WorldWideScience

Sample records for abuse treatment admissions

  1. Characteristics of Pregnant Teen Substance Abuse Treatment Admissions

    Science.gov (United States)

    ... treatment admission (“other female teen admissions”). Note that TEDS is a census of all admissions to treatment facilities reported to the Substance Abuse and Mental Health Services Administration (SAMHSA) by State substance abuse agencies. IN BRIEF X X Between 2007 and 2010, about 57,000 ...

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

    Science.gov (United States)

    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…

  3. Admissions of injection drug users to drug abuse treatment following HIV counseling and testing.

    Science.gov (United States)

    McCusker, J; Willis, G; McDonald, M; Lewis, B F; Sereti, S M; Feldman, Z T

    1994-01-01

    The outcomes of counseling and testing programs related to human immunodeficiency virus (HIV) infection and risk of infection among injection drug users (IDUs) are not well known or understood. A counseling and testing outcome of potential public health importance is attaining admission to drug abuse treatment by those IDUs who are either infected or who are at high risk of becoming infected. The authors investigated factors related to admission to drug abuse treatment among 519 IDUs who received HIV counseling and testing from September 1987 through December 1990 at a men's prison and at community-based testing sites in Worcester, MA. By June 1991, 123 of the 519 IDUs (24 percent) had been admitted to treatment. Variables associated with their admission included a long history of drug injection, frequent recent drug injection, cleaning injection equipment using bleach, prior drug treatment, and a positive HIV test result. Logistic regression analyses, controlling for effects of recruitment site, year, sex, and area of residence, generally confirmed the associations. IDUs in the study population who were HIV-infected sought treatment or were admitted to treatment more frequently than those who were not infected. The results indicate that access to drug abuse treatment should be facilitated for high-risk IDUs and for those who have begun to inject drugs recently.

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

    Science.gov (United States)

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

    2016-10-14

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

  5. Decline in adolescent treatment admissions for methamphetamine ...

    African Journals Online (AJOL)

    Background and objectives. The purpose of this report is to describe the changing trends in adolescent treatment admissions for methamphetamine in Cape Town, and to discuss possible implications. Method. Data were collected on admissions for drug abuse treatment through a regular monitoring system involving drug ...

  6. Treatment Episode Data Set: Admissions (TEDS-A-2002)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  7. Treatment Episode Data Set: Admissions (TEDS-A-1994)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  8. Treatment Episode Data Set: Admissions (TEDS-A-2008)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  9. Treatment Episode Data Set: Admissions (TEDS-A-2003)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  10. Treatment Episode Data Set: Admissions (TEDS-A-2006)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  11. Treatment Episode Data Set: Admissions (TEDS-A-2011)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  12. Treatment Episode Data Set: Admissions (TEDS-A-1999)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  13. Treatment Episode Data Set: Admissions (TEDS-A-1997)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  14. Treatment Episode Data Set: Admissions (TEDS-A-2000)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  15. Treatment Episode Data Set: Admissions (TEDS-A-2009)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  16. Treatment Episode Data Set: Admissions (TEDS-A-2010)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  17. Treatment Episode Data Set: Admissions (TEDS-A-1998)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  18. Treatment Episode Data Set: Admissions (TEDS-A-2007)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  19. Treatment Episode Data Set: Admissions (TEDS-A-1993)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  20. Treatment Episode Data Set: Admissions (TEDS-A-1995)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  1. Treatment Episode Data Set: Admissions (TEDS-A-1996)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  2. Treatment Episode Data Set: Admissions (TEDS-A-2005)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  3. Treatment Episode Data Set: Admissions (TEDS-A-1992)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  4. Treatment Episode Data Set: Admissions (TEDS-A-2001)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  5. Treatment Episode Data Set: Admissions (TEDS-A-2004)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  6. Treatment Episode Data Set: Admissions (TEDS-A-2013)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  7. Treatment Episode Data Set: Admissions (TEDS-A-2012)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Treatment Episode Data Set -- Admissions (TEDS-A) is a national census data system of annual admissions to substance abuse treatment facilities. TEDS-A provides...

  8. Admission to acute care hospitals for adolescent substance abuse: a national descriptive analysis

    Directory of Open Access Journals (Sweden)

