographics. PMID:24238715

  17. 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

  18. [Gynecological clinical study in girls and adolescent victims of sexual abuse].

    PubMed

    Sam Soto, Selene; Gayón Vera, Eduardo; García Piña, Corina A

    2008-07-01

    In spite of a very important under-registration, sexual abuse represents a social and public health problem worldwide. In Mexico, estimated prevalence of sexual abuse in women is 17.3%, half of them in youngsters under 15 years old. Most of cases have a late gynecological evaluation, due to a delay in a formal complaint. Gynecologist or pediatrician are the specialists who most frequently perform the genital examination of girls suspected of sexual abuse, due to this a complete knowledge of the topic is necessary in order to make an accurate diagnosis, register the physical findings and give prompt medical and psychological treatment as well as follow up to the patient. Despite the low risk of acquiring a sexually transmitted infection, it is important to evaluate the use of prophylactic treatment and the prevention of unwanted pregnancy with emergency contraception. Big efforts are being made by preventive programs on sexual abuse, sexually transmitted infections and unwanted pregnancy, all of which are serious problems in Mexican children and youths, and should constitute a fundamental part of the public politics on sexual health. PMID:18798442

  19. [Sexual abuse of boys. Examples of a group-oriented treatment].

    PubMed

    Horneland, M; Hanstad, A M

    1996-11-30

    Although the sexual abuse of boys is much less written and talked about than the sexual abuse of girls, it is thought that one of three victims of abuse is a boy. This article sums up the symptoms and reactions seen in male victims. Whereas women usually react with depression and guilt, men react more with anger. Psychosomatic symptoms are often seen, as well as sexual problems such as homophobia or exaggerated masculinisation. As many as 30-50% of male rapist and child molesters have been molested as children. This makes it important to establish a therapeutic dialogue with these men about what they have been through, so as to avoid the development of such behaviour if possible. Experience from the treatment of male adults who were sexually abused in childhood is described, and placed in relation to the existing literature on the subject. PMID:9019854

  20. Relapse and Risk-taking among Iranian Methamphetamine Abusers Undergoing Matrix Treatment Model

    PubMed Central

    Taymoori, Parvaneh; Pashaei, Tahereh

    2016-01-01

    Background This study investigated the correlation between risk-taking and relapse among methamphetamine (MA) abusers undergoing the Matrix Model of treatment. Methods This cross-sectional study was conducted on male patients who were stimulant drug abusers undergoing the matrix treatment in the National Center for Addiction Research. A sampling was done using the availability method including 92 male patients. Demographic questionnaires and drug abuse related questionnaire were completed for each patient. Then, Bart’s balloon risk-taking test was administered to the patients. Findings Participants had a mean age ± standard deviation (SD) of 27.59 ± 6.60 years with an age range of 17-29 years. Unemployment, unmarried status, criminal offense, and also addiction family history increased the probability of relapse. In addition, a greater adjusted score of the risk-taking test increased the odds of relapse by more than 97%. The simultaneous abuse of opium and stimulants compared to the abuse of stimulants only, revealed no statistically significant differences for relapse. Patients with higher risk-taking behavior had a more probability of relapse. Conclusion This finding indirectly implies the usefulness of Bart’s risk-taking test in assessing risk-taking behavior in stimulant drug abusers. PMID:27274793

  1. Structural Equation Analyses of Clinical Subpopulation Differences and Comparative Treatment Outcomes: Characterizing the Daily Lives of Drug Addicts.

    ERIC Educational Resources Information Center

    Aiken, Leona S.; And Others

    1994-01-01

    Used structural equation modeling for comparative treatment outcome research conducted with heterogeneous clinical subpopulations within large multimodality treatment settings. Evaluated effect of early period of treatment on daily lives of 486 clients in 2 drug abuse treatment modalities (methadone maintenance and outpatient counseling).…

  2. Predictors of Substance Abuse Treatment Entry Among Rural Illicit Stimulant Users in Ohio, Arkansas, and Kentucky

    PubMed Central

    Carlson, Robert G.; Sexton, Rocky; Wang, Jichuan; Falck, Russel; Leukefeld, Carl G.; Booth, Brenda M.

    2010-01-01

    Illicit drug use in the rural United States is increasingly common, yet little is known about drug users’ treatment-seeking behaviors. This study identifies predictors of substance abuse treatment entry over 24 months among 710 illicit stimulant users in rural areas of Ohio, Arkansas, and Kentucky. Active users of powdered cocaine, crack cocaine, and/or methamphetamine (MA) were recruited using respondent-driven sampling. Participants completed structured interviews at baseline and follow-up questionnaires every 6 months for 24 months. Data were analyzed using the Cox proportional hazards model. The paper is informed by the Anderson-Newman Model. Overall, 18.7% of the sample entered treatment. Ohio or Kentucky residence, perceived need for substance abuse treatment, higher ASI legal problem composite scores, prior substance abuse treatment, and tranquilizer use were positively associated with treatment entry. Non-daily crack cocaine users and marijuana users were less likely to enter treatment. The findings can help inform rural substance abuse treatment program development and outreach. PMID:20391264

  3. 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.…

  4. 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…

  5. Early Working Alliance in Outpatient Substance Abuse Treatment: Predicting Substance Use Frequency and Client Satisfaction

    ERIC Educational Resources Information Center

    Knuuttila, Vesa; Kuusisto, Katja; Saarnio, Pekka; Nummi, Tapio

    2012-01-01

    Background: The study examined the effect of the early working alliance on outcome in outpatient substance abuse treatment. Methods: A total of 327 clients and 33 therapists participated in the study. Data were collected in southern and western Finland in outpatient treatment units (N = 7). The dependent variables were percentage of days abstinent…

  6. Training Probation and Parole Officers to Provide Substance Abuse Treatment: A Field Test.

    ERIC Educational Resources Information Center

    Cunningham, John A.; Herie, Marilyn; Martin, Garth; Turner, Bonnie J.

    1998-01-01

    The results of field-testing a substance-abuse treatment protocol are reported. Ten probation and parole officers were trained in Structured Relapse Prevention, and 55 clients were treated. Incentives and barriers to treatment are highlighted. The use of this type of field test as a dissemination technique is discussed. (EMK)

  7. Longitudinal HIV Risk Behavior among the Drug Abuse Treatment Outcome Studies (DATOS) Adult Sample

    ERIC Educational Resources Information Center

    Murphy, Debra A.; Brecht, Mary-Lynn; Herbeck, Diane; Evans, Elizabeth; Huang, David; Hser, Yih-Ing

    2008-01-01

    Longitudinal trajectories for HIV risk were examined over 5 years following treatment among 1,393 patients who participated in the nationwide Drug Abuse Treatment Outcome Studies. Both injection drug use and sexual risk behavior declined over time, with most of the decline occurring between intake and the first-year follow-up. However, results of…

  8. Brief Interventions and Brief Therapies for Substance Abuse. Treatment Improvement Protocol (TIP) Series 34.

    ERIC Educational Resources Information Center

    CDM Group, Inc.

    This TIP, on the best practice guidelines for treatment of substance use disorders, was compiled from an increasing body of research literature that documents the effectiveness of brief interventions and therapies in both the mental health and substance abuse treatment fields. It links research to practice by providing counselors with up-to-date…

  9. 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,…

  10. Maintaining Addiction: Tobacco Cessation Policy and Substance Abuse Treatment for Youth.

    ERIC Educational Resources Information Center

    Kurst-Swanger, Karel; Stockweather, Danielle

    2003-01-01

    Examines how institutions, which are part of the substance abuse treatment industry, address the connection between tobacco and other drugs in youth. Results suggest that the majority of treatment programs are routinely assessing tobacco use of the youth in their care, but only a small proportion follow through with tobacco cessation as an…

  11. Social Network Characteristics of Urban Adolescents in Brief Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Mason, Michael

    2009-01-01

    In this study, the social network characteristics of 102 urban adolescents in brief substance abuse treatment are described and analyzed longitudinally to examine risk and protective mechanisms. The treatment intervention had one session devoted to social support and networks. Social networks were conceptualized and measured along two dimensions…

  12. Training Needs of Rehabilitation Counselors concerning Alcohol and Other Drugs Abuse Assessment and Treatment

    ERIC Educational Resources Information Center

    Ong, Lee Za; Cardoso, Elizabeth; Chan, Fong; Chronister, Julie; Chou, Chih Chin

    2007-01-01

    Forty-two rehabilitation counselors participated in a study regarding perceived training needs concerning alcohol and other drug abuse (AODA) treatment and assessment. Participants reported that 85% of consumers with whom they worked had AODA issues, yet over half rated their graduate training in AODA treatment and assessment as poor, and their…

  13. Substance Abuse among Older Adults. Treatment Improvement Protocol (TIP) Series 26.

    ERIC Educational Resources Information Center

    Cook, Paddy; Davis, Carolyn; Howard, Deborah L.; Kimbrough, Phyllis; Nelson, Anne; Paul, Michelle; Shuman, Deborah; Brooks, Margaret K.; Dogoloff, Mary Lou; Vitzthum, Virginia; Hayws, Elizabeth

    As alcohol and other drug disorders become acknowledged as major problems, the need increases for current information on the scope of the problem and appropriate treatment. This TIP serves to educate treatment providers with information about older adults who, in general, are more likely to hide their substance abuse, less likely to seek…

  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. Brief Substance Abuse Treatment with Urban Adolescents: A Translational Research Study

    ERIC Educational Resources Information Center

    Mason, Michael J.; Posner, Michael A.

    2009-01-01

    The purpose of this translational research study was to test a brief, manualized adolescent substance abuse treatment protocol's effects in an urban community setting compared to a sample in an experimental study from which the treatment was first employed. One hundred two adolescents who were treated with a manualized protocol of five sessions of…

  16. Substance Abuse: Improving the Quality of Treatment. Join Together Action Kit, Spring 2002.

    ERIC Educational Resources Information Center

    Join Together, Boston, MA.

    The issue of quality in substance abuse treatment is often complicated due to persistent discrimination against people with drug and alcohol disease. The result is a self-perpetuating cycle of poor outcomes and misperceptions about the disease. However, research shows that treatment for drug and alcohol conditions, when properly delivered, can…

  17. Substance Abuse Treatment Agencies and Self-Help Groups: Collaborators or Competitors?

    ERIC Educational Resources Information Center

    Humphreys, Keith; And Others

    While self-help groups such as Alcoholics Anonymous are becoming more integrated into the professional substance abuse treatment network, many professionals are still hesitant to encourage clients to attend self-help groups after treatment. This study examined what factors predict the degree of cooperation between professional agencies and…

  18. Cognitive-Behavioural Treatment for Men with Intellectual Disabilities and Sexually Abusive Behaviour: A Pilot Study

    ERIC Educational Resources Information Center

    Murphy, Glynis; Powell, Simon; Guzman, Ana-Maria; Hays, Sarah-Jane

    2007-01-01

    Background: Cognitive-behaviour therapy (CBT) seems to be becoming the treatment of choice for non-disabled sex offenders. Nevertheless, there have been relatively few evaluations of such treatment for men with intellectual disabilities (ID) and sexually abusive behaviour. Method: A pilot study providing CBT for two groups of men with ID is…

  19. The Impact of Drug Abuse Treatment upon Criminality: A Look at 19 Programs.

    ERIC Educational Resources Information Center

    Nash, George

    This document reports on an exhaustive study into the large-scale treatment of drug abuse in New Jersey. Seeking to assess the impact of these programs, the state provided money to cover the cost of this comprehensive, year-long survey of both methadone maintenance and drug-free treatment projects. The findings generally supported the New Jersey…

  20. Drug Abuse

    MedlinePlus

    ... as drugged driving, violence, stress, and child abuse. Drug abuse can lead to homelessness, crime, and missed work or problems with keeping a job. It harms unborn babies and destroys families. There are different types of treatment for drug abuse. But the best is to prevent drug ...

  1. Clinical and psychological characteristics of propofol abusers in Korea: a survey of propofol abuse in 38, non-healthcare professionals

    PubMed Central

    Kim, Eun-Jung; Kim, Seon-Hwa; Hyun, Yang-Jin; Noh, Yeon-Keun; Jung, Ho-Sang; Han, Soon-Young; Park, Chan-hye; Choi, Byung Moon

    2015-01-01

    Background The aim of this study is to investigate the characteristics of propofol abuse based on the results of a survey analysis of abusers among non-healthcare professionals in Korea. Methods Thirty-eight propofol abusers were questioned between October and December 2010, and were enrolled and voluntarily participated in a structured survey consisting of an interview and completing a previously prepared questionnaire. The questionnaire was divided into three distinct parts: part 1 dealt with the history of propofol abuse; part 2 highlighted the problems caused by propofol abuse; and part 3 enquired regarding demographics of abusers. Results Thirty-one (81.6%) of the 38 interviewees abused propofol for more than one year. During the last 12 months, 34 (89.0%) received propofol at two or three times a week. The minimum and maximum amounts of propofol (median, range) administered each time were 500 (100, 1000) and 2000 (500, 4000) mg, respectively. Stress relief and the maintenance of a sense of well-being were quoted the most important reasons for the first-time administration of propofol and its subsequent abuse, respectively. The majority of abusers (36.0, 97.3%) reported a sense of pleasure or euphoria at the time of their propofol injection. Withdrawal symptoms occurred in five abusers (13.2%). Thirteen (36.1%) reported disruptions in their work life. None of the respondents had previously admitted to and or reported abuse of any other controlled substances. Conclusions These results provided reference data for the regulation of propofol in Korea as a controlled substance and may also be of interest to international agencies in other countries. PMID:26634083

  2. Substance-abusing Mothers and Fathers’ Willingness to Allow their Children to Receive Mental Health Treatment

    PubMed Central

    Kelley, Michelle L.; D’Lima, Gabrielle M.; Henson, James M.; Cotton, Cayla

    2014-01-01

    The purpose of this study was to examine attitudes of substance-abusing mothers and fathers entering outpatient treatment toward allowing their children to participate in individual- or family-based interventions. Data were collected from a brief anonymous survey completed by adults at intake into a large substance abuse treatment program in western New York. Only one-third of parents reported they would be willing to allow their children to participate in any form of mental health treatment. Results of chi-square analyses revealed that a significantly greater proportion of mothers reported they would allow their children to participate in mental health treatment (41%) compared to fathers (28%). Results of logistic regression analyses revealed even after controlling for child age, mothers were more likely than fathers indicate their willingness to allow their children to receive mental health treatment; however, type of substance abuse (alcohol versus drug abuse) was not associated with parents’ willingness to allow their children to receive treatment. Parental reluctance to allow their children to receive individual or family-based treatment is a significant barrier in efforts to intervene with these at-risk children. PMID:24680218

  3. Substance-abusing mothers and fathers' willingness to allow their children to receive mental health treatment.

    PubMed

    Kelley, Michelle L; D'Lima, Gabrielle M; Henson, James M; Cotten, Cayla

    2014-07-01

    The purpose of this study was to examine attitudes of substance-abusing mothers and fathers entering outpatient treatment toward allowing their children to participate in individual- or family-based interventions. Data were collected from a brief anonymous survey completed by adults at intake into a large substance abuse treatment program in western New York. Only one-third of parents reported that they would be willing to allow their children to participate in any form of mental health treatment. Results of chi-square analyses revealed that a significantly greater proportion of mothers reported that they would allow their children to participate in mental health treatment (41%) compared to fathers (28%). Results of logistic regression analyses revealed even after controlling for child age, mothers were more likely than fathers to indicate their willingness to allow their children to receive mental health treatment; however, type of substance abuse (alcohol versus drug abuse) was not associated with parents' willingness to allow their children to receive treatment. Parental reluctance to allow their children to receive individual or family-based treatment is a significant barrier in efforts to intervene with these at-risk children. PMID:24680218

  4. Impact of Research Network Participation on the Adoption of Buprenorphine for Substance Abuse Treatment

    PubMed Central

    Rieckmann, Traci R.; Abraham, Amanda J.; Kovas, Anne E.; McFarland, Bentson H.; Roman, Paul M.