    Chisolm Deena J

    2006-07-01

    Full Text Available Abstract Background Use of alcohol and illicit drugs by adolescents remains a problem in the U.S. Case identification and early treatment can occur within a broad variety of healthcare and non-healthcare settings, including acute care hospitals. The objective of this study is to describe the extent and nature of adolescent admissions to the acute inpatient setting for substance abuse (SA. We use the Agency for Healthcare Research and Quality (AHRQ 2000 Healthcare Cost and Utilization Project Kids Inpatient Database (HCUP-KID which includes over 2.5 million admissions for youth age 20 and under to 2,784 hospitals in 27 states in the year 2000. Specifically, this analysis estimates national number of admissions, mean total charges, and mean lengths of stay for adolescents between the ages of 12 and 17 admitted to an acute care hospital for the following diagnostic categories from the AHRQ's Clinical Classifications Software categories: "alcohol-related mental disorders" and "substance-related mental disorders". Frequency and percentage of total admissions were calculated for demographic variables of age, gender and income and for hospital characteristic variables of urban/rural designation and children's hospital designation. Results SA admissions represented 1.25 percent of adolescent admissions to acute care hospitals. Nearly 90 percent of the admission occurred in non-Children's hospitals. Most were for drug dependence (38% or non-dependent use of alcohol or drugs (35%. Costs were highest for drug dependence admissions. Nearly half of admissions had comorbid mental health diagnoses. Higher rates of admission were seen in boys, in older adolescents, and in "self-pay" patients. Alcohol and drug rehabilitation/detoxification, alone or in combination with psychological and psychiatric evaluation and therapy, was documented for 38 percent of admissions. Over 50 percent of cases had no documentation of treatment specific to substance use behavior

  9. 24 CFR 5.857 - When must I prohibit admission of alcohol abusers?

    Science.gov (United States)

    2010-04-01

    ... Assisted Housing-Denying Admission and Terminating Tenancy for Criminal Activity or Alcohol Abuse Denying... right to peaceful enjoyment of the premises by other residents. Terminating Tenancy ...

  10. Management practices in substance abuse treatment programs.

    Science.gov (United States)

    McConnell, K John; Hoffman, Kim A; Quanbeck, Andrew; McCarty, Dennis

    2009-07-01

    Efforts to understand how to improve the delivery of substance abuse treatment have led to a recent call for studies on the "business of addiction treatment." This study adapts an innovative survey tool to collect baseline management practice data from 147 addiction treatment programs enrolled in the Network for the Improvement of Addiction Treatment 200 project. Measures of "good" management practice were strongly associated with days to treatment admission. Management practice scores were weakly associated with revenues per employee but were not correlated with operating margins. Better management practices were more prevalent among programs with a higher number of competitors in their catchment area.

  11. Local macroeconomic trends and hospital admissions for child abuse, 2000-2009.

    Science.gov (United States)

    Wood, Joanne N; Medina, Sheyla P; Feudtner, Chris; Luan, Xianqun; Localio, Russell; Fieldston, Evan S; Rubin, David M

    2012-08-01

    To examine the relationship between local macroeconomic indicators and physical abuse admission rates to pediatric hospitals over time. Retrospective study of children admitted to 38 hospitals in the Pediatric Hospital Information System database. Hospital data were linked to unemployment, mortgage delinquency, and foreclosure data for the associated metropolitan statistical areas. Primary outcomes were admission rates for (1) physical abuse in children <6 years old, (2) non-birth, non-motor vehicle crash-related traumatic brain injury (TBI) in infants <1 year old (which carry high risk for abuse), and (3) all-cause injuries. Poisson fixed-effects regression estimated trends in admission rates and associations between those rates and trends in unemployment, mortgage delinquency, and foreclosure. Between 2000 and 2009, rates of physical abuse and high-risk TBI admissions increased by 0.79% and 3.1% per year, respectively (P ≤ .02), whereas all-cause injury rates declined by 0.80% per year (P < .001). Abuse and high-risk TBI admission rates were associated with the current mortgage delinquency rate and with the change in delinquency and foreclosure rates from the previous year (P ≤ .03). Neither abuse nor high-risk TBI rates were associated with the current unemployment rate. The all-cause injury rate was negatively associated with unemployment, delinquency, and foreclosure rates (P ≤ .007). Multicenter hospital data show an increase in pediatric admissions for physical abuse and high-risk TBI during a time of declining all-cause injury rate. Abuse and high-risk TBI admission rates increased in relationship to local mortgage delinquency and foreclosure trends.

  12. [Injecting drug abuse: survival after intensive care admission and forensic toxicology reports at death].

    Science.gov (United States)

    Sigvaldason, Kristinn; Ingvarsson, Thoroddur; Thordardottir, Svava; Kristinsson, Jakob; Karason, Sigurbergur

    2014-10-01

    Injecting drug abuse is a worldwide problem with serious consequences for the individual and for society. The purpose of this study was to gather information on the most serious complications of injecting drug use from two perspectives, intensive care admissions and forensic toxicology reports. Firstly, intensive care admissions related to injecting drug abuse during a five year period were reviewed for demographics, complications and 5 year survival. Secondly, information from forensic toxicology reports regarding deaths amongst known injecting drug abusers were gathered for the same period. A total of 57 patients with a history of active injecting drug use were admitted to intensive care or approximately 1% of admissions, most often for overdose (52%) or life threatening infections (39%). Median age was 26, males were 66%. The most common substances used were prescription drugs. Hospital mortality was 16% and five year survival 65%. Average time from hospital discharge to death was 916±858 days. During the study period 38 deaths of individuals with a history of injecting drugs were identified by forensic toxicology reports or 4.1/10(5) population/year (age 15-59). Cause of death was most often overdose (53%), usually from prescription opiates but multiple drug use was common. The life expectancy of injecting drug abusers after intensive care admission is substantially decreased, with 35% death rate within five years. A widespread use of prescription drugs is of concern. Injecting drug abuse seems to be a similar health problem in magnitude in Iceland as in other Scandinavian countries.