    2014-01-01

    There is a growing body of research supporting the use of buprenorphine and other medication assisted treatments (MATs) for the rapidly accelerating opioid epidemic in the United States. Despite numerous advantages of buprenorphine (accessible in primary care, no daily dosing required, minimal stigma), implementation has been slow. As the field progresses, there is a need to understand the impact of participation in practitioner-scientist research networks on acceptance and uptake of buprenorphine. This paper examines the impact of research network participation on counselor attitudes toward buprenorphine addressing both counselor-level characteristics and program-level variables using hierarchical linear modeling (HLM) to account for nesting of counselors within treatment programs. Using data from the National Treatment Center Study, this project compares privately funded treatment programs (n=345) versus programs affiliated with the National Institute on Drug Abuse Clinical Trials Network (CTN) (n=198). Models included 922 counselors in 172 CTN programs and 1,203 counselors in 251 private programs. Results of two-level HLM logistic (Bernoulli) models revealed that counselors with higher levels of education, larger caseloads, more buprenorphine-specific training, and less preference for 12-step treatment models were more likely to perceive buprenorphine as acceptable and effective. Furthermore, buprenorphine was 50% more likely to be perceived as effective among counselors working in CTN-affiliated programs as compared to private programs. This study suggests that research network affiliation positively impacts counselors’ acceptance and perceptions of buprenorphine. Thus, research network participation can be utilized as a means to promote positive attitudes toward the implementation of innovations including medication assisted treatment. PMID:24594902

  5. 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

  6. Child abuse and neglect prevention and treatment program--HHS. Final rule.

    PubMed

    1985-04-15

    This rule contains a new basic State grant requirement to implement the Child Abuse Amendments of 1984 (Pub. L. 98-457). As a condition of receiving State grants under the Child Abuse Prevention and Treatment Act, States must establish programs and/or procedures within the State's child protective service system to respond to reports of medical neglect, including reports of the withholding of medically indicated treatment for disabled infants with life-threatening conditions. Other changes in regulations required by these Amendments will be published as a separate NPRM at a later date. PMID:10270565

  7. Child abuse and neglect prevention and treatment program--HHS. Notice of proposed rulemaking.

    PubMed

    1984-12-10

    This rule proposes a new basic State grant requirement to implement the Child Abuse Amendments of 1984 (Pub. L. 98-457). As a condition of receiving State grants under the Child Abuse Prevention and Treatment Act, States must establish programs and/or procedures within the State's child protective service system to respond to reports of medical neglect, including reports of the withholding of medically indicated treatment for disabled infants with life-threatening conditions. Other changes in regulations required by these Amendments will be published as a separate NPRM at a later date. PMID:10269290

  8. BARRIERS TO DRUG ABUSE TREATMENT FOR LATINO MIGRANTS: TREATMENT PROVIDERS’ PERSPECTIVES1

    PubMed Central

    Pagano, Anna

    2014-01-01

    This paper disseminates findings from a pilot study undertaken to learn more about treatment providers’ perceptions of treatment access barriers faced by Latino migrants with substance use disorders (SUDs) in Northern California. Semi-structured interviews were conducted with treatment providers (n=11) at 7 residential treatment programs with Spanish-language services. Interviewees identified and described three primary types of treatment barriers: language, legal, and gender-based. In response to these barriers, Latino migrants with SUDs have opened their own residential recovery houses called anexos (annexes). Collaborative efforts by community clinics and public health agencies are needed to facilitate Latino migrants’ access to SUD treatment. PMID:25176120

  9. Organizational Consequences of Staff Turnover in Outpatient Substance Abuse Treatment Programs

    PubMed Central

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

    2014-01-01

    The purpose of this study was to examine the impact of staff turnover on perceptions of organizational demands and support among staff who remained employed in substance abuse treatment programs. The sample consisted of 353 clinical staff from 63 outpatient agencies. Two scales from the Survey of Organizational Functioning (SOF) measured work-environment demands (Stress, Inadequate Staffing), and three measured supportive work relationships (Communication, Cohesion, Peer Collaboration). Results from a series of multilevel models documented that counselors working in programs that had previously experienced high staff turnover perceived higher demands and lower support within their organization, even after controlling for other potentially burdensome factors such as budget, census, and individual measures of workload. Two individual-level variables, caseload and tenure, were important determinants of work-environment demands, but were not related to supportive work relationships. Findings suggest that staff turnover increases workplace demands and decreases perceptions of support, and underscore the need to reduce stress and minimize subsequent turnover among clinical staff. PMID:22154028

  10. Sibling Outcomes from a Randomized Trial of Evidence-Based Treatments with Substance Abusing Juvenile Offenders

    ERIC Educational Resources Information Center

    Rowland, Melisa D.; Chapman, Jason E.; Henggeler, Scott W.

    2008-01-01

    This study examined the substance use and delinquency outcomes for the nearest age siblings of substance abusing and delinquent adolescents that participated in a randomized clinical trial evaluating the effectiveness of integrating evidence-based practices into juvenile drug court. The sample of 70 siblings averaged 14.4 years of age, 50% were…

  11. A Clinician's Guide to STAIR/MPE: Treatment for PTSD Related to Childhood Abuse

    ERIC Educational Resources Information Center

    Levitt, Jill T.; Cloitre, Marylene

    2005-01-01

    Women who have PTSD related to childhood abuse have significant deficits in the areas of emotion regulation and interpersonal skills. These problems are associated with impaired functioning in social, work, and home life. In addition, there is substantial clinical concern that limited emotion-regulation skills puts this population at risk for…

  12. Demographic and Clinical Characteristics of Middle-Aged versus Younger Adults Enrolled in a Clinical Trial of a Web-Delivered Psychosocial Treatment for Substance Use Disorders

    PubMed Central

    Kalapatapu, Raj K.; Campbell, Aimee; Aharonovich, Efrat; Hu, Mei-Chen; Levin, Frances R.; Nunes, Edward V.

    2012-01-01

    Objective Evidence suggests that substance abuse is becoming more prevalent in middle-aged adults. The objective of this secondary analysis was to add to the growing empirical literature on the unique features of middle-aged substance abuse populations. Methods We descriptively compared baseline demographic and clinical characteristics of middle-aged (age 45–62, n = 111) and younger (age 18–44, n = 395) substance abusers entering a web-based psychosocial treatment study as part of the National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN). Results A significantly greater percentage of middle-aged adults were non-Caucasian and had a marital status other than single/never married. There was a significant association between frequency of Internet use and the age group. Forty-six percent of middle-aged adults versus 21% of younger adults reported no Internet use in the prior 90 days. A significantly greater percentage of middle-aged adults used cocaine, and a significantly greater percentage of younger adults used marijuana and opioids. Clinically significant cognitive impairment (z less than −1.0) was found for the average participant in both groups on logical association of familiar concepts. Conclusions This secondary analysis of a NIDA CTN study provides additional information on the unique features of middle-aged substance abusers. Increasing knowledge of similarities and differences between younger and middle-aged substance abusers can help with potential age-specific substance abuse treatment planning. PMID:23340711

  13. Child physical abuse and neglect.

    PubMed

    Schilling, Samantha; Christian, Cindy W

    2014-04-01

    This article provides an overview of child physical abuse and neglect, and describes the magnitude of the problem and the triggers and factors that place children at risk for abuse and neglect. After examining the legal and clinical definitions of child abuse and neglect, common clinical outcomes and therapeutic strategies are reviewed, including the lifelong poor physical and mental health of victims and evidence-supported treatment interventions. Mandated reporting laws, and facilitating collaboration among child welfare, judicial, and health care systems are considered. Important tools and resources for addressing child maltreatment in clinical practice are discussed, and future approaches posited. PMID:24656582

  14. Drug Abuse Office, Prevention, and Treatment Amendments of 1978. Hearing Before the Subcommittee on Alcoholism and Drug Abuse of the Committee on Human Resources, United States Senate, Ninety-Fifth Congress, Second Session on S. 2916.

    ERIC Educational Resources Information Center

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

    The purpose of the testimony presented before the Subcommittee on Alcoholism and Drug Abuse in April, 1978 was to amend the drug abuse office and treatment act of 1972, thereby extending assistance programs for drug abuse prevention, education, treatment, rehabilitation and other purposes. Speakers represented such organizations as National…

  15. Factors predicting retention in treatment: 10-year experience of a methadone maintenance treatment (MMT) clinic in Israel.

    PubMed

    Peles, Einat; Schreiber, Shaul; Adelson, Miriam

    2006-05-20

    The aims were to identify predictors of treatment retention in an Israeli methadone maintenance treatment (MMT) clinic, and to compare the findings to other international settings. We prospectively studied 492 patients admitted since 1993 through 10 years to an Israeli MMT clinic associated with a university-affiliated tertiary care medical center. Analyses (Kaplan Meier and Cox regression) included methadone dose and urinalysis results (for methadone, cocaine, opiates, benzodiazepines, THC, amphetamines) of each patient in the first month and after 1 year in treatment (or during the last month if the stay was >3 months and <1 year) and patients' characteristics (modified ASI). The 1-year retention rate was 74.4%; 65.8% stopped opiate abuse after 1 year in treatment. On admission, 13.6% of patients had used cocaine: there was a net decrease of 61.6% after 1 year. Factors predicting prolonged retention in MMT treatment (Cox regression) were daily methadone dose of 100mg or greater, negative urine for opiates after 1 year, and being a parent on admission. We conclude that our good outcome results (high rate of retention after 1 year (74.4%), high proportion of opiate abuse cessation (65.8%), and net reduction in cocaine abuse, similar to normal standards in other MMT clinics elsewhere in the world, justify the expansion of the MMT clinic network in Israel in order to make treatment available to all those who need it. A protocol favoring higher methadone dosage as appropriate is recommended. PMID:16219428

  16. 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. PMID:26233697

  17. An exploratory study of alternative configurations of governing boards of substance abuse treatment centers

    PubMed Central

    Blum, Terry C.; Roman, Paul M.

    2011-01-01

    Boards of directors are the ultimate governing authorities for most organizations providing substance abuse treatment. A governing board may establish policies, monitor and improve operations, and represent a treatment organization to the public. This paper explores alternative configurations of governing boards in a national sample of 500 substance abuse treatment centers. The study proceeds from the premise that boards may be configured with varying levels of engagement in five aspects of internal management and external connections in treatment center operating environments. Based on interviews with treatment center administrative directors, four clusters emerge, describing boards that are: (1) active and balanced across internal and external domains; (2) active boundary spanners concentrating primarily on external relationships; (3) focused primarily on internal organizational management; and (4) relatively inactive. In post hoc analysis, we found that placement in these clusters is associated with treatment center attributes such as rate of growth and financial results, use of evidence based practices and provision of integrated care. PMID:21489737

  18. Meta-analysis of psychological treatments for posttraumatic stress disorder in adult survivors of childhood abuse.

    PubMed

    Ehring, Thomas; Welboren, Renate; Morina, Nexhmedin; Wicherts, Jelte M; Freitag, Janina; Emmelkamp, Paul M G

    2014-12-01

    Posttraumatic stress disorder (PTSD) is highly prevalent in adult survivors of childhood sexual and/or physical abuse. However, intervention studies focusing on this group of patients are underrepresented in earlier meta-analyses on the efficacy of PTSD treatments. The current meta-analysis exclusively focused on studies evaluating the efficacy of psychological interventions for PTSD in adult survivors of childhood abuse. Sixteen randomized controlled trials meeting inclusion criteria could be identified that were subdivided into trauma-focused cognitive behavior therapy (CBT), non-trauma-focused CBT, eye movement desensitization and reprocessing, and other treatments (interpersonal, emotion-focused). Results showed that psychological interventions are efficacious for PTSD in adult survivors of childhood abuse, with an aggregated uncontrolled effect size of g=1.24 (pre- vs. post-treatment), and aggregated controlled effect sizes of g=0.72 (post-treatment, comparison to waitlist control conditions) and g=0.50 (post-treatment, comparison with TAU/placebo control conditions), respectively. Effect sizes remained stable at follow-up. As the heterogeneity between studies was large, we examined the influence of two a priori specified moderator variables on treatment efficacy. Results showed that trauma-focused treatments were more efficacious than non-trauma-focused interventions, and that treatments including individual sessions yielded larger effect sizes than pure group treatments. As a whole, the findings are in line with earlier meta-analyses showing that the best effects can be achieved with individual trauma-focused treatments. PMID:25455628

  19. Effects of Trauma Intervention on HIV Sexual Risk Behaviors among Women with Co-Occurring Disorders in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Amaro, Hortensia; Larson, Mary Jo; Zhang, Annie; Acevedo, Andrea; Dai, Jianyu; Matsumoto, Atsushi

    2007-01-01

    Women in substance abuse treatment often have co-occurring mental health disorders and a history of trauma; they are also at high risk for HIV infection and other sexually transmitted diseases via unprotected sex. A quasi-experimental study evaluated the effectiveness of trauma-enhanced substance abuse treatment combined with HIV/AIDS prevention…

  20. A Behavioral Perspective of Childhood Trauma and Attachment Issues: Toward Alternative Treatment Approaches for Children with a History of Abuse

    ERIC Educational Resources Information Center

    Prather, Walter; Golden, Jeannie A.

    2009-01-01

    Attachment theory provides a useful conceptual framework for understanding trauma and the treatment of children who have been abused. This article examines childhood trauma and attachment issues from the perspective of behavior analysis, and provides a theoretical basis for two alternative treatment models for previously abused children and their…

  1. Adolescent Substance Abuse Treatment Resource Allocation in Rural and Frontier Conditions: The Impact of Including Organizational Readiness to Change

    ERIC Educational Resources Information Center

    Minugh, P. Allison; Janke, Susan L.; Lomuto, Nicoletta A.; Galloway, Diane K.

    2007-01-01

    Context: Rural and frontier states are significantly affected by substance abuse and poverty. The high rate of substance abuse coupled with high levels of dependence on state-funded treatment systems places a burden on rural treatment systems and makes resource allocation a central planning issue. Purpose: The goal of this study was to combine…

  2. Rural Issues in Alcohol and Other Drug Abuse Treatment: Award for Excellence Papers. Technical Assistance Publication Series No. 10.