  13. 24 CFR 960.204 - Denial of admission for criminal activity or drug abuse by household members.

    Science.gov (United States)

    2010-04-01

    ... activity or drug abuse by household members. 960.204 Section 960.204 Housing and Urban Development... HOUSING Admission § 960.204 Denial of admission for criminal activity or drug abuse by household members. (a) Required denial of admission—(1) Persons evicted for drug-related criminal activity. The PHA...

  14. Treatment outcomes for substance abuse among adolescents with learning disorders.

    Science.gov (United States)

    Yu, Jennifer W; Buka, Stephen L; Fitzmaurice, Garrett M; McCormick, Marie C

    2006-07-01

    This paper assesses whether chemically dependent adolescents with comorbid learning disorders (LDs) derived less effective treatment results when compared to chemically dependent adolescents without LD and examines the moderating effects of prior treatments, treatment length, and treatment completion. Two hundred one adolescents were recruited between 1992 and 1993 from Massachusetts residential treatment centers and subsequently followed up 6 months after enrollment. Compared to chemically dependent teenagers without LD, those with LD were twice as likely to re-use substances at least once by follow-up. LD teenagers were more likely to attend Alcoholics/Narcotics Anonymous if they had prior admissions to treatment programs and longer treatment length. LD teenagers who completed treatment also experienced a greater decrease in current depression compared to LD teenagers not completing the treatment. This study is the first to consider outcomes of substance abuse treatment for adolescents with LD and contributes to the growing literature on comorbidity and substance abuse treatment.

  15. Paid family leave's effect on hospital admissions for pediatric abusive head trauma.

    Science.gov (United States)

    Klevens, Joanne; Luo, Feijun; Xu, Likang; Peterson, Cora; Latzman, Natasha E

    2016-12-01

    Paediatric abusive head trauma (AHT) is a leading cause of fatal child maltreatment among young children. Current prevention efforts have not been consistently effective. Policies such as paid parental leave could potentially prevent AHT, given its impacts on risk factors for child maltreatment. To explore associations between California's 2004 paid family leave (PFL) policy and hospital admissions for AHT, we used difference-in-difference analyses of 1995-2011 US state-level data before and after the policy in California and seven comparison states. Compared with seven states with no PFL policies, California's 2004 PFL showed a significant decrease in AHT admissions in both <1 and <2-year-olds. Analyses using additional data years and comparators could yield different results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

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

    Science.gov (United States)

    Greberman, S B; Jasinski, D

    2001-01-01

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

  17. The effects of residential dual diagnosis treatment on alcohol abuse

    Science.gov (United States)

    Schoenthaler, Stephen J; Blum, Kenneth; Fried, Lyle; Oscar-Berman, Marlene; Giordano, John; Modestino, Edward J.; Badgaiyan, Rajendra

    2017-01-01

    This multi-center study of dual diagnosis (DD) programs involved 804 residential patients with co-occurring alcohol and mental health disorders. The Addiction Severity Index was administered at admission and at one, six, and 12 months after discharge. Repeated measures analysis showed the intoxication rate per month stabilized between months six and 12 with 68% still in remission and an 88% mean reduction from baseline (F = 519, p treatment of both disorders and explained their effectiveness. Co-occurring DSM IV mood disorders such as anxiety and depression as well as drug abuse involving opioids or cocaine fell between 66 and 95% at months one, six, and twelve. PMID:28868159

  18. Residential Treatment Centers for Child Abuse

    Directory of Open Access Journals (Sweden)

    Serhat Nasiroglu

    2014-02-01

    Full Text Available Every year millions of reports are being held and cases regarding those reports in courts are carrying on about abusement and omission against children . Abusement against children has been seen throughout of the history. Significant and permanent impacts can occur upon child abusement and neglect on victim children. It is important to know the psychological dynamics which have been lived by the children by the mental health professionalsto protect the children after the abusement report has been written. Cognitive Behaviour Therapy and medications are being used commonly in the treatment of abusement cases. However in some cases it is necessary to send away the victims from environment, enable them to continue their education life, make sure that they are treated by the professional individuals in safe area. For this end there are many Residential Treatment Centers around the world. and ldquo;Oguz Kagan Koksal Social Care and Rehabilitation Center and rdquo; was established in Adana as the first Residential Treatment Center in Turkey. In this report the historical dimensions of the child abusement, the definition of it, its psychological dynamics, the psychological disorders caused by it, treatment approaches and residential treatment centers have been reviewed. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(1.000: 67-78

  19. Rural Child Sexual Abuse Prevention and Treatment.

    Science.gov (United States)

    Ray, JoAnn; Murty, Susan A.

    1990-01-01

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

  20. Medical marijuana users in substance abuse treatment

    OpenAIRE

    Swartz Ronald

    2010-01-01

    Abstract 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 ...

  1. Failure to get into substance abuse treatment.

    Science.gov (United States)

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

    2017-02-01

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

  2. Reforming Dutch substance abuse treatment services.

    Science.gov (United States)

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

    2002-01-01

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

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

    Science.gov (United States)

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

    2002-12-01

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

  4. Addressing Trauma in Substance Abuse Treatment

    Science.gov (United States)

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

    2016-01-01

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

  5. Medical marijuana users in substance abuse treatment

    Directory of Open Access Journals (Sweden)

    Swartz Ronald

    2010-03-01

    Full Text Available Abstract 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

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

    Science.gov (United States)

    Clow, Daniel R.; And Others

    1992-01-01

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

  7. Supervisory Turnover in Outpatient Substance Abuse Treatment

    Science.gov (United States)

    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

  8. Effect of the Earned Income Tax Credit on Hospital Admissions for Pediatric Abusive Head Trauma, 1995-2013.

    Science.gov (United States)

    Klevens, Joanne; Schmidt, Brian; Luo, Feijun; Xu, Likang; Ports, Katie A; Lee, Rosalyn D

    Policies that increase household income, such as the earned income tax credit (EITC), have shown reductions on risk factors for child maltreatment (ie, poverty, maternal stress, depression), but evidence is lacking on whether the EITC actually reduces child maltreatment. We examined whether states' EITCs are associated with state rates of hospital admissions for abusive head trauma among children aged tax filer gets money even if taxes are not owed) from nonrefundable EITCs (ie, tax filer gets credit only for any tax owed), controlling for state rates of child poverty, unemployment, high school graduation, and percentage of non-Latino white people. A refundable EITC was associated with a decrease of 3.1 abusive head trauma admissions per 100 000 population in children aged Tax refunds ranged from $108 to $1014 and $165 to $1648 for a single parent working full-time at minimum wage with 1 child or 2 children, respectively. Our findings with others suggest that policies such as the EITC that increase household income may prevent serious abusive head trauma.

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

    Science.gov (United States)

    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 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. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Association between Reported Elder Abuse and Rates of Admission to the Skilled Nursing Facilities: Findings from a Longitudinal Population-Based Cohort Study

    Science.gov (United States)

    Dong, XinQi; Simon, Melissa A.

    2013-01-01

    Background Elder abuse is common and is a frank violation of an older adult’s fundamental rights to be safe and free of violence. Our prior study indicates elder abuse is independently associated with mortality. This study aims to quantify the relationship between overall elder abuse and specific subtypes of elder abuse and rate of admission to skilled nursing facilities (SNF). Methods A prospective population-based study is conducted in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project (CHAP). Of the 6,674 participants in the CHAP study, 106 participants were reported to social services agency for elder abuse. The primary predictor was elder abuse reported to social services agency. The outcome of interest was the annual rate of admission to SNF obtained from the Center for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. Results The average annual rate of SNF for those without elder abuse was 0.14(0.58) and for those with elder abuse was 0.66(1.63). After adjusting for sociodemographic, socioeconomic variables, medical commorbidities, cognitive and physical function, and psychosocial wellbeing, older adults who have been abused had higher rates of SNF admission (RR, 4.60 (2.85–7.42)). Psychological abuse (RR, 2.31(1.17–4.56)), physical abuse (RR, 2.36(1.19–4.66)), financial exploitation (RR, 2.81(1.53–5.17)) and caregiver neglect (RR, 4.73(3.03–7.40)) were associated with increased rates of admission to SNF, after considering the same confounders. Elder abuse is associated with higher rate of SNF stay of great than 30 days (RR, 6.27(3.68–10.69). Conclusion Elder abuse was associated with increased rates of admission to SNF in this community population. Specific subtypes of elder abuse had differential association with increased rate of admission to SNF. PMID:23816799

  11. Involuntary psychiatric admission based on risk rather than need for treatment: report from the Dublin Involuntary Admission Study (DIAS).

    LENUS (Irish Health Repository)

    Kelly, BD

    2018-04-01

    Involuntary psychiatric admission in Ireland is based on the presence of mental disorder plus serious risk to self\\/others and\\/or need for treatment. This study aimed to examine differences between use of risk and treatment criteria, about which very little is known.

  12. Involuntary admission may support treatment outcome and motivation in patients receiving assertive community treatment.

    Science.gov (United States)

    Kortrijk, Hans Erik; Staring, A B P; van Baars, A W B; Mulder, C L

    2010-02-01

    Patients with severe mental illness who are treated in assertive community treatment (ACT) teams are sometimes involuntarily admitted when they are dangerous to themselves or others, and are not motivated for treatment. However, the consequences of involuntary admission in terms of psychosocial outcome and treatment motivation are largely unknown. We hypothesized that involuntary admission would improve psychosocial outcome and not adversely affect their treatment motivation. In the context of routine 6-monthly outcome monitoring in the period January 2003-March 2008, we used the Health of the Nation Outcome Scales (HoNOS) and a motivation-for-treatment scale to assess 260 severely mentally ill patients at risk for involuntary admission. Mixed models with repeated measures were used for data analyses. During the observation period, 77 patients (30%) were involuntarily admitted. Relative to patients who were not involuntarily admitted, these patients improved significantly in HoNOS total scores (F = 17,815, df = 1, p < 0.001) and in motivation for treatment (F = 28.139, df = 1, p < 0.001). Patients who were not involuntarily admitted had better HoNOS and motivation scores at baseline, but did not improve. Involuntary admission in the context of ACT was associated with improvements in psychosocial outcome and motivation for treatment. There are no indications that involuntary admission leads to deterioration in psychosocial outcome or worsening of motivation for treatment.