    ERIC Educational Resources Information Center

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

    This document consists of papers that received recognition in a competition sponsored by the Center for Substance Abuse Treatment and the National Rural Institute on Alcohol and Drug Abuse. The competition sought to focus attention on problems in providing treatment and prevention services for drug and alcohol problems in rural areas. The papers…

  3. 38 CFR 17.83 - Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation. 17.83 Section 17.83 Pensions... Agencies § 17.83 Limitations on payment for alcohol and drug dependence or abuse treatment...

  4. 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...

  5. 38 CFR 17.83 - Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation. 17.83 Section 17.83 Pensions... Agencies § 17.83 Limitations on payment for alcohol and drug dependence or abuse treatment...

  6. 38 CFR 17.83 - Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation. 17.83 Section 17.83 Pensions... Agencies § 17.83 Limitations on payment for alcohol and drug dependence or abuse treatment...

  7. 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. PMID:16490677

  8. 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

  9. Assertive Outreach Strategies for Narrowing the Adolescent Substance Abuse Treatment Gap: Implications for Research, Practice, and Policy

    PubMed Central

    Ozechowski, Timothy J.; Waldron, Holly Barrett

    2009-01-01

    In any given year, only about 10% of the nearly two million adolescents exhibiting substance abuse or dependence in the United States receive substance abuse treatment. Given this state of affairs, it is unlikely that the massive effort and expenditure of resources over the past decade on developing, testing, and disseminating effective treatments for adolescent substance abuse can have an appreciable impact on the prevalence of substance use disorders among the adolescent population. In order to substantially diminish the pervasive gap between levels of need for and utilization of adolescent substance abuse treatment, specialized assertive outreach strategies may be needed. This paper outlines a framework for assertive outreach for adolescents with substance use disorders, and proposes specific types of strategies for identifying and enrolling such adolescents into treatment. Implications for practice and policy pertaining to adolescent substance abuse treatment service delivery are considered. PMID:18690540

  10. 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…

  11. Satanism as a Response to Abuse: The Dynamics and Treatment of Satanic Involvement in Male Youths.

    ERIC Educational Resources Information Center

    Belitz, Jerald; Schacht, Anita

    1992-01-01

    Asserts that male youths from abusive family environments may be particularly vulnerable to recruitment into satanic cults. Describes etiological factors and treatment approaches of 10 hospitalized boys who voluntarily involved themselves in repeated group satanic activities during their adolescence. Includes two case illustrations. Provides…

  12. The Nature of Victimization among Youths with Hearing Loss in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Titus, Janet C.

    2010-01-01

    The author profiles the prevalence, severity, and characteristics of victimization among a group of youths with hearing loss presenting to substance abuse treatment. Intake data on 111 deaf and hard of hearing youths (42% female) were analyzed and compared with data from a weighted, gender-matched sample of hearing youths. After gender is…

  13. Characteristics of Youths with Hearing Loss Admitted to Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Titus, Janet C.; Schiller, James A.; Guthmann, Debra

    2008-01-01

    The purpose of this study is to provide a profile of youths with hearing loss admitted to substance abuse treatment facilities. Intake data on 4,167 youths (28% female; 3% reporting a hearing loss) collected via the Global Appraisal of Individual Need-I assessment was used for the analyses. Information on demographics, environmental…

  14. Federal Standards for Child Abuse and Neglect Prevention and Treatment Programs and Projects.

    ERIC Educational Resources Information Center

    Higgs, A. Catherine

    Presented are federal standards designed to synthesize and describe the knowledge available on the prevention and treatment of child abuse and negect. A summary chapter (Chapter I) covers background information, organization and content of the standards, and utilization of the standards. Chapter II discusses the relationships among children,…

  15. Spiritual Involvement as a Predictor to Completing a Salvation Army Substance Abuse Treatment Program

    ERIC Educational Resources Information Center

    Wolf-Branigin, Michael; Duke, Jerry

    2007-01-01

    This study investigates successful completion at a faith-based organization providing residential substance abuse treatment services. Method: The authors apply a complex systems paradigm using a single moderator variable. The participants are primarily African Americans and most have current criminal justice involvement. Probabilities of treatment…

  16. Mortality and Return to Work of Drug Abusers From Therapeutic Community Treatment 3 Years After Entry.

    PubMed

    Berg, John E.

    2003-08-01

    BACKGROUND: The outcome of therapeutic community treatment for drug abuse has been disputed with regard to mortality and rehabilitation to school or work as compared with other treatment modalities. METHOD: All patients (N = 130) admitted to a therapeutic community during 3 consecutive years (1996-1998), who had failed to stop abusing drugs after ambulatory and primary care initiatives, were assessed 1 to 4 years (mean = 36.5 months) after end of treatment. Rates of rehabilitation to school or work, changes in drug use patterns, and mortality were observed. RESULTS: Nine persons died during the observation period (the observation time to death seemed to be shorter in women than in men). The mortality rate per 100 observation years was 2.28. Among the surviving drug abusers, 39% were working or attending school at study endpoint. One fourth currently used drugs, and approximately 14% were enrolled in a methadone maintenance program. Another 13% were in treatment or prison. CONCLUSION: Drug abuse is an activity that increases the mortality rate, but among the surviving persons, a considerable number are rehabilitated, as assessed after a longer observation period. The authors suggest that this outcome could not have been attained with ambulatory general practice-driven services, even with empathic follow-up. PMID:15213778

  17. Economic Evaluation of Continuing Care Interventions in the Treatment of Substance Abuse: Recommendations for Future Research

    ERIC Educational Resources Information Center

    Popovici, Ioana; French, Michael T.; McKay, James R.

    2008-01-01

    The chronic and relapsing nature of substance abuse points to the need for continuing care after a primary phase of treatment. This article reviews the economic studies of continuing care, discusses research gaps, highlights some of the challenges of conducting rigorous economic evaluations of continuing care, and offers research guidelines and…

  18. Evaluating Animal-Assisted Therapy in Group Treatment for Child Sexual Abuse

    ERIC Educational Resources Information Center

    Dietz, Tracy J.; Davis, Diana; Pennings, Jacquelyn

    2012-01-01

    This study evaluates and compares the effectiveness of three group interventions on trauma symptoms for children who have been sexually abused. All of the groups followed the same treatment protocol, with two of them incorporating variations of animal-assisted therapy. A total of 153 children ages 7 to 17 who were in group therapy at a Child…

  19. Psychological Symptoms and Drug Use Severity among Israeli Adolescents Presenting for Outpatient Drug Abuse Treatment

    ERIC Educational Resources Information Center

    Diamond, G.M.; Izzard, M.C.; Kedar, T.; Hutlzer, A.; Mell, H.

    2005-01-01

    The objective of this study was to assess the rates of externalizing and internalizing symptoms, and the relation between psychological symptoms and drug use severity, among 117 Israeli adolescents presenting for outpatient drug abuse treatment. Psychological symptoms were assessed via both adolescent self-report and parent report. Drug use was…

  20. The ADSS Cost Study: Costs of Substance Abuse Treatment in the Specialty Sector.

    ERIC Educational Resources Information Center

    Substance Abuse and Mental Health Services Administration (DHHS/PHS), Rockville, MD. Office of Applied Studies.

    Understanding the cost of resources used in substance abuse treatment is of critical concern to policymakers, payers, and providers of care. The Alcohol and Drug Services Study (ADSS) was performed from 1996 to 1999. ADSS is a national study conducted in three phases to collect representative data on the characteristics of substance abuse…

  1. 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…

  2. Protecting Children: Substance Abuse Treatment and Child Welfare Working Together. Exective Summary of Regional Meetings, 2002.

    ERIC Educational Resources Information Center

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

    The Division of State and Community Assistance of the Center for Substance Abuse Treatment (CSAT), in conjunction with the Administration on Children, Youth and Families (ACYF), held four, two-day State team-building workshops. These workshops were designed to help build the State infrastructure necessary to bring about coordinated delivery of…

  3. The Incidence of Incest Histories among Clients Receiving Substance Abuse Treatment.

    ERIC Educational Resources Information Center

    Glover, Noreen M.; And Others

    1995-01-01

    Volunteer participants (n=77) enrolled in 8 substance abuse treatment facilities were surveyed in order to examine the prevalence and nature of incest contacts among the group. Results indicated that approximately 49 percent of the participants had reported histories of incest. Data are presented under various parameters. Also gives comparisons by…

  4. Therapeutic Alliance, Negative Mood Regulation, and Treatment Outcome in Child Abuse-Related Posttraumatic Stress Disorder

    ERIC Educational Resources Information Center

    Cloitre, Marylene; Chase Stovall McClough,K.; Miranda, Regina; Chemtob, Claude M.

    2004-01-01

    This study examined the related contributions of the therapeutic alliance and negative mood regulation to the outcome of a 2-phase treatment for childhood abuse-related posttraumatic stress disorder (PTSD). Phase 1 focused on stabilization and preparatory skills building, whereas Phase 2 was comprised primarily of imaginal exposure to traumatic…

  5. Moving Towards Gray: Art Therapy and Ambivalence in Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Horay, Brian J.

    2006-01-01

    Although some consider the 12-step method of Alcoholics Anonymous to be the treatment of choice for people struggling with substance abuse, differing approaches have been developed within the area of addictions. Motivational interviewing (Miller & Rollnick, 2002), enacted within a stages-of change model (DiClemente & Velasquez, 2002), seeks to…

  6. 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…

  7. Alternative Funding Resources Manual for Drug Abuse and Alcohol Treatment and Rehabilitation Programs.

    ERIC Educational Resources Information Center

    Bertagnoli, Cliff

    The purpose of this manual is to guide and assist alcohol and other drug abuse treatment programs to maximize cost recovery from third party reimbursements. It is intended to be a guide for planning and decision making rather than a resource manual. The text is based on the experiences of agencies in six states participating in a demonstration…

  8. Students' Reactions to Manual-Based Treatments for Substance Abuse: An Exploratory Study

    ERIC Educational Resources Information Center

    Simons, Lori; Jacobucci, Raymond; Houston, Hank

    2006-01-01

    A quasi-experimental research design with quantitative and qualitative methodologies was conducted to explore reactions of 21 students to treatment manuals for substance abuse. Students were randomized to experimental (n = 11) and attention-control (n = 10) groups involving exposure to one of two manual-based therapy interventions. Quantitative…

  9. Criminal Violence and Drug Use: An Exploratory Study among Substance Abusers in Residential Treatment

    ERIC Educational Resources Information Center

    Workowski, Eric J.

    2003-01-01

    This study examined the relationship between criminal violence and type of substance abuse among 184 current and former residents of an inpatient non-hospital drug and alcohol treatment facility. The criminal justice system functioned as the source of referral into the program for 89% of the subjects studied while only 11% came to treatment…

  10. Addressing Substance Abuse Treatment Needs of Parents Involved with the Child Welfare System

    ERIC Educational Resources Information Center

    Oliveros, Arazais; Kaufman, Joan

    2011-01-01

    The goal of this paper is to synthesize available data to help guide policy and programmatic initiatives for families with substance abuse problems who are involved with the child welfare system, and identify gaps in the research base preventing further refinement of practices in this area. To date, Family Treatment Drug Court and newly developed…

  11. Myth and reality in the family patterns and treatment of substance abusers.

    PubMed

    Kaufman, E

    1980-01-01

    Family therapy has become an increasingly important modality in the treatment of substance abuse over the past decade. As knowledge of family patterns and therapy in this area has increased, many myths have evolved. This article examines these myths and presents the realities as perceived by the author at this time. PMID:7258162

  12. 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…

  13. HIV risks of men in methadone maintenance treatment programs who abuse their intimate partners: a forgotten issue.

    PubMed

    el-Bassel, N; Fontdevila, J; Gilbert, L; Voisin, D; Richman, B L; Pitchell, P

    2001-01-01

    Accumulating findings suggest a relationship between partner violence and HIV risk among women, however, this issue has yet to be adequately researched among men. This study examines the relationship between perpetrating intimate partner violence and HIV risk behavior among a sample of men in methadone maintenance treatment programs (MMTPs). Data were collected on 273 sexually active men, who were recruited from four inner-city MMTP clinics. More than a third of the sample reported perpetrating intimate physical abuse and 15% reported severe physical abuse in the past 12 months. Results from multiple logistic regression analyses indicate that after adjusting for demographic, poverty, and drug-use factors, men who abused an intimate partner were almost 4 times more likely to have more than one intimate partner, almost 3 times more likely to have unprotected anal sex, and 2.6 times more likely to have sex with a drug-injecting sexual partner than their counterparts. This study showed that men who perpetrated partner violence were at higher risk for HIV transmission. HIV prevention interventions need to consider the complex relationship between partner violence and HIV risk. PMID:11547622

  14. "Who can you tell?" Features of Arab culture that influence conceptualization and treatment of childhood sexual abuse.

    PubMed

    Haboush, Karen L; Alyan, Hala

    2013-01-01

    The literature on child sexual abuse reflects growing recognition of the manner in which culture impacts the conceptualization, experience, and treatment of such cases. Despite heightened visibility of Arab Americans within the United States, population due to recent media attention, little empirical research exists on the occurrence of child sexual abuse within this population. Arab culture is often characterized by an emphasis on collectivism and familial obligations, and such features may prove to either facilitate or impede assessment and treatment of child sexual abuse, depending on how they are manifested. In terms of reporting child sexual abuse, cultural values pertaining to shame and honor as well as the stigma attached to mental health problems may influence the response to abuse. As such, enhancing the cultural competence of the therapist is key to facilitating effective cultural practice. Empirical research is required to investigate and substantiate these concepts as they relate to child sexual abuse in Arab-American populations. PMID:23829830

  15. A Qualitative Examination of the Positive and Negative Consequences Associated With Going Tobacco-Free in Substance Abuse Treatment: The NY State Experience

    PubMed Central

    Sparks, Taylor E.; Evans, Elizabeth; Selzer, Jeffrey A.

    2012-01-01

    Introduction: In 2008, the New York State (NYS) Office of Alcoholism and Substance Abuse Services (OASAS) required all state-funded or state-certified addiction treatment programs to be 100% tobacco-free. The regulation prohibits the use or possession of all tobacco products by patients, employees, volunteers, and visitors. This includes exterior grounds and vehicles owned, leased, or operated by the facility. Addiction treatment centers are also required to screen patients for tobacco use and incorporate tobacco cessation into treatment programming. This study examined the perceived effectiveness of this regulation from the perspective of counselors and clinical supervisors. Methods: Qualitative data were collected from 261 counselors and 80 clinical supervisors working in 50 free-standing substance abuse treatment programs throughout NYS. Questions asked about the perceived positive and negative consequences of the OASAS regulation approximately 1 year after its implementation. Results: The findings indicate mixed reactions to the regulation. A wide range of positive and negative consequences were identified, which were generally consistent across counselor and clinical supervisor reports. The most commonly reported positive outcomes were positive behavior change (e.g., less smoking, increased intentions to quit) and increased awareness about smoking (e.g., dangers, available assistance to quit). The most commonly reported negative consequences were reinforcing addict behaviors among patients (e.g., lying, “dealing” cigarettes) and enforcement problems (e.g., difficulty enforcing, policing for compliance). Conclusion: Findings have implications for the implementation of tobacco-free regulations in substance abuse treatment programs. PMID:22416113

  16. Relationship between custodial status and psychosocial problems among cocaine-abusing parents initiating substance abuse treatment.