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

    Science.gov (United States)

    Wolk, James L.; Hartmann, David J.

    1996-01-01

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

  14. Abuse

    Science.gov (United States)

    ... Kids For Teens For Parents & Teachers Resolving Family Conflicts The Holidays and Alzheimer's Glossary Virtual Library Online ... Types of abuse Signs of abuse Reporting abuse Types of abuse Abuse comes in many forms: Physical: ...

  15. The Survey of Treatment Entry Pressures (STEP): identifying client's reasons for entering substance abuse treatment.

    Science.gov (United States)

    Dugosh, Karen Leggett; Festinger, David S; Lynch, Kevin G; Marlowe, Douglas B

    2014-10-01

    Systematically identifying reasons that clients enter substance abuse treatment may allow clinicians to immediately focus on issues of greatest relevance to the individual and enhance treatment engagement. We developed the Survey of Treatment Entry Pressures (STEP) to identify the specific factors that precipitated an individual's treatment entry. The instrument contains 121 items from 6 psychosocial domains (i.e., family, financial, social, medical, psychiatric, legal). The current study examined the STEP's psychometric properties. A total of 761 participants from various treatment settings and modalities completed the STEP prior to treatment admission and 4-7 days later. Analyses were performed to examine the instrument's psychometric properties including item response rates, test-retest reliability, internal consistency, and factor structure. The items displayed adequate test-retest reliability and internal consistency within each psychosocial domain. Generally, results from exploratory and confirmatory factor analyses support a 2-factor structure reflecting type of reinforcement schedule. The study provides preliminary support for the psychometric properties of the STEP. The STEP may provide a reliable way for clinicians to characterize and capitalize on a client's treatment motivation early on which may serve to improve treatment retention and therapeutic outcomes. © 2014 Wiley Periodicals, Inc.

  16. 64 Percent of Asian and Pacific Islander Treatment Admissions Name Alcohol as Their Problem

    Science.gov (United States)

    Data Spotlight May 28, 2013 64 Percent of Asian and Pacific Islander Treatment Admissions Name Alcohol as ... common problem in the United States. 1 When Asians and Pacific Islanders (APIs) go to treatment, alcohol ...

  17. Metaphyseal fractures mimicking abuse during treatment for clubfoot

    International Nuclear Information System (INIS)

    Grayev, A.M.; Boal, D.K.B.; Wallach, D.M.; Segal, L.S.

    2001-01-01

    Background. Metaphyseal injuries resembling the classic metaphyseal lesion (CML) of abuse may occur as the result of serial casting during treatment of clubfoot deformity. Mentioned in the orthopedic literature in 1972, this iatrogenic fracture has not been described in the radiologic literature nor has the similarity to injuries occurring with abuse been previously recognized. Objective. To describe the mechanism and radiographic appearance of metaphyseal injury observed during serial casting of clubfoot. Note similarities to the CML of abuse. Materials and methods. Eight children ranging in age from 1 to 4 months underwent casting for clubfoot. Five orthopedic surgeons from three different institutions performed the casting. Two patients had spina bifida and one, arthrogryposis. A complete skeletal survey was performed on one child who was abused; there was no suspicion of abuse in the remaining seven. Results. All children manifest injury with periosteal new bone. One child had clear evidence of abuse with 24 rib fractures. X-rays of lower extremities in short leg casts revealed bilateral tibial metaphyseal fractures. Four other children had metaphyseal fractures resembling the CML of abuse, and three developed an area of sclerosis within the metaphysis. Conclusion. In the setting of serial casting for equinovarus deformity, metaphyseal injury even the CML of abuse may be noted. Since inflicted injuries are almost always unobserved and explanations rarely offered, the fact that the CML occurs as a result of orthopedic manipulation may offer some further insight concerning the pathogenesis of this well-described abuse injury. (orig.)