    PubMed

    Lewis, Marilyn W; Petry, Nancy M

    2005-01-01

    Using the Addiction Severity Index and Brief Symptom Inventory, drug use and psychosocial problems are compared between 93 custodial and 125 non-custodial mothers and fathers initiating outpatient treatment for cocaine dependence. Compared to non-custodial parents, custodial parents experienced more severe current cocaine and alcohol problems, including spending more money on cocaine and alcohol, as well as using more cocaine and being intoxicated on more days. Non-custodial parents demonstrated more psychological distress, more prior history of alcohol problems, and greater current employment and legal problems than custodial parents. Suggestions are made for differential treatment plans based on these findings. PMID:16257878

  17. SOUTH SANTA CLARA COUNTY MIGRANT TREATMENT CLINIC.

    ERIC Educational Resources Information Center

    SKILLICORN, STANLEY A.

    IN THE SUMMER OF 1965, A MIGRANT HEALTH CLINIC WAS STARTED IN THE SOUTHERN PART OF SANTA CLARA COUNTY, CALIFORNIA. THE CLINIC DIFFERS FROM THE PUBLIC HEALTH DEPARTMENT'S CLINICS BY OFFERING TREATMENT AND MEDICATION, INSTEAD OF ONLY PREVENTIVE SERVICES. THE ENTIRE STAFF, FROM DOCTORS TO BABY-SITTERS, VOLUNTEERS ITS TIME, AND THE CLINIC IS NOW OPEN…

  18. Clinical measures and treatment needs.

    PubMed

    Marcus, M; Reifel, N M; Nakazono, T T

    1997-05-01

    Clinically evaluated oral health outcome variables from the ICS-II USA data set were examined in the diverse ethnic groups, for two adult age cohorts (35-44 and 65-74 years). These measures were derived from epidemiological examinations and include the DMFT components, loss of attachment, and an indicator of treatment need--the ratio of decayed teeth over decayed and filled teeth. The ratio of decayed over decayed and filled teeth was used in multivariate analysis, since this measure represents an area where public policy could have an impact if determinants were understood. The most important independent variables were race-ethnicity, educational attainment, no fear of dental visits because of pain, and oral hygiene practices. Having a usual source of dental care and visiting the dentist within the past 12 months did not appear to be as important in predicting unmet needs as these other variables. To bridge the gap between the oral health status of majority and minority populations, health educators in minority communities need to become more accessible, have a pro-active interest in oral health, and also be cognizant of the various socio-cultural issues influencing oral health. The problems regarding Native American adults are more complex and require more careful study. PMID:9549992

  19. Multidimensional Family Therapy: Addressing Co-Occurring Substance Abuse and Other Problems among Adolescents with Comprehensive Family-Based Treatment

    PubMed Central

    Rowe, Cynthia L.

    2010-01-01

    Synopsis Adolescent substance abuse rarely occurs without other psychiatric and developmental problems, yet it is often treated and researched as if it can be isolated from comorbid conditions. Few comprehensive interventions are available that effectively address the range of co-occurring problems associated with adolescent substance abuse. This article reviews the clinical interventions and research evidence supporting the use of Multidimensional Family Therapy (MDFT) for adolescents with substance abuse and co-occurring problems. MDFT is uniquely suited to address adolescent substance abuse and related disorders given its comprehensive interventions that systematically target the multiple interacting risk factors underlying many developmental disruptions of adolescence. PMID:20682221

  20. Differences in legal characteristics between Caucasian and African-American women diverted into substance abuse treatment.

    PubMed

    Scott, Melanie C; Edwards, Laurie; Lussier, Lauren R; Devine, Susan; Easton, Caroline J

    2011-01-01

    In this exploratory study, we examined differences in the legal characteristics of Caucasian and African-American female offenders (n = 122) who were diverted into substance abuse treatment, to identify any racial disparities. We also examined the differences between groups in demographics and in substance abuse, family, and violence histories. In terms of legal characteristics, the results showed that African-American female offenders were significantly more likely to have been incarcerated at the time of their substance dependency evaluation than were Caucasian female offenders. Also, African-American women were more likely to have served 13 months for the current legal charge in comparison to the 4 months served by Caucasian women, although no differences were found between groups in the severity of the current legal charge. Comparison of demographics and substance abuse, family, and violence histories indicated that African-American women were more likely to be undereducated, crack cocaine dependent, and overly exposed to violence. Overall, the sample of female offenders evidenced severe substance dependency problems, a strong need for inpatient substance abuse treatment, and chronic legal and social difficulties. Implications of these findings are discussed in relation to unbalanced sentencing policies and increasing awareness of the treatment needs of this unique population. PMID:21389168

  1. Sexual orientation and substance abuse treatment utilization in the United States: results from a national survey.

    PubMed

    McCabe, Sean Esteban; West, Brady T; Hughes, Tonda L; Boyd, Carol J

    2013-01-01

    This study examined substance abuse treatment utilization across three dimensions of sexual orientation (identity, attraction, and behavior) in a large national sample of adults in the United States. Prevalence estimates were based on data collected from the 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions. The sample consisted of 34,653 adults 20 years and older, and represented a population that was 52% women, 71% White, 12% Hispanic, 11% African American, 4% Asian, and 2% other race/ethnicities. An estimated 2% of the target population self-identified as lesbian, gay or bisexual; 4% reported same-sex sexual behavior, and 6% reported same-sex sexual attraction. Sexual minorities, especially women, had a greater likelihood of lifetime substance use disorders and earlier age of drinking onset. The majority of respondents with substance use disorders were untreated and lifetime substance abuse treatment utilization differed based on sexual orientation. Sexual minorities were found to have more extensive family histories of substance abuse problems. The findings indicate the underutilization of substance abuse treatment among all adults, and highlight some important factors to consider when working with sexual minorities. PMID:22444421

  2. Influences of family and friends on client progress during drug abuse treatment.

    PubMed

    Knight, D K; Simpson, D D

    1996-01-01

    Relationships with family and friends by 439 heroin addicts during the first 3 months of drug abuse treatment were examined in relation to behavioral improvements of clients. Family conflict and peer deviance were significant predictors of injection frequency and illegal activity during treatment, and reductions in family conflict were associated with lower drug use, injection frequency, and illegal activity during treatment. These results provide support for treatment emphasis on helping clients reduce conflict among family members, improve dysfunctional relationships with peers, and replace deviant friendships with others that encourage treatment participation and conformance to social norms. PMID:9058354

  3. Alcohol and drug abusers' reasons for seeking treatment.

    PubMed

    Cunningham, J A; Sobell, L C; Sobell, M B; Gaskin, J

    1994-01-01

    Clients at two different treatment facilities were asked at assessment how influential each of 10 possible reasons were in their decision to change their alcohol or drug use. Clients at both facilities most often endorsed "weighing the pros and cons of drinking or drug use" and a "warning from spouse." Client's reasons for seeking treatment were also examined in relation to treatment compliance. Three reasons--"weighing the pros and cons," "hitting rock bottom," and experiencing a "major lifestyle change"--were predictive of treatment compliance. Clients who rated any of these reasons as influential were more likely to enter and complete treatment. Although more research is needed, knowledge of clients' reasons for seeking treatment might be useful in treatment matching. PMID:7701979

  4. Substance abuse treatment for HIV infected young people: an open pilot trial.

    PubMed

    Esposito-Smythers, Christianne; Brown, Larry K; Wolff, Jennifer; Xu, Jiahong; Thornton, Sarah; Tidey, Jennifer

    2014-02-01

    The purpose of this study was to test an integrated cognitive behavioral and contingency management (CBT/CM) intervention for young people living with HIV (YPLH) with an alcohol and/or cannabis use disorder in an open pilot trial. Seventeen participants (ages 18-24) were recruited from three HIV community clinics. Assessments were completed at pre-and post-treatment as well as 3 month follow-up. Eighty percent of participants were retained in the study. Results suggest that the CBT/CM intervention was acceptable, feasible, and could be delivered with fidelity. Further, participants reported significant reductions in alcohol use, withdrawal symptoms, dependence symptoms and related problems, as well as co-occurring depressive symptoms and delinquent behavior across assessment periods. A trend was evident for reductions in marijuana use and related problems. Overall, these preliminary results suggest that a substance abuse CBT/CM intervention tailored to YPLH is acceptable, feasible, and holds promise for symptomatic improvement. Further testing of this type of protocol is warranted. PMID:23988190

  5. 78 FR 15961 - Center for Substance Abuse Treatment National Advisory Council; Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-13

    ... HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Substance Abuse... meeting of the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance... below). Committee Name: Substance Abuse and Mental Health Services Administration Center for...

  6. Effect of Primary Medical Care on Addiction and Medical Severity in Substance Abuse Treatment Programs

    PubMed Central

    Friedmann, Peter D; Zhang, Zhiwei; Hendrickson, James; Stein, Michael D; Gerstein, Dean R

    2003-01-01

    OBJECTIVE To examine whether the availability of primary medical care on-site at addiction treatment programs or off-site by referral improves patients' addiction severity and medical outcomes, compared to programs that offer no primary care. DESIGN Secondary analysis of a prospective cohort study of patients admitted to a purposive national sample of substance abuse treatment programs. SETTING Substance abuse treatment programs in major U.S. metropolitan areas eligible for demonstration grant funding from the federal Substance Abuse and Mental Health Services Administration. RESPONDENTS Administrators at 52 substance abuse treatment programs, and 2,878 of their patients who completed treatment intake, discharge, and follow-up interviews. MEASUREMENTS Program administrators reported whether the program had primary medical care available on-site, only off-site, or not at all. Patients responded to multiple questions regarding their addiction and medical status in intake and 12-month follow-up interviews. These items were combined into multi-item composite scores of addiction and medical severity. The addiction severity score includes items measuring alcohol and drug use, employment, illegal activities, legal supervision, family and other social support, housing, physical conditions, and psychiatric status. The medical severity score includes measures of perceived health, functional limitations, and comorbid physical conditions. MAIN RESULTS After controlling for treatment modality, geographic region, and multiple patient-level characteristics, patients who attended programs with on-site primary medical care experienced significantly less addiction severity at 12-month follow-up (regression coefficient, −25.9; 95% confidence interval [95% CI], −43.2 to −8.5), compared with patients who attended programs with no primary medical care. However, on-site care did not significantly influence medical severity at follow-up (coefficient, −0.28; 95% CI, −0.69 to 0

  7. 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

  8. Child Abuse: Definition.

    ERIC Educational Resources Information Center

    Wilson, Timothy L.-Y.

    The purpose of this paper was to elaborate on the definitions of child abuse in order to improve the understanding of child abuse. The definitions given by the U.S. House Joint Committee on Child Abuse in the Child Abuse Prevention and Treatment Act, and in research by Holden (1984), are cited. These definitions refer to the nature of abusive acts…

  9. How do providers serving American Indians and Alaska Natives with substance abuse problems define evidence-based treatment?

    PubMed

    Moore, Laurie A; Aarons, Gregory A; Davis, Jordan H; Novins, Douglas K

    2015-05-01

    Rates of substance abuse remain high in American Indian and Alaska Native (AI/AN) populations. While there are many evidence-based treatments (EBTs) for substance use problems, no studies exist describing how directors of treatment programs serving AI/ANs perceive and use EBTs. Twenty-one key informant interviews with program administrators and 10 focus groups with clinicians were conducted at 18 treatment programs for AI/ANs with substance use problems. Demographic data were not collected to protect participant privacy. Transcripts were coded to identify relevant themes. A majority of participants correctly defined an EBT using the key terms "effective" and "research" found in standard definitions of the phrase. More detailed descriptions were uncommon. Prevalent themes related to attitudes about EBTs included concerns about cultural relevance, external mandates to use EBTs, and their reliance on western conceptualization of substance abuse. While most administrators and clinicians who treat AI/AN clients for substance abuse had a basic understanding of what constitutes an EBT, there was little consensus regarding their relevance for use with AI/ANs. Recognizing that broad geographic and tribal diversity among AI/AN populations may impact conclusions drawn about EBTs, several factors may enhance the abilities of program staff to identify EBTs most appropriate for local implementation. These include gaining a more detailed understanding of how an EBT is developed and how to assess its scientific grounding, as well as utilizing definitions of EBTs that include not only research evidence, but also clinical expertise and judgment, and fit with consumer choice, preference, and culture. PMID:25961645

  10. Who Benefits from Gender Responsive Treatment? Accounting for Abuse History on Longitudinal Outcomes for Women in Prison

    PubMed Central

    Saxena, Preeta; Messina, Nena; Grella, Christine E.

    2014-01-01

    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. PMID:24910481

  11. An Emerging Problem: Methamphetamine Abuse among Treatment Seeking Youth

    ERIC Educational Resources Information Center

    Gonzales, Rachel; Ang, Alfonso; McCann, Michael J.; Rawson, Richard A.

    2008-01-01

    This study examined correlates of methamphetamine (MA) and marijuana (MJ) use and treatment response among treatment-involved youth (N = 4,430) in Los Angeles County, California treated between 2000 and 2005. Of the sample, 912 (21%) were primary MA and 3,518 (79%) were primary MJ users. Correlates of increased MA use included being female, White,…

  12. A Qualitative Exploration of Drug Abuse Relapse Following Treatment

    ERIC Educational Resources Information Center

    Islam, Manirul; Hashizume, Masahiro; Yamamoto, Taro; Alam, Faruq; Rabbani, Golam

    2012-01-01

    Drug use is an alarming issue in Bangladesh. Most drug users return to drugs after treatment, in what becomes a vicious cycle of treatment and relapse. This study explored why they return and what pathways they follow. We carried out 5 key informant interviews, 10 in-depth interviews, 2 focus group discussions, 3 case studies, 8 observations, and…

  13. Drug and Alcohol Abuse: Implications for Treatment. Treatment Research Monograph Series.

    ERIC Educational Resources Information Center

    Gardner, Stephen E., Ed.

    Articles in this monograph examine key issues in combined drug and alcohol use. The first chapter discusses clinical and research evidence about the physical and psychological effects of various drug and alcohol combinations. Chapter Two presents findings about usage patterns of alcohol and drugs. The impact of alcohol use in a treatment setting…

  14. ENGAGEMENT IN OUTPATIENT SUBSTANCE ABUSE TREATMENT AND EMPLOYMENT OUTCOMES

    PubMed Central

    Dunigan, Robert; Acevedo, Andrea; Campbell, Kevin; Garnick, Deborah W.; Horgan, Constance M.; Huber, Alice; Lee, Margaret T.; Panas, Lee; Ritter, Grant A.

    2013-01-01

    This study, a collaboration between an academic research center and Washington State’s health, employment and correction departments, investigates the extent to which treatment engagement, a widely adopted performance measure, is associated with employment, an important outcome for individuals receiving treatment for substance use disorders. Two-stage Heckman probit regressions were conducted using 2008 administrative data for 7,570 adults receiving publicly-funded treatment. The first stage predicted employment in the year following the first treatment visit and three separate second stages models predicted number of quarters employed, wages, and hours worked. Engagement as a main effect was not significant for any of the employment outcomes. However, for clients with prior criminal justice involvement, engagement was associated with both employment and higher wages following treatment. Clients with criminal justice involvement face greater challenge regarding employment, so the identification of any actionable step which increases the likelihood of employment or wages is an important result. PMID:23686216

  15. Early Childhood Interventionists' Perceptions of the Child Abuse Prevention and Treatment Act: Provider Characteristics and Organizational Climate

    ERIC Educational Resources Information Center

    Herman-Smith, Robert L.

    2013-01-01

    Research Findings: A 2003 amendment to the Child Abuse Prevention and Treatment Act (CAPTA) required states to develop plans to ensure that children younger than the age of 3 years who are victims of substantiated abuse or neglect have access to developmental screenings. Programs authorized under Part C of the Individuals with Disabilities…

  16. 38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 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... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Alcohol and...

  17. 38 CFR 17.80 - Alcohol and drug dependence or abuse treatment and rehabilitation in residential and...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 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... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Alcohol and...

  18. Development of a model and measure of process-oriented quality of care for substance abuse treatment.

    PubMed

    Mael, Fred A; O'Shea, Patrick Gavan; Smith, Mark Alan; Burling, Andrea Seidner; Carman, Kristin L; Haas, Amie; Rogers, Kelly S

    2010-01-01

    The development of a detailed model of substance-abuse treatment (SAT) staff performance is described. The model describes the key behaviors of SAT staff. Specifically, researchers used the critical incident technique to develop the model, which includes a total of 15 dimensions, nested under four meta-dimensions: providing clinical services, employee citizenship behaviors, providing clinical support, and managerial behavior. Development and validation of a measure based on the model are also described. More than 600 SAT staff members in 51 SAT agencies completed the new measure. Factor analyses supported the measure's hypothesized dimensional structure; high internal consistency reliabilities were observed for all scales; and interrater agreement metrics indicated an acceptable level of within-agency agreement. Moreover, the measure correlated in expected and theoretically consistent ways with measures of job satisfaction and other job-related opinions. PMID:19462245

  19. Effectiveness of communication and relationship skills training for men in substance abuse treatment.

    PubMed

    Bartholomew, N G; Hiller, M L; Knight, K; Nucatola, D C; Simpson, D D

    2000-04-01

    Although the importance of gender-sensitive programming for women has been acknowledged, few studies have examined outcomes from male-centered interventions in substance abuse treatment programs. Data were collected from 122 male clients in a court-mandated residential treatment program who participated in a study of a psychoeducational group intervention for men. The intervention (Time Out! For Men) addressed communication skills, sexuality, gender socialization, and intimacy. Participation in the training resulted in significant increases in knowledge and social conformity, along with reductions in attitudes that may be associated with rigid socialization and gender-role conflict. The results provide support for the utility of male-targeted programming in substance abuse treatment settings. PMID:10742634

  20. Predictors of mental distress among substance abusers receiving inpatient treatment

    PubMed Central

    2010-01-01

    Background Mental distress measured by the HSCL-10 is used as an indicator of psychiatric disorders in population studies, where a higher level of mental distress has been shown to be related to demographic factors such as living conditions and level of education. The first aim of the study was to explore whether mental distress could be a valuable concept in substance use treatment. The second aim of the study was to explore to what degree mental distress among substance users at admission to treatment could be explained by the same demographic factors as in population studies, or whether treatment differences or differences in substance use would be better predictors of mental distress in this population. Methods Patients (N = 185) who received inpatient substance use treatment in five different settings in Northern Norway participated in the study. HSCL-10 was used as a measure for mental distress at admission to treatment. The self-report measures AUDIT, DUDIT and DUDIT-E were used for measuring substance use and readiness for treatment. The patients' clinicians reported demographic and treatment factors. A three-block hierarchical multiple regression analysis was conducted to determine potential predictors of mental distress. Block 1 included demographic variables, Block 2 included treatment variables, and Block 3 substance use variables. Results Patients generally reported a high level of mental distress at admission to treatment, and 83% reported mental distress higher than the established cut-off level. Being female, having previously received psychiatric treatment, having a higher score on DUDIT and AUDIT, and using a larger number of substances all predicted a higher level of mental distress. The model explained 32% of the variance in mental distress. Conclusions Mental distress measured by the HSCL-10 can be a valuable concept in substance use treatment. The HSCL-10 can be useful in screening for patients who are in need of further assessment for

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

    PubMed Central

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

    2014-01-01

    Introduction This study investigates factors predicting past year quit attempts among smokers enrolled in substance abuse treatment in New York State. Methods 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. Results 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). Conclusions 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. PMID:25218064

  2. Clinical laboratory assessment of the abuse liability of an electronic cigarette

    PubMed Central

    Vansickel, Andrea R; Weaver, Michael F; Eissenberg, Thomas

    2012-01-01

    Aims To provide an initial abuse liability assessment of an electronic cigarette (EC) in current tobacco cigarette smokers. Design The first of four, within-subject sessions was an EC sampling session that involved six, 10-puff bouts (30s interpuff interval) with each bout separated by 30-mins. In the remaining three sessions participants made choices between 10 EC puffs and varying amounts of money, 10 EC puffs and a varying number of own brand cigarette (OB) puffs, or 10 OB puffs and varying amounts of money using the multiple-choice procedure (MCP). The MCP was completed six times at 30-min intervals, and one choice was randomly reinforced at each trial. Setting Clinical laboratory. Participants Twenty current tobacco cigarette smokers. Measurements Sampling session outcome measures included plasma nicotine, cardiovascular response, and subjective effects. Choice session outcome was the crossover value on the MCP. Findings: EC use resulted in significant nicotine delivery, tobacco abstinence symptom suppression, and increased product acceptability ratings. On the MCP, participants chose to receive 10 EC puffs over an average of $1.06 or 3 OB puffs and chose 10 OB puffs over an average of $1.50 (p<.003). Conclusions Electronic cigarettes can deliver clinically significant amounts of nicotine and reduce cigarette abstinence symptoms and appear to have lower potential for abuse relative to traditional tobacco cigarettes, at least under certain laboratory conditions. PMID:22229871

  3. Asociality and engagement in adult offenders in substance abuse treatment.

    PubMed

    Pankow, Jennifer; Knight, Kevin

    2012-01-01

    In therapeutic community models for drug treatment, individual recovery is principally structured around group meetings and positive peer influences. Research shows that asocial group members with resistant behaviors and attitudes are at risk for poor treatment outcomes and have the potential to adversely impact the therapeutic group. To gain a better understanding of the asocial client's role in the larger treatment process, in-prison treatment data were used: (1) to model and confirm a two-factor solution of asociality consistent with the literature, and (2) to examine the relationship between asocial clients and treatment engagement for validation of the two-factor model. Exploratory analysis resulted in a three-factor solution representing behavioral responsivity, cognitive distortion, and social disassociation dimensions. Nested ANOVA (i.e., clients nested within prison programs) demonstrated that asocial levels (low, medium, and high risk) predicted treatment engagement. Furthermore, comparisons among asocial risk levels indicated that high asocial clients reported significantly lower engagement levels when compared with low and medium asocial clients. PMID:22786817

  4. 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

  5. Risk factors for HIV infection in German i.v. drug abusers. Clinical, serological and epidemiological features.

    PubMed

    Harms, G; Laukamm-Josten, U; Bienzle, U; Guggenmoos-Holzmann, I

    1987-04-15

    A series of 320 German i.v. drug abusers (32.2% female, 67.8% male) were tested in a cross-sectional study for antibodies against HIV. Seroprevalence increased from 0 in those who discontinued i.v. drug abuse before 1982 to 37.2% in those who stopped injecting drugs in 1985/1986 or who were still addicted. Antibodies to HIV were significantly associated with lymphadenopathy and clinical symptoms (fever, weight loss, diarrhea, fatigue, night sweat, dermal lesions) and with markers of hepatitis A and hepatitis B virus infection. Participants of the study admitted in 92.5% of cases to "needle sharing" and in 83.1% of cases to sexual contacts among drug abusers. Prostitution and drug abuse in prison were significantly correlated with seropositivity. No antibodies to HIV infection were detected in 131 subjects of a control group of household contacts. PMID:3495695

  6. Gender differences in predictors of initiation, retention, and completion in an HMO-based substance abuse treatment program.

    PubMed

    Green, Carla A; Polen, Michael R; Dickinson, Daniel M; Lynch, Frances L; Bennett, Marjorie D

    2002-12-01

    We studied gender differences in treatment process indicators among 293 HMO members recommended for substance abuse treatment. Treatment initiation, completion, and time spent in treatment did not differ by gender, but factors predicting these outcomes differed markedly. Initiation was predicted in women by alcohol diagnoses; in men, by being employed or married. Failure to initiate treatment was predicted in women by mental health diagnoses; in men, by less education. Treatment completion was predicted in women by higher income and legal/agency referral; in men, by older age. Failure to complete was predicted in women by more dependence diagnoses and higher Addiction Severity Index Employment scores; in men, by worse psychiatric status, receiving Medicaid, and motivation for entering treatment. More time spent in treatment was predicted, in women, by alcohol or opiate diagnoses and legal/agency referral; in men, by fewer mental health diagnoses, higher education, domestic violence victim status, and prior 12-step attendance. Clinical implications of results are discussed. PMID:12495790

  7. Diversity in relapse prevention needs: gender and race comparisons among substance abuse treatment patients.

    PubMed

    Walton, M A; Blow, F C; Booth, B M

    2001-05-01

    Attempts to address high relapse rates following substance abuse treatment have focused on identifying relapse prevention needs and development of subsequent relapse prevention programs. Few studies have examined whether women and African-Americans have unique relapse prevention needs. Research in this area could provide an initial basis for the development of alternative relapse prevention approaches that could be more appropriate for this pop ulation. This study examined gender and race differences in psychosocial concerns among patients recruited from substance abuse treatment as potential indicators of relapse prevention needs. Participants (N = 331) completed several questionnaires during their first month of substance abuse treatment. Assessment packets included measures of coping, self-efficacy, resource needs, cravings, social influences, exposure, and leisure activities. Analyses focused on gender and race differences in these variables before and after controlling for background characteristics (i.e., age, marital status, income, polysubstance use, treatment type, and problem severity). Gender differences found were that men reported poorer coping skills and more negative social influences and exposure to substances than women; these differences remained significant when controlling for background characteristics. Significant race differences were found on all scales except negative social influences. After controlling for background characteristics, African-Americans reported significantly greater coping skills and self-efficacy than did Caucasians; however, African-Americans also reported greater resource needs in comparison to Caucasians. Results highlight the diversity in psychosocial issues among substance abusers in treatment, particularly between Caucasians and African-Americans. Implications for developing alternative relapse prevention approaches to address this diversity are discussed. PMID:11417937

  8. Prospective Patterns and Correlates of Quality of Life among Women in Substance Abuse Treatment

    PubMed Central

    Tracy, Elizabeth M.; Laudet, Alexandre B.; Min, Meeyoung O.; Kim, HyunSoo; Brown, Suzanne; Jun, Min Kyoung; Singer, Lynn

    2012-01-01

    Background Quality of life (QOL) is increasingly recognized as central to the broad construct of recovery in substance abuse services. QOL measures can supplement more objective symptom measures, identify specific service needs and document changes in functioning that are associated with substance use patterns. To date however, QOL remains an under investigated area in the addictions field, especially in the United States. Methods This study examines patterns and predictors of QOL at 1 and 6 months post treatment intake among 240 women enrolled in substance abuse treatment in Cleveland, Ohio. The World Health Organization Quality of Life (WHOQOL-BREF) measure was used to assess physical, psychological, social and environmental domains. Hierarchical multiple regressions were conducted to identify correlates of QOL at 6 months post treatment intake. Results All QOL domains across the follow up time points improved significantly. However, QOL scores across domains remained below those of healthy population norms. Trauma symptoms significantly predicted Physical and Psychological QOL. Among treatment process variables, alcohol use was the sole significant factor associated with QOL and only for Environmental QOL. Recovery support and friends support for abstinence were consistently associated with QOL across all four domains. Implications This study suggests the usefulness of the WHOQOL measure as an indicator of functioning in substance abusing populations. Findings underline the importance of helping women deal with trauma symptoms and develop support for recovery. Further research is needed on the longitudinal relationship between QOL and substance use patterns PMID:22333265

  9. 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

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

    PubMed Central

    2012-01-01

    Background Substance use disorders and perpetration of intimate partner violence (IPV) are interrelated, major public health problems. Methods 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. Results 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. Conclusions SUDPs may have difficulty addressing violence because they have a clientele with relatively few resources and more complex psychological and medical

  11. Changes in personal networks of women in residential and outpatient substance abuse treatment.

    PubMed

    Min, Meeyoung O; Tracy, Elizabeth M; Kim, Hyunsoo; Park, Hyunyong; Jun, Minkyoung; Brown, Suzanne; McCarty, Christopher; Laudet, Alexandre

    2013-10-01

    Changes in personal network composition, support and structure over 12 months were examined in 377 women from residential (n=119) and intensive outpatient substance abuse treatment (n=258) through face-to-face interviews utilizing computer based data collection. Personal networks of women who entered residential treatment had more substance users, more people with whom they had used alcohol and/or drugs, and fewer people from treatment programs or self- help groups than personal networks of women who entered intensive outpatient treatment. By 12 months post treatment intake, network composition improved for women in residential treatment; however, concrete support was still lower and substance users are still more prevalent in their networks. Network composition of women in outpatient treatment remained largely the same over time. Both groups increased cohesiveness within the network over 12 months. Targeting interventions that support positive changes in personal networks may heighten positive long term outcomes for women entering treatment. PMID:23755971

  12. Changes in Personal Networks of Women in Residential and Outpatient Substance Abuse Treatment

    PubMed Central

    Min, Meeyoung O.; Tracy, Elizabeth M.; Kim, Hyunsoo; Park, Hyunyong; Jun, MinKyong; Brown, Suzanne; McCarty, Christopher; Laudet, Alexandre

    2013-01-01

    Changes in personal network composition, support and structure over 12 months were examined in 377 women from residential (n=119) and intensive outpatient substance abuse treatment (n=258) through face-to-face interviews utilizing computer based data collection. Personal networks of women who entered residential treatment had more substance users, more people with whom they had used alcohol and/or drugs, and fewer people from treatment programs or self- help groups than personal networks of women who entered intensive outpatient treatment. By 12 months post treatment intake, network composition improved for women in residential treatment; however, concrete support was still lower and substance users still more prevalent in their networks. Network composition of women in outpatient treatment remained largely the same over time. Both groups increased cohesiveness within the network over 12 months. Targeting interventions that support positive changes in personal networks may heighten positive long term outcomes for women entering treatment. PMID:23755971

  13. Novel approaches for the treatment of psychostimulant and opioid abuse – focus on opioid receptor-based therapies

    PubMed Central

    Bailey, Chris P.; Husbands, Steve M.