  18. Metaphyseal fractures mimicking abuse during treatment for clubfoot

    Energy Technology Data Exchange (ETDEWEB)

    Grayev, A.M.; Boal, D.K.B. [Milton S. Hershey Medical Center, Penn State University College of Medicine, Hershey, PA (United States); Wallach, D.M.; Segal, L.S. [Milton S. Hershey Medical Center, Penn State University College of Medicine, Hershey, PA (United States)

    2001-08-01

    Background. Metaphyseal injuries resembling the classic metaphyseal lesion (CML) of abuse may occur as the result of serial casting during treatment of clubfoot deformity. Mentioned in the orthopedic literature in 1972, this iatrogenic fracture has not been described in the radiologic literature nor has the similarity to injuries occurring with abuse been previously recognized. Objective. To describe the mechanism and radiographic appearance of metaphyseal injury observed during serial casting of clubfoot. Note similarities to the CML of abuse. Materials and methods. Eight children ranging in age from 1 to 4 months underwent casting for clubfoot. Five orthopedic surgeons from three different institutions performed the casting. Two patients had spina bifida and one, arthrogryposis. A complete skeletal survey was performed on one child who was abused; there was no suspicion of abuse in the remaining seven. Results. All children manifest injury with periosteal new bone. One child had clear evidence of abuse with 24 rib fractures. X-rays of lower extremities in short leg casts revealed bilateral tibial metaphyseal fractures. Four other children had metaphyseal fractures resembling the CML of abuse, and three developed an area of sclerosis within the metaphysis. Conclusion. In the setting of serial casting for equinovarus deformity, metaphyseal injury even the CML of abuse may be noted. Since inflicted injuries are almost always unobserved and explanations rarely offered, the fact that the CML occurs as a result of orthopedic manipulation may offer some further insight concerning the pathogenesis of this well-described abuse injury. (orig.)

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

    Science.gov (United States)

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

  20. Research on drug abuse and addiction treatment in prisons

    Directory of Open Access Journals (Sweden)

    Kljajević Srđan

    2017-01-01

    Full Text Available The causes of drug abuse and criminal behavior are closely linked. Not surprisingly, there is a high percentage of prisoners who during sentence execution abuse or are dependent on drugs. Antisocial personality disorder can be considered a common predictor of committing criminal offenses and drug abuse. A review of studies has revealed a high prevalence of inmates who use drugs while serving a sentence. Also, prison environment represents only a new context of the continuum of drug abuse by inmates. There are different theoretical approaches in explaining this phenomenon. Treatment programs based on empirically validated principles that guarantee the effectiveness, may be one strategy for solving the problem of drug abuse in prisons, with multiple positive effects.

  1. Transportation and retention in outpatient drug abuse treatment programs.

    Science.gov (United States)

    Friedmann, P D; Lemon, S C; Stein, M D

    2001-09-01

    To determine whether certain types of transportation assistance improve outpatient treatment retention beyond thresholds shown to have therapeutic benefits, we analyzed data from 1,144 clients in 22 outpatient methadone maintenance (OMM) programs and 2,031 clients in 22 outpatient drug-free (ODF) programs in the Drug Abuse Treatment Outcomes Study (DATOS), a national, 12-month, longitudinal study of drug abuse treatment programs. Directors' surveys provided information about provision of car, van, or contracted transportation services or individual vouchers/payment for public transportation. Chart-abstracted treatment retention was dichotomized at 365 days for OMM and 90 days for ODF. Separate multivariate hierarchical linear models revealed that provision of car, van, or contracted transportation services improved treatment retention beyond these thresholds for both OMM and ODF, but individual vouchers or payment for public transportation did not. Future research should validate whether car, van, or contracted transportation services improve retention and other treatment outcomes in outpatient drug abuse treatment.

  2. Complications related to osteopenia in the thoracic spine on admission chest radiographs of substance abuse detoxification patients

    International Nuclear Information System (INIS)

    Haramati, L.B.; Alterman, D.D.; Israel, G.M.; Haramati, N.; Mallavurapu, R.

    1998-01-01

    Objective. To assess the prevalence of complications related to osteopenia in the thoracic spine (anterior wedging and fish vertebrae) of patients admitted for substance abuse detoxification. Design and patients. We retrospectively identified 150 sequential patients admitted to our drug and alcohol detoxification ward in whom posteroanterior and lateral admission chest radiographs and clinical charts were available for review. There were 116 men and 34 women with a mean age of 37 years (range 19-67 years). Thirty-eight patients were admitted for drug detoxification, 37 for alcohol detoxification, and 75 for drug and alcohol detoxification. These patients were compared with 66 age- and sex-matched controls from our hospital's employee health service. Two radiologists reviewed all chest radiographs for the presence of anterior wedging and fish vertebrae in the thoracic spine and other nonspinal fractures. Serum calcium and inorganic phosphorus levels were recorded for the substance abuse detoxification patients. Results. Forty-nine percent (n=73) of detoxification patients had complications of osteopenia in the thoracic spine including: anterior wedging (n=47), fish vertebrae (n=21), or both (n=5). Twenty-four percent (n=36) of patients had an elevated serum inorganic phosphorus level and one patient had an elevated serum calcium level. Patients with anterior wedging or fish vertebrae included: 45% (n=45) of patients below age 40 years, 35% (n=12) of women, 41% (n=15) of drug detoxification patients, 58% (n=22) of alcohol detoxification patients, 48% (n=36) of drug and alcohol detoxification patients, and 47% (n=17) of patients with elevated serum inorganic phosphorus (P=NS). Six percent (n=9) of our study population had nonspinal fractures on their chest radiographs. Twenty-one percent (n=14) of controls had complications of osteopenia in the thoracic spine (all anterior wedging). This prevalence differed significantly (P<0.05, chi-squared) from the study population

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

    Science.gov (United States)

    2010-07-01

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

  4. Treatment and Rehabilitation of Abused and Neglected Children an Inpatient Center Model

    Directory of Open Access Journals (Sweden)

    Sunay Fırat

    2014-09-01

    Full Text Available Rehabilitation and treatment centers are organizations that provide services for children and adolescents, with the main goal being to implement a “mental health” treatment plan for the individuals under their care. These organizations, which provide a continuous 24-hour service, may differ from one another in terms of the specific programs and treatment methods they apply. The Oğuz Kağan Köksal Children and Youth Center was established in the Adana Province to provide for the treatment and rehabilitation of girls between the ages of 8 and 18 who have been subject to abuse or neglect, who suffer from alcohol/substance abuse, who are in need of treatment for mental problems and/or who live on the streets. A study was made of 72 girls who had been admitted to the institution for treatment and rehabilitation since 2004 with a history abuse and neglect. The girls were assessed with the Beck Depression Inventory (BDI, the State Anxiety Inventory (STAI-I, the Trait Anxiety Inventory (STAI-II and the Maudsley Obsessive Compulsive Inventory (MOCI upon being admitted to the institution and at the end of their stay (i.e. their discharge. The differences between the mean admission and discharge scores of the girls in the BDI, STAI-I, STAI-II and MOCI assessments was determined to be statistically significant (p<0.001. According to the duration of stay groups (0–3 months; 4–6 months; 7–9 months and ≥10 months, a statistically significant difference was identified between the mean admission and discharge scores of children who remained in the institution for 3–7 months, with the post-treatment scores of the inventories being significantly lower in comparison to the baseline values (p≤0.05. These results suggest discharging patients from the center prior to their third month of stay or a stay period of longer than seven months does not affect with any significance the scores of the depression, anxiety and obsession inventories. To ensure a

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

    Science.gov (United States)

    Cohn, Amy; Elmasry, Hoda; Niaura, Ray

    2017-06-01

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

  6. Features and challenges of alcohol abuse treatment in Uganda ...

    African Journals Online (AJOL)

    Challenges of the Minnesota model not withstanding treatment providers are faced with inadequate skills and facilities rendering them unable to meet the ever increasing demand. Research into culturally adopted treatment intervention strategies is necessary to enhance the effectiveness and treatment of alcohol abuse in ...

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

    Science.gov (United States)

    Kantak, Kathleen M

    2003-01-01

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

  8. Trends in substance use admissions among older adults.

    Science.gov (United States)

    Chhatre, Sumedha; Cook, Ratna; Mallik, Eshita; Jayadevappa, Ravishankar

    2017-08-22

    Substance abuse is a growing, but mostly silent, epidemic among older adults. We sought to analyze the trends in admissions for substance abuse treatment among older adults (aged 55 and older). Treatment Episode Data Set - Admissions (TEDS-A) for period between 2000 and 2012 was used. The trends in admission for primary substances, demographic attributes, characteristics of substance abused and type of admission were analyzed. While total number of substance abuse treatment admissions between 2000 and 2012 changed slightly, proportion attributable to older adults increased from 3.4% to 7.0%. Substantial changes in the demographic, substance use pattern, and treatment characteristics for the older adult admissions were noted. Majority of the admissions were for alcohol as the primary substance. However there was a decreasing trend in this proportion (77% to 64%). The proportion of admissions for following primary substances showed increase: cocaine/crack, marijuana/hashish, heroin, non-prescription methadone, and other opiates and synthetics. Also, admissions for older adults increased between 2000 and 2012 for African Americans (21% to 28%), females (20% to 24%), high school graduates (63% to 75%), homeless (15% to 19%), unemployed (77% to 84%), and those with psychiatric problems (17% to 32%).The proportion of admissions with prior history of substance abuse treatment increased from 39% to 46% and there was an increase in the admissions where more than one problem substance was reported. Ambulatory setting continued to be the most frequent treatment setting, and individual (including self-referral) was the most common referral source. The use of medication assisted therapy remained low over the years (7% - 9%). The changing demographic and substance use pattern of older adults implies that a wide array of psychological, social, and physiological needs will arise. Integrated, multidisciplinary and tailored policies for prevention and treatment are necessary to

  9. Coordination of Care in Substance Abuse Treatment: An Interorganizational Perspective

    OpenAIRE

    Spear, Suzanne Evelyn

    2012-01-01

    The high cost of detoxification (detox) services and health risks associated with continued substance abuse make readmission to detox an important indicator of poor performance for substance abuse treatment systems. One major service gap in the continuum of care for substance use disorders associated with readmissions is not transitioning patients to rehabilitation after a detox service. This study examined the problem of detox readmissions from an interorganizational network perspective. The...