    2015-01-01

    Introduction Psychostimulant and opioid addiction are poorly treated. The majority of abstinent users relapse back to drug-taking within a year of abstinence, making ‘anti-relapse’ therapies the focus of much current research. There are two fundamental challenges to developing novel treatments for drug addiction. Firstly, there are 3 key stimuli that precipitate relapse back to drug-taking: stress, presentation of drug-conditioned cue, taking a small dose of drug. The most successful novel treatment would be effective against all 3 stimuli. Secondly, a large number of drug users are poly-drug users: taking more than one drug of abuse at a time. The ideal anti-addiction treatment would therefore be effective against all classes of drugs of abuse. Areas Covered In this review, the authors discuss the clinical need and animal models used to uncover potential novel treatments. There is a very broad range of potential treatment approaches and targets currently being examined as potential anti-relapse therapies. These broadly fit into 2 categories: ‘memory-based’ and ‘receptor-based’ and the authors discuss the key targets here within. Expert opinion Opioid receptors and ligands have been widely studied, and research into how different opioid subtypes affect behaviours related to addiction (reward, dysphoria, motivation) suggests that they are tractable targets as anti-relapse treatments. Regarding opioid ligands as novel ‘anti-relapse’ medications targets - research suggests that a ‘non-selective’ approach to targeting opioid receptors will be the most effective. PMID:25253272

  14. Drug Abuse Treatment Training in Peru: A Social Policy Experiment.

    ERIC Educational Resources Information Center

    Johnson, Knowlton W.; Young, Linda C.; Suresh, Geetha; Berbaum, Michael L.

    2002-01-01

    Conducted a social policy experiment in 76 drug treatment organizations in Peru from 1997 to 2000. Programs were assigned to one of three training conditions. Positive effects were found for increased staff empowerment to use training tools and principles, and larger effects were found on the implementation of therapeutic community methods with…

  15. HIV/AIDS, Drug Abuse Treatment, and the Correctional System.

    ERIC Educational Resources Information Center

    Lipton, Douglas S.

    1997-01-01

    Discusses in-prison prevalence and transmission of Human Immunodeficiency Virus (HIV). Focuses on epidemiology in prison settings, the role of ethnicity and gender in transmission, screening for HIV, segregating the HIV-positive inmate, condom distribution, medical treatment for HIV-positive inmates, HIV education and prevention, and tuberculosis…

  16. Substance Abuse Treatment Outcomes for Coerced and Noncoerced Clients

    ERIC Educational Resources Information Center

    Burke, Anna C.; Gregoire, Thomas K.

    2007-01-01

    This study provides new evidence regarding the relation of coerced care to posttreatment substance use and addiction severity while controlling for two important factors: readiness to change and addiction severity at admission to treatment. The initial study sample consisted of 289 people who agreed to participate in a prospective study of…

  17. New Treatment for Drug-Abusing Women Offenders in Virginia.

    ERIC Educational Resources Information Center

    Clement, Mary

    1997-01-01

    Compares a new approach to treatment using traditional social work. Reports on the therapeutic regimen and Results/Kinesiology (RK), which addresses body-mind control, brain hemispheric integration, energy balancing, and stress elimination. Examination of 40 women addicted to alcohol and/or drugs indicated that RK helped with anxiety,…

  18. Increasing abused children's access to evidence-based treatment: diffusion via parents as consumers.

    PubMed

    Gully, Kevin J; Price, Brittany L; Johnson, Marilyn K

    2008-08-01

    This investigation evaluated an experimental protocol employed by nurses with parents to increase access to evidence-based mental health treatment for children who are suspected victims of abuse. The protocol was compared with typical services during forensic medical examinations, first in a quasi-experimental design, then as a randomized controlled trial. In both studies, the protocol produced a significant increase in parental reports of having discussed evidence-based treatment during a mental health appointment within 1 month after the forensic medical examination. Likewise, both studies showed that the protocol produced a significant increase in parent-reported satisfaction with the forensic medical examination. Similarly, nurses viewed the protocol favorably. These findings suggest that this approach may be sustainable as a standard component of forensic medical examinations for children who are suspected victims of abuse. PMID:18359928

  19. Elimination of drugs of abuse and their toxicity from natural waters by photo-Fenton treatment.

    PubMed

    Catalá, M; Domínguez-Morueco, N; Migens, A; Molina, R; Martínez, F; Valcárcel, Y; Mastroianni, N; López de Alda, M; Barceló, D; Segura, Y

    2015-07-01

    This paper investigates the elimination of drugs of abuse from six different chemical classes and their metabolites in natural fluvial waters (nearby the output of a sewage system). Mineralization of these substances and toxicological characterization before and after treatment by a heterogeneous photo-Fenton system has been evaluated. This advanced oxidation technology was able to significantly reduce the concentration of the drugs of abuse in all the tested conditions (different hydrogen peroxide and catalyst loadings). However, toxicological analyses measured as inhibition of fern spore mitochondrial activity, showed only a complete elimination of acute and chronic toxicity when a higher solid catalyst loading was used (0.6 g/L). A lower catalyst loading of 0.2 g/L was not enough for toxicity elimination. These results evidence the need for combining toxicological tests and chemical analyses in order to establish the effectiveness of the water treatment technologies based on advanced oxidation processes. PMID:25817756

  20. [Psychological treatment of posttraumatic stress disorder after sexual abuse: an overview].

    PubMed

    Priebe, Kathlen; Steil, Regina; Kleindienst, Nikolaus; Dyer, Anne S; Krüger, Antje; Bohus, Martin

    2012-01-01

    There is an ongoing debate how to treat posttraumatic stress disorder related to childhood sexual abuse. In Germany patients mostly receive a psychodynamically oriented treatment with a long-lasting stabilization before the use of exposure-based interventions. The number of randomized controlled trials on posttraumatic stress disorder related to childhood sexual abuse is quite limited. The results of these studies show that cognitive-behavioral trauma-focussing interventions are very efficacious with large effect sizes. 2 controlled studies on psychodynamically oriented treatment found only small improvements in posttraumatic symptoms. The high dropout rates in prolonged exposure especially in patients with co-occurring personality disorders point towards the need of a emotion regulation training before the exposure phase. Future studies should include subgroup-analyses and the assessment of adverse effects during therapy. PMID:22271171

  1. Understanding the Etiology of Prescription Opioid Abuse: Implications for Prevention and Treatment

    PubMed Central

    Rigg, Khary K.; Murphy, John W.

    2013-01-01

    Although studies on the initiation of substance abuse abound, the body of literature on prescription opioid abuse (POA) etiology is small. Little is known about why and how the onset of POA occurs, especially among high-risk populations. In this study we aimed to fill this important knowledge gap by exploring the POA initiation experiences of 90 prescription opioid abusers currently in treatment and their narrative accounts of the circumstances surrounding their POA onset. This research was conducted within a storyline framework, which operates on the premise that the path to drug abuse represents a biography or a process rather than a static condition. Audiotapes of in-depth interviews were transcribed, coded, and thematically analyzed. Analyses revealed the presence of four trajectories leading to POA. This study adds to the limited research on POA etiology by not only illuminating the psychosocial factors that contribute to POA onset, but also by situating initiation experiences within broader life processes. The study findings provide crucial insights to policymakers and interventionists in identifying who is at risk for POA, and more important, when and how to intervene most efficaciously. PMID:23656723

  2. Clinical biochemical and hormonal profiling in plasma: a promising strategy to predict growth hormone abuse in cattle.

    PubMed

    Doué, Mickael; Dervilly-Pinel, Gaud; Cesbron, Nora; Stefani, Annalisa; Moro, Letizia; Biancotto, Giancarlo; Le Bizec, Bruno

    2015-06-01

    Recombinant bovine somatotrophin (rbST) is widely used in some countries to increase milk production. Since 1994, both marketing and use of this substance have been prohibited within the European Union. In this context, the targeted plasma biochemical and hormonal profiling was assessed as a potential screening strategy to highlight rbST (ab)use in cattle. Twenty-one routinely measured clinical blood parameters, representative of main biological profiles (energetic, proteic, etc.), were measured in the plasma of six lactating cows before and after rbST treatment throughout a 23-day study period. Appropriate multivariate statistical analyses [principal component analysis (PCA) and orthogonal partial least square (OPLS)] enabled discriminating animal samples before and after treatment (days 0 vs. 2 to 9, P = 2.10(-9)) and highlighted the five most relevant blood parameters in this discrimination. Based on each five-analyte contribution, a simple mathematically weighted equation was suggested to predict the status of samples. A suspicious threshold was proposed, and the model was further tested with the status prediction of the supplementary samples from untreated (n = 20) and treated cows (n = 22). The calculated false-positive (10%) and false-negative (4.5%) rates were in accordance with the EU requirements for screening methods. Although the model needs to be further validated with additional samples, such targeted plasma biochemical and hormonal profiling already appears as a potential promising screening strategy to highlight rbST (ab)use in cattle. PMID:25716468

  3. 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…

  4. Intervention with Substance Abusing Runaway Adolescents and their Families: Results of a Randomized Clinical Trial

    PubMed Central

    Slesnick, Natasha; Erdem, Gizem; Bartle-Haring, Suzanne; Brigham, Gregory S.

    2013-01-01

    Objectives To examine the efficacy of three theoretically distinct interventions among substance-abusing runaway adolescents and to explore individual differences in trajectories of change. Methods Adolescents (N=179) between the ages of 12–17 were recruited from a runaway shelter in a Midwestern city. The sample included 94 females (52.5%) and 85 males (47.5%), the majority of the adolescents were African American (n= 118, 65.9%). Adolescents were randomly assigned to the Community Reinforcement Approach (CRA, n = 57), Motivational Interviewing (MI, n = 61), or Ecologically-Based Family Therapy (EBFT, n = 61). Substance use was assessed at baseline, 3, 6, 9, 12, 18, and 24 months via Form 90 and urine screens. Results Hierarchical linear modeling revealed statistically significant improvement in frequency of substance use among runaways in all three treatment groups with a slight increase at post-treatment. Latent trajectory profile analysis explored individual differences in change trajectories and yielded a 3 class model. The majority of adolescents (n = 136, 76%) showed reductions in substance use over time with a slight increase at follow-up (Class 1: Decreasing). Twenty-four (13.4%) adolescents had shown high levels of substance use over time with patterns of increase and decrease (Class 2: Fluctuating high users), and 19 (10.6%) decreased but returned to baseline levels by two years post-baseline (Class 3: U shaped). Few differences among treatment conditions were noted; within the “decreasing” group, adolescents in MI treatment showed a quicker decline in their substance use but a faster relapse compared to those receiving EBFT. Conclusions These findings suggest that CRA, EBFT and MI are viable treatments for runaway substance-abusing adolescents. PMID:23895088

  5. Psychotherapy and Counseling in the Treatment of Drug Abuse [Technical Review] (Rockville, Maryland, May 18-19, 1989). National Institute on Drug Abuse Research Monograph Series 104.

    ERIC Educational Resources Information Center

    Onken, Lisa Simon; Blaine, Jack D.

    This monograph is based on the papers from a technical review. These papers are included: (1) Psychotherapy and Counseling Research in Drug Abuse Treatment: Questions, Problems, and Solutions (Lisa Onken, Jack Blaine); (2) Psychotherapy and Counseling for Methadone-Maintained Opiate Addicts: Results of Research Studies (George Woody, A. T.…

  6. Substance Use among Lesbian, Gay, and Bisexual Clients Entering Substance Abuse Treatment: Comparisons to Heterosexual Clients

    PubMed Central

    Flentje, Annesa; Heck, Nicholas C.; Sorensen, James L.

    2015-01-01

    Objective This study evaluated whether sexual orientation-specific differences in substance use behaviors exist among adults entering substance abuse treatment. Method Admissions records (July 2007-December 2009) were examined for treatment programs in San Francisco, California receiving government funding. Lesbian, gay, and bisexual (LGB) persons (n=1441) were compared to heterosexual persons (n=11770) separately by sex, examining primary problem substance of abuse, route of administration, age of first use, and frequency of use prior to treatment. Results Regarding bisexual males, the only significant finding of note was greater prevalence of methamphetamine as the primary substance of abuse. When compared to heterosexual men, gay and bisexual men evidenced greater rates of primary problem methamphetamine use (44.5% and 21.8% respectively versus 7.7%, adjusted odds ratios [ORs] 6.43 and 2.94), and there was lower primary heroin use among gay men (9.3% vs. 25.8%,OR 0.35). Among LGB individuals, race and ethnicity did not predict primary problem substance, except that among LGB men and women, a non-White race predicted cocaine use (OR 4.83 and 6.40, respectively), and among lesbian and bisexual women, Hispanic ethnicity predicted lower odds of primary cocaine use (OR 0.24). When compared to heterosexual men, gay men were more likely to smoke their primary problem substance (OR 1.61), first used this substance at an older age (M = 23.16 versus M=18.55, p<.001), and used this substance fewer days prior to treatment (M=8.75 versus M=11.41, p<.001). There were no differences between heterosexual and lesbian or bisexual women. Conclusions There wereunique patterns of substance use for gay and bisexual men entering substance abuse treatment, but women did not evidence differences. Gay men evidenced unique factors that may reflect less severity of use when entering treatment including fewer days of use and a later age of initiation of their primary problem substances. The

  7. Illicit peyote use among American Indian adolescents in substance abuse treatment: a preliminary investigation.

    PubMed

    Fickenscher, Alexandra; Novins, Douglas K; Manson, Spero M

    2006-01-01

    Few studies to date have addressed illicit (i.e., nonceremonial) peyote use among American Indians (AIs). Participants were 89 AI adolescents admitted to a tribally operated residential substance abuse treatment program (RSATP) between 1998 and 2001. The RSATP is designed to provide specialized treatment of patients with substance use and other comorbid psychiatric disorders and is infused with a culturally sensitive approach to treatment. The participants completed a series of interviews that collected information on psychiatric diagnostic status, history of substance use, and ethnic identity. The majority of participants were male (65%), did not come from a two-parent household (75%), reported a mean use of 5.4 substances, and met full criteria for a median of 2.9 substance use disorders. Of 89 clients, 10 (11.2%) reported illicit use of peyote. The vast majority of these youth (n = 8) reported using peyote only once or twice in their lifetime. Illicit peyote users did not differ from nonusers in terms of age, gender, other substance use, prevalence of either other substance abuse/dependence or other nonsubstance use psychiatric disorders. However, illicit peyote users were more likely to report low levels of social support, low levels of self-esteem, and low identification with AI culture yet comparable involvement in AI traditional practices. The results of this exploratory study suggest that illicit peyote use is uncommon among AI adolescents with serious substance abuse problems. PMID:16798681

  8. Examining human rights and mental health among women in drug abuse treatment centers in Afghanistan

    PubMed Central

    Abadi, Melissa Harris; Shamblen, Stephen R; Johnson, Knowlton; Thompson, Kirsten; Young, Linda; Courser, Matthew; Vanderhoff, Jude; Browne, Thom

    2012-01-01

    Denial of human rights, gender disparities, and living in a war zone can be associated with severe depression and poor social functioning, especially for female drug abusers. This study of Afghan women in drug abuse treatment (DAT) centers assesses (a) the extent to which these women have experienced human rights violations and mental health problems prior to entering the DAT centers, and (b) whether there are specific risk factors for human rights violations among this population. A total of 176 in-person interviews were conducted with female patients admitted to three drug abuse treatment centers in Afghanistan in 2010. Nearly all women (91%) reported limitations with social functioning. Further, 41% of the women indicated they had suicide ideation and 27% of the women had attempted suicide at least once 30 days prior to entering the DAT centers due to feelings of sadness or hopelessness. Half of the women (50%) experienced at least one human rights violation in the past year prior to entering the DAT centers. Risk factors for human rights violations among this population include marital status, ethnicity, literacy, employment status, entering treatment based on one’s own desire, limited social functioning, and suicide attempts. Conclusions stemming from the results are discussed. PMID:22532779

  9. Resources and Training in Outpatient Substance Abuse Treatment Facilities

    PubMed Central

    Lehman, Wayne E. K.; Becan, Jennifer E.; Joe, George W.; Knight, Danica K.; Flynn, Patrick M.

    2011-01-01

    The exposure to new clinical interventions through formalized training and the utilization of strategies learned through training are two critical components of the program change process. The current study considers the combined influence of actual program fiscal resources and counselors’ perceptions of workplace resources on two mechanisms of training: exposure and utilization. Data were collected from 323 counselors nested within 59 programs located in 9 states. Multilevel analysis revealed that training exposure and training utilization represent two distinct constructs that are important at different stages in the Program Change Model. Training exposure is associated primarily with physical and financial resources, whereas utilization is associated with professional community and job burnout. These results suggest that financial resources are important in initial exposure to new interventions, but that successful utilization of new techniques depends in part on the degree of burnout and collaboration experienced by counselors. PMID:22154031

  10. Prescription opioid abuse, chronic pain, and primary care: a Co-occurring Disorders Clinic in the chronic disease model.

    PubMed

    Pade, Patricia A; Cardon, Karen E; Hoffman, Richard M; Geppert, Cynthia M A

    2012-12-01

    Abuse of opioids has become a public health crisis. The historic separation between the addiction and pain communities and a lack of training in medical education have made treatment difficult to provide, especially in primary care. The Co-occurring Disorders Clinic (COD) was established to treat patients with co-morbid chronic pain and addiction. This retrospective chart review reports results of a quality improvement project using buprenorphine/naloxone to treat co-occurring chronic non-cancer pain (CNCP) and opioid dependence in a primary care setting. Data were collected for 143 patients who were induced with buprenorphine/naloxone (BUP/NLX) between June 2009 and November 2011. Ninety-three patients (65%) continued to be maintained on the medication and seven completed treatment and were no longer taking any opioid (5%). Pain scores showed a modest, but statistically significant improvement on BUP/NLX, which was contrary to our expectations and may be an important factor in treatment retention for this challenging population. PMID:22980449

  11. All Might Have Won, But Not All Have the Prize: Optimal Treatment for Substance Abuse Among Adolescents with Conduct Problems

    PubMed Central

    Spas, Jayson; Ramsey, Susan; Paiva, Andrea L.; Stein, L.A.R.

    2012-01-01

    Considerable evidence from the literature on treatment outcomes indicates that substance abuse treatment among adolescents with conduct problems varies widely. Treatments commonly used among this population are cognitive-behavioral therapy (CBT), 12-step facilitation, multisystemic therapy (MST), psychoeducation (PE), and motivational interviewing (MI). This manuscript thoroughly and systematically reviews the available literature to determine which treatment is optimal for substance-abusing adolescents with conduct problems. Results suggest that although there are several evidence-based and empirically supported treatments, those that incorporate family-based intervention consistently provide the most positive treatment outcomes. In particular, this review further reveals that although many interventions have gained empirical support over the years, only one holds the prize as being the optimal treatment of choice for substance abuse treatment among adolescents with conduct problems. PMID:23170066

  12. Assessing Adolescent Substance Abuse Programs with Updated Quality Indicators: The Development of a Consumer Guide for Adolescent Treatment

    PubMed Central

    Cacciola, John S.; Meyers, Kathleen; Bates, Suzanne E.; Rosenwasser, Beth; Arria, Amelia; McLellan, A. Thomas

    2013-01-01

    When adolescent substance abuse requires treatment, few parents know which treatment features are important and which treatment programs are effective. There are few resources to help them select appropriate care. We describe early work on an evaluation method and comparative treatment guide for parents based upon the premise that the quality of a program and its potential effectiveness is a function of the number and frequency of evidence-based treatment practices (EBPs) delivered. Thus, we describe the development of and measurement approach for a set of EBPs toward the goal of developing a Consumer Guide to Adolescent Substance Abuse Treatment. PMID:26417196

  13. Clinicians' information sources for new substance abuse treatment.

    PubMed

    Arfken, Cynthia L; Agius, Elizabeth; Dickson, Marcus W

    2005-09-01

    Little is known about clinicians' information sources for new treatments or ways to improve dissemination of that information. We analyzed 163 clinicians' responses to a checklist of where and how frequently they obtain information on new treatment approaches. They reported at least yearly use of a median of four cosmopolite categories (e.g., journals or books, Internet) and a median of three local categories (e.g., co-workers, personal experience) with interpersonal contact with co-workers (89%) and seminars/conferences (86%) being the most frequently endorsed responses for at least yearly use. In response to the hypothetical scenario of receiving monthly e-mail summaries of journal articles, 59% of the clinicians rated the strategy as "very helpful". If continuing education credits were offered, more clinicians (from 50-80%) would read the relevant articles. Information dissemination may improve with expanded Internet access at programs and short e-mailed summaries carrying links to full articles coupled with the incentive of earning continuing education credits. PMID:16122619

  14. Gender-Sensitive Substance Abuse Treatment and Arrest Outcomes for Women

    PubMed Central

    Kissin, Wendy B.; Tang, Zhiqun; Campbell, Kevin M.; Claus, Ronald E.; Orwin, Robert G.

    2013-01-01

    The present study links an empirically-developed quantitative measure of gender-sensitive (GS) substance abuse treatment to arrest outcomes among 5,109 substance abusing women in mixed-gender short-term residential programs in Washington State. Frailty models of survival analysis and 3-level hierarchical linear models were conducted to test the beneficial effects of GS treatment on decreasing criminal justice involvement. Propensity scores were used to control for the pre-existing differences among women due to the quasi-experimental nature of the study. Men's arrest outcomes were used to control for confounding at the program level. Results show that women in more GS treatment programs had a lower risk of drug-related arrests, and women in more GS treatment programs who also completed treatment had a significant reduction in overall arrests from two years before- to two years after treatment, above and beyond the reduction in arrests due to treatment alone. Implications and directions for future research are discussed. PMID:24209383

  15. Gender differences in outcomes in an HMO-based substance abuse treatment program.

    PubMed

    Green, Carla A; Polen, Michael R; Lynch, Frances L; Dickinson, Daniel M; Bennett, Marjorie D

    2004-01-01

    This study examined gender differences in treatment outcomes and outcomes predictors among 155 men and 81 women attending a gender-sensitive substance abuse treatment program. Bivariate analyses indicated women improved more than men in social/family and daily functioning domains, but differences disappeared after controlling for baseline characteristics. Multivariate models predicting treatment outcomes revealed that, across Addiction Severity Index domains, outcomes for men were predicted primarily by mental health and medical conditions, severity of the substance abuse problem, and treatment com- pletion. For women, in addition to treatment completion, outcomes were more likely to be predicted by social, socio-demographic, and life-history characteristics. For abstinence outcomes, women who completed treatment were 9 times as likely to be abstinent at 7-month follow-up as other women; men who completed were 3 times more likely to be abstinent than other men. Women with more severe psychiatric status and those who felt their life was out of control were less likely to be abstinent, as were men who lived alone. Clinicians targeting such factors differentially for men and women may enhance the effectiveness of treatment. PMID:15132342

  16. Ethical Dilemmas in Online Research and Treatment of Sexually Abused Adolescents

    PubMed Central

    Ruwaard, Jeroen

    2010-01-01

    Background In a recent uncontrolled trial of a new therapist-assisted Web-based treatment of adolescent victims of sexual abuse, the treatment effects were found to be promising. However, the study suffered a large pretreatment withdrawal rate that appeared to emanate from reluctance among the participants to disclose their identity and obtain their parents’ consent. Objective Our objectives were to confirm the effects of the online treatment in a controlled trial and to evaluate measures to reduce pretreatment withdrawal in vulnerable populations including young victims of sexual abuse. Methods The study was designed as a within-subject baseline-controlled trial. Effects of an 8-week attention-placebo intervention were contrasted with the effects of an 8-week treatment episode. Several measures were taken to reduce pretreatment dropout. Results Pretreatment withdrawal was reduced but remained high (82/106, 77%). On the other hand, treatment dropout was low (4 out of 24 participants), and improvement during treatment showed significantly higher effects than during the attention placebo control period (net effect sizes between 0.5 and 1.6). Conclusions In treatment of vulnerable young populations, caregivers and researchers will have to come to terms with high pretreatment withdrawal rates. Possible measures may reduce pretreatment withdrawal to some degree. Providing full anonymity is not a viable option since it is incompatible with the professional responsibility of the caregiver and restricts research possibilities. PMID:21169170

  17. Impact of approach used to determine removal levels of drugs of abuse during wastewater treatment.

    PubMed

    Rodayan, Angela; Majewsky, Marius; Yargeau, Viviane

    2014-07-15

    In this study the levels of 19 drugs of abuse were estimated throughout a wastewater treatment plant using polar organic chemical integrative samplers (POCIS), 24h composite samples and grab samples. Overall removal efficiencies and removals in between each treatment unit were calculated using load data for each sampling technique as well as removals that take into account the hydraulic residence time distribution of the treatment plant (time-shifted mass balancing approach). Amphetamine-type stimulants, cocaine and its major metabolite, benzoylecgonine and opioid levels determined with 24h composite samples were generally comparable to those obtained with POCIS and grab samples. Negative mass balances resulting from the estimation of overall removal efficiencies by POCIS, day-to-day mass balancing of 24h composite and grab sample data did not occur when the hydraulic retention time (HRT) distributions of the plant were taken into account for calculation. Among the compounds investigated, cocaine exhibited the highest overall removal (90%) while codeine had the lowest with 13%, respectively. Sampling between the treatment units revealed that highest removal occurs during biological treatment as compared to primary or secondary clarification. Methylenedioxyamphetamine (MDA), fentanyl, dihydrocodeine and heroin were not detected in wastewater at any of the sampling locations at the treatment plant regardless of the sampling technique. The study demonstrates the benefits of applying the time-shifted mass balancing approach to the calculation of removals of drugs of abuse during wastewater treatment. PMID:24726517

  18. Childhood sexual abuse, post-traumatic stress disorder, and use of heroin among female clients in Israeli methadone maintenance treatment programs (MMTPS).

    PubMed

    Schiff, Miriam; Levit, Shabtay; Cohen-Moreno, Rinat

    2010-01-01

    This study investigated association between post-traumatic stress disorder (PTSD) and a 1-year follow-up heroin use among female clients in methadone clinics in Israel. Participants were 104 Israeli female clients from four methadone clinics (Mean age = 39.09, SD = 8.61) who reported victimization to childhood sexual abuse. We tested traces in urine of these female clients for heroin a year preceding and a year following the assessment of their PTSD. Results show that 54.2% reported symptoms that accedes the DSM-IV criteria for PTSD. We found that among childhood victimized women PTSD is associated with more frequent use of heroin at a 1-year follow-up even after controlling for duration of the stay at the clinic, background, other traumatic experiences and heroin use a year prior the assessment of their PTSD. This study shows the potential long-run negative consequences of childhood sexual abuse. Not only are these sexually abused women trapped into drug dependence and addiction, they cannot break the vicious cycle of continuing the use of illicit drugs even when treated for their addiction. One major practice implication is that treatment for PTSD proven efficacious will be provided in the methadone and other drug treatment services. PMID:20938876

  19. 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

    -based treatments to other salient issues such as building the necessary research evidence (including incorporating American Indian and Alaska Native cultural values into clinical practice) and developing the human and infrastructural resources to support the use of this evidence may be far more effective for advancing efforts to improve substance abuse services for American Indian and Alaska Native communities. PMID:21679438

  20. Sexual Abuse of Individuals with Disabilities: Prevention Strategies for Clinical Practice

    ERIC Educational Resources Information Center

    McEachern, Adriana G.

    2012-01-01

    Sexual abuse of individuals with disabilities occurs in alarming proportions, although the prevalence and incidence of such abuse is difficult to determine. Although all states maintain statistics on child sexual abuse, the rate of victimization for individuals with disabilities is not specific. This paper reviews several studies conducted on…

  1. Primary elements for STD clinical treatment.

    PubMed

    Townsend, S

    1992-04-01

    This article discusses the 4 basic elements of STD clinical treatment: diagnostic tools, training, well-run clinics, and antibiotics. In many developing countries, primary health care (PHC) centers serve as the initial source of STD preventive and curative services. If necessary, PHC centers can refer patients to the more specialized STD clinics. As the article explains, PHC clinics ideally need tables for pelvic examinations, lamps, reliable supplies of water and electricity, instruments for pelvic exams, sterilization equipment, gloves, microscopes and blood-taking equipment. Furthermore, PHC clinics should be able to perform 2 simple microscopic tests: the "wet-mount" test (for trichomoniasis, candidiasis, or bacterial vaginosis in women and the Gram stain Test (for gonorrhea in men). STD clinics should provide more comprehensive services, but such services are often more costly and time-consuming. In 1990, several organization launched an international initiative to develop diagnostic techniques appropriate for use in settings with limited resources. In addition to diagnostic tools, effective STD clinical treatment requires a well-trained staff, skilled not only in diagnosis but also in counseling about condoms and partner notification. Well-run clinics is another requisite of effective STD treatment. Well-run clinics is another requisite of effective STD treatment. Well-run clinics usually share the following features: 1) a convenient location; 2) clearly displayed signs directing patients to the clinic; 3) convenient operating hours; 4) privacy; 5) comfortable waiting areas; and 6) short waiting periods. Finally, effective STD treatment depends on the administration of the right type and dosage of a drug. Cost, however, remains the principal obstacle to availability of effective drugs. PMID:12343659

  2. Outcome Prediction in Clinical Treatment Processes.

    PubMed

    Huang, Zhengxing; Dong, Wei; Ji, Lei; Duan, Huilong

    2016-01-01

    Clinical outcome prediction, as strong implications for health service delivery of clinical treatment processes (CTPs), is important for both patients and healthcare providers. Prior studies typically use a priori knowledge, such as demographics or patient physical factors, to estimate clinical outcomes at early stages of CTPs (e.g., admission). They lack the ability to deal with temporal evolution of CTPs. In addition, most of the existing studies employ data mining or machine learning methods to generate a prediction model for a specific type of clinical outcome, however, a mathematical model that predicts multiple clinical outcomes simultaneously, has not yet been established. In this study, a hybrid approach is proposed to provide a continuous predictive monitoring service on multiple clinical outcomes. More specifically, a probabilistic topic model is applied to discover underlying treatment patterns of CTPs from electronic medical records. Then, the learned treatment patterns, as low-dimensional features of CTPs, are exploited for clinical outcome prediction across various stages of CTPs based on multi-label classification. The proposal is evaluated to predict three typical classes of clinical outcomes, i.e., length of stay, readmission time, and the type of discharge, using 3492 pieces of patients' medical records of the unstable angina CTP, extracted from a Chinese hospital. The stable model was characterized by 84.9% accuracy and 6.4% hamming-loss with 3 latent treatment patterns discovered from data, which outperforms the benchmark multi-label classification algorithms for clinical outcome prediction. Our study indicates the proposed approach can potentially improve the quality of clinical outcome prediction, and assist physicians to understand the patient conditions, treatment inventions, and clinical outcomes in an integrated view. PMID:26573645

  3. 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

  4. Risk and prevalence of treatable sexually transmitted diseases at a Birmingham substance abuse treatment facility.

    PubMed Central

    Bachmann, L H; Lewis, I; Allen, R; Schwebke, J R; Leviton, L C; Siegal, H A; Hook, E W

    2000-01-01

    OBJECTIVES: We evaluated the prevalence of gonorrhea, chlamydia, trichomoniasis, and syphilis in patients entering residential drug treatment. METHODS: Data on sexual and substance abuse histories were collected. Participants provided specimens for chlamydia and gonorrhea ligase chain reaction testing. Trichomonas vaginalis culture, and syphilis serologic testing. RESULTS: Of 311 patients, crack cocaine use was reported by 67% and multisubstance use was reported by 71%. Sexually transmitted disease (STD) risk behaviors were common. The prevalence of infection was as follows: Chlamydia trachomatis, 2.3%; Neisseria gonorrhoeae, 1.6%; trichomoniasis, 43%; and syphilis, 6%. CONCLUSIONS: STD counseling and screening may be a useful adjunct to inpatient drug treatment. PMID:11029998

  5. Therapeutic approach to sexual abuse.

    PubMed Central

    Furniss, T; Bingley-Miller, L; Bentovim, A

    1984-01-01

    An account is given of the development of a treatment project for sexually abused children and their families. We review incidence data which indicate that sexual abuse of children is likely to be a far more frequent problem than has been recognised and cause an appreciable degree of psychological damage. Professional responses to this are confused and treatment facilities limited. Sexual abuse is seen as an expression of severe relationship problems in the family and therapeutic provision is made, therefore, not only for the abused child but for other members of the family (including both parents). The method adopted is to offer group therapy to the child, mother, and father and regular family meetings with professionals in the community, concerned with care and protection of children. Clinical data on the first 56 children treated are discussed and our approach to treatment is evaluated. PMID:6486864

  6. Childhood Sexual Abuse and Sexual Risk Behavior among Men and Women Attending a Sexually Transmitted Disease Clinic

    ERIC Educational Resources Information Center

    Senn, Theresa E.; Carey, Michael P.; Vanable, Peter A.; Coury-Doniger, Patricia; Urban, Marguerite A.

    2006-01-01

    Childhood sexual abuse (CSA) is associated with a wide range of negative outcomes. The authors investigated the relation between CSA and sexual risk behavior in 827 patients recruited from a sexually transmitted disease (STD) clinic. Overall, CSA was reported by 53% of women and 49% of men and was associated with greater sexual risk behavior,…

  7. Parent Abuse: A Review

    ERIC Educational Resources Information Center

    Kennair, Nicola; Mellor, David

    2007-01-01

    A recent focus of research and clinical practice has been on the issue of abuse of parents by their children (parent abuse). This paper reviews the literature on this phenomenon. While parent abuse falls under the umbrella of family violence, it appears to be qualitatively different from other forms of intra-family abuse. Research has primarily…

  8. Profile of female patients seeking in-patient treatment for prescription opioid abuse from a tertiary care drug dependence treatment centre from India

    PubMed Central

    Dayal, Prabhoo; Balhara, Yatan Pal Singh

    2016-01-01

    Background & objectives: There has been a limited focus on prescription drug abuse among women in the country. Choice of psychoactive substance, reasons for initiation and co-occurring disorders have been found to be different among men and women. The current study was aimed at studying the profile of female patients seeking in-patient treatment for prescription drug use over a period of five years at a tertiary care drug dependence treatment centre in India. Methods: Case records of all female patients admitted with substance use disorder at a national level drug dependence treatment centre in north India across five years (between January 2008 and December 2012) were reviewed retrospectively to study their socio-demographic and clinical profile. The information was gathered using a semi-structured proforma and detailed case records. Abstinence, relapse and retention rates were calculated. Results: Over the five years, 31 female patients were admitted with prescription drug abuse. Of them, 12 (39%) used prescription opioids and 11 (36%) used prescription opioid along with benzodiazepines. Commonest prescription opioid was pentazocine used by 87 per cent of the women. Twenty two (71%) women were introduced to opioid by medical practitioners and commonest reason for introduction was pain (among 48%). Common co-occurring psychiatric diagnoses were depressive disorder (26%), cluster B traits/disorder (19%) and somatoform disorder (13%). Eight women did not complete treatment and left against medical advice. Thirteen women were advised maintenance treatment, and 70 per cent of them were retained for at least six months. Interpretation & conclusions: Our findings revealed a link between mental illness, pain and non-medical use of prescription opioids among women. Majority of these women received opioids as a legitimate prescription form physician. Therefore, these legitimate prescribers should be trained for pain management to facilitate proper treatment of pain and to

  9. Child sexual abusers' views on treatment: a study of convicted and imprisoned adult male offenders.

    PubMed

    Colton, Matthew; Roberts, Susan; Vanstone, Maurice

    2009-01-01

    In spite of an increasing focus on the assessment and treatment of sexual offenders over the past two decades, much debate persists as to the effectiveness of treatment in reducing recidivism. Given the dearth of research on offenders' perspectives in this area and the potential for offenders' views to inform the development of effective treatment, we consider the views of 35 adult male child sexual abusers on the prison treatment program. Focusing on a number of key themes, namely victim empathy, strategies for desistence, group or individual treatment, motivation, and postprogram support. In doing so, the extent to which this work furthers knowledge in this area and future research directions was considered. PMID:19856736

  10. Improving quality of care in substance abuse treatment using five key process improvement principles

    PubMed Central

    Hoffman, Kim A.; Green, Carla A.; Ford, James H.; Wisdom, Jennifer P.; Gustafson, David H.; McCarty, Dennis

    2012-01-01

    Process and quality improvement techniques have been successfully applied in health care arenas, but efforts to institute these strategies in alcohol and drug treatment are underdeveloped. The Network for the Improvement of Addiction Treatment (NIATx) teaches participating substance abuse treatment agencies to use process improvement strategies to increase client access to, and retention in, treatment. NIATx recommends five principles to promote organizational change: 1) Understand and involve the customer; 2) Fix key problems; 3) Pick a powerful change leader; 4) Get ideas from outside the organization; and 5) Use rapid-cycle testing. Using case studies, supplemented with cross-agency analyses of interview data, this paper profiles participating NIATx treatment agencies that illustrate application of each principle. Results suggest that the most successful organizations integrate and apply most, if not all, of the five principles as they develop and test change strategies. PMID:22282129

  11. Chronic Pruritus: Clinics and Treatment

    PubMed Central

    Grundmann, Sonja

    2011-01-01

    Chronic pruritus, one of the main symptoms in dermatology, is often intractable and has a high impact on patient's quality of life. Beyond dermatologic disorders, chronic pruritus is associated with systemic, neurologic as well as psychologic diseases. The pathogenesis of acute and chronic (>6 weeks duration) pruritus is complex and involves in the skin a network of resident (e.g., sensory neurons) and transient inflammatory cells (e.g., lymphocytes). In the skin, several classes of histamine-sensitive or histamine-insensitve C-fibers are involved in itch transmission. Specific receptors have been discovered on cutaneous and spinal neurons to be exclusively involved in the processing of pruritic signals. Chronic pruritus is notoriously difficult to treat. Newer insights into the underlying pathogenesis of pruritus have enabled novel treatment approaches that target the pruritus-specific pathophysiological mechanism. For example, neurokinin-1 antagonists have been found to relieve chronic pruritus. PMID:21738356

  12. 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. PMID:7761302

  13. Childhood Sexual Abuse: Identification, Screening, and Treatment Recommendations in Primary Care Settings.

    PubMed

    Hanson, Rochelle F; Adams, Cristin S

    2016-06-01

    It is estimated that 8% to 12% of American youths have experienced at least one sexual assault in their lifetime, making childhood sexual abuse (CSA) an important public health problem that is likely to be encountered by primary care providers. Use of screening tools and understanding the principles behind targeted clinical evaluation can aid in identification of CSA victims despite highly variable presentation. The primary care provider must be aware of potential signs and symptoms as well as differential diagnoses in order to identify children who may benefit from further mental health evaluation and intervention. PMID:27262010

  14. Serial-Episodic Brief Treatment for Borderline Spectrum Families: Employing the Matrix of Projections in a Child Abuse Case

    ERIC Educational Resources Information Center

    Clark, Steven

    2006-01-01

    The author addresses the fact that many families with a borderline structure receive treatment throughout the life cycle. Serial episodic brief treatment is recommended, utilizing projective identification as an organizing principle to promote incremental change during each treatment episode. The author selects a child abuse case to review, that…

  15. Demographic Characteristics and Rates of Progress of Deaf and Hard of Hearing Persons Receiving Substance Abuse Treatment

    ERIC Educational Resources Information Center

    Moore, Dennis; McAweeney, Mary

    2007-01-01

    A lack of demographic information and data related to the achievement of short-term goals during substance abuse treatment among persons who are deaf or hard of hearing dictated the need for the study. New York State maintains a database on all individuals who participate in treatment. Within this database, 1.8% of persons in treatment for…

  16. History of Interpersonal Violence, Abuse, and Nonvictimization Trauma and Severity of Psychiatric Symptoms among Children in Outpatient Psychiatric Treatment

    ERIC Educational Resources Information Center

    Ford, Julian D.; Gagnon, Kerry; Connor, Daniel F.; Pearson, Geraldine

    2011-01-01

    In a clinical sample of child psychiatry outpatients, chart review data were collected for 114 consecutive admissions over a 1-year period at a Child and Adolescent Outpatient Psychiatry Clinic. Data included history of documented maltreatment, potentially traumatic domestic or community violence, neglect or emotional abuse, and noninterpersonal…

  17. Perceptions of child sexual abuse:victim and perpetrator characteristics, treatment efficacy, and lay vs. legal opinions of abuse.

    PubMed

    Reynolds, Lisa L; Birkimer, John C

    2002-01-01

    Two studies examined interactions between victim age and victim response, and victim relation to perpetrator and victim response influencing perceptions of child sexual abuse (CSA). Undergraduates read one of several vignettes describing a sexual encounter between a man and a girl. In Experiment 1, age of the girl was varied; victim age interacted with victim response to increase ratings of abuse and expected trauma for the girl. In Experiment 2, age was held constant while victim relation to perpetrator was varied; men gave higher ratings of abuse than did women for scenarios involving a step father rather than a neighbor, regardless of victim response. In both studies, psychotherapy was expected to help the victim more than the perpetrator and the law was judged to be less stringent than it is regarding CSA. Results suggest that perceptions of CSA are influenced by several factors and that laws regarding CSA may not be well understood. PMID:16221633

  18. Substance Use, Childhood Sexual Abuse and Sexual Risk Behavior among Women in Methadone Treatment

    PubMed Central

    Cohen, Lisa R.; Tross, Susan; Pavlicova, Martina; Hu, Mei-Chen; Campbell, Aimee N.; Nunes, Edward V.

    2009-01-01

    Substance use and a history of childhood sexual abuse have both been identified as risk factors for unprotected sex among women, yet questions remain as to how their combined influence may differentially affect sexual risk behavior. In the current study a Generalized Linear Mixed Model was used to examine the interaction effect between current cocaine and opioid use and a history of childhood sexual abuse (CSA) on number of unprotected sexual occasions (USO) in a sample of 214 sexually active women in outpatient methadone maintenance treatment programs. Results show significant interaction effects between drug use in the past 30 days and CSA on unprotected sexual occasions. These interactions, however, differ depending on type of drug used and CSA status. For women with CSA, an increase in days of cocaine use was significantly associated with an increase in USO, whereas an increase in number of days of opiate use was not significantly associated with an increase in USO. In contrast, for women who did not report CSA, an increase in number of days of cocaine use was associated with a significant decrease in USO and number of days of opiate use was significantly correlated with an increase in USO. Findings indicate that CSA is related to unprotected sexual occasions depending on drug type and severity of use. Women with childhood sexual abuse using cocaine are at particularly high risk for having unprotected sex, which suggests that this group of women should be specifically targeted for HIV prevention interventions. PMID:19637103

  19. Clinical features of pedophilia and implications for treatment.

    PubMed

    Cohen, Lisa J; Galynker, Igor I

    2002-09-01

    The authors discuss the diagnostic criteria for pedophilia and review the literature on its clinical features, including data on prevalence, gender, age of onset, number of victims, frequency and type of acts, violence, impulsivity, and insight. Findings concerning the characteristics of victims (e.g., sex, age, relationship to the pedophile) and research on pedophilic subtypes-exclusive versus nonexclusive; incestuous versus nonincestuous; heterosexual, homosexual, or bisexual-are reviewed. Studies have shown that pedophiles may share many psychiatric features beyond deviant sexual desire, including high rates of comorbid axis I disorders (affective disorders, substance use disorders, impulse control disorders, other paraphilias) as well as severe axis II psychopathology (especially antisocial and Cluster C personality disorders). The authors present several possible etiological models for pedophilia and conclude that further research is needed concerning the etiological role of a childhood history of sexual abuse as well as the underlying neurobiology of deviant sexual arousal and decreased erotic differentiation. Finally, findings concerning pharmacological and cognitive-behavioral treatments for pedophilia are briefly reviewed. Recidivism, drop-out, and noncompliance are significant problems in the treatment of pedophilia. The authors review predictors of treatment outcome and conclude that pedophilia is extremely difficult to treat and that effective treatment needs to be intensive, long-term, and comprehensive, possibly with lifetime follow-up. PMID:15985890

  20. Assessment and treatment of abuse risk in opioid prescribing for chronic pain.

    PubMed

    Jamison, Robert N; Serraillier, Juliana; Michna, Edward

    2011-01-01

    Opioid analgesics provide effective treatment for noncancer pain, but many physicians have concerns about adverse effects, tolerance, and addiction. Misuse of opioids is prominent in patients with chronic back pain and early recognition of misuse risk could help physicians offer adequate patient care while implementing appropriate levels of monitoring to reduce aberrant drug-related behaviors. In this review, we discuss opioid abuse and misuse issues that often arise in the treatment of patients with chronic back pain and present an overview of assessment and treatment strategies that can be effective in improving compliance with the use of prescription opioids for pain. Many persons with chronic back pain have significant medical, psychiatric and substance use comorbidities that affect treatment decisions and a comprehensive evaluation that includes a detailed history, physical, and mental health evaluation is essential. Although there is no "gold standard" for opioid misuse risk assessment, several validated measures have been shown to be useful. Controlled substance agreements, regular urine drug screens, and interventions such as motivational counseling have been shown to help improve patient compliance with opioids and to minimize aberrant drug-related behavior. Finally, we discuss the future of abuse-deterrent opioids and other potential strategies for back pain management. PMID:22110936