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

    Science.gov (United States)

    Ellington, Erin

    2017-11-01

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

  11. Epidemiology of drug abuse treatment in South Africa

    Directory of Open Access Journals (Sweden)

    Shandir Ramlagan

    2010-04-01

    Full Text Available Background. The aim of the study was to explore the epidemiology of drug abuse treatment in South Africa. Methods. Treatment demand statistics were analysed from South African National Council on Alcoholism and Drug Dependence and the South African Community Epidemiology Network on Drug Use records, and a rapid situation assessment was conducted. Twenty-one key informant interviews were conducted in all 9 provinces among provincial substance abuse co-ordinators, and one manager per treatment centre from a sample of treatment centres. Three focus groups were conducted and 46 self-administered questionnaires were distributed among inpatients at 2 selected treatment centres in Free State and North West provinces. Qualitative data were analysed using grounded theory, and quantitative data analysed using SPSS. Results. Treatment records show that the most frequent substance of abuse was alcohol (51%, followed by cannabis (21%, crack/cocaine (9.6%, heroin/opiates (7.9%, methamphetamine (Tik (4.5%, prescription/over-the-counter drugs (2.0%, and cannabis/mandrax (1.7%. More substance abusers were male, of lower education, white or black, than were female, more highly educated, coloured and Indian/Asian. Key informant interviews showed that females are the ‘hidden’ substance abusers and tend not to be identified in research statistics and at treatment centres. Poverty, unemployment, lack of recreational facilities, being surrounded by substance abusers, and long work shifts were also mentioned as factors contributing to substance abuse. The age of initiation of substance abuse using non-drugs such as glue was 9 years old, alcohol 10 - 12 years old, dagga 11 - 12 years old, poly-drug use (alcohol, tobacco and dagga 14 years old, and harder drugs such as cocaine and heroin at 16 - 17 years old, as reported by key informants. Family care and support, improved socio-economic conditions and increased law enforcement would help to discourage substance

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

    Science.gov (United States)

    2010-07-01

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

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

    Science.gov (United States)

    Kandel, Isack

    2007-01-01

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

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

    Science.gov (United States)

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

    2002-12-01

    dependence tended to have more co-occurring problems and significantly less denial at admission. The characteristics of this sample exemplify the complex nature of adolescent substance use and abuse among adolescents entering outpatient treatment programs. Patterns of co-occurring problems are at rates comparable to those found in other clinical studies. Those with more severe substance use disorders tend to manifest more problems of social functioning, more mental health problems, and physical health problems. Implications of these findings are discussed in terms of treatment needs, challenges, and prognostic implications.

  15. Culturally competent substance abuse treatment with transgender persons.

    Science.gov (United States)

    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.

  16. Enhanced Case Management versus Substance Abuse Treatment Alone among Substance Abusers with Depression

    Science.gov (United States)

    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…

  17. Targeting the treatment of drug abuse with molecular imaging

    Energy Technology Data Exchange (ETDEWEB)

    Schiffer, Wynne K. [Medical Department, Brookhaven National Laboratory, Upton, NY 11973 (United States)], E-mail: wynne@bnl.gov; Liebling, Courtney N.B.; Patel, Vinal; Dewey, Stephen L. [Medical Department, Brookhaven National Laboratory, Upton, NY 11973 (United States)

    2007-10-15

    Although imaging studies in and of themselves have significant contributions to the study of human behavior, imaging in drug abuse has a much broader agenda. Drugs of abuse bind to molecules in specific parts of the brain in order to produce their effects. Positron emission tomography (PET) provides a unique opportunity to track this process, capturing the kinetics with which an abused compound is transported to its site of action. The specific examples discussed here were chosen to illustrate how PET can be used to map the regional distribution and kinetics of compounds that may or may not have abuse liability. We also discussed some morphological and functional changes associated with drug abuse and different stages of recovery following abstinence. PET measurements of functional changes in the brain have also led to the development of several treatment strategies, one of which is discussed in detail here. Information such as this becomes more than a matter of academic interest. Such knowledge can provide the bases for anticipating which compounds may be abused and which may not. It can also be used to identify biological markers or changes in brain function that are associated with progression from drug use to drug abuse and also to stage the recovery process. This new knowledge can guide legislative initiatives on the optimal duration of mandatory treatment stays, promoting long-lasting abstinence and greatly reducing the societal burden of drug abuse. Imaging can also give some insights into potential pharmacotherapeutic targets to manage the reinforcing effects of addictive compounds, as well as into protective strategies to minimize their toxic consequences.

  18. Targeting the treatment of drug abuse with molecular imaging

    International Nuclear Information System (INIS)

    Schiffer, Wynne K.; Liebling, Courtney N.B.; Patel, Vinal; Dewey, Stephen L.

    2007-01-01

    Although imaging studies in and of themselves have significant contributions to the study of human behavior, imaging in drug abuse has a much broader agenda. Drugs of abuse bind to molecules in specific parts of the brain in order to produce their effects. Positron emission tomography (PET) provides a unique opportunity to track this process, capturing the kinetics with which an abused compound is transported to its site of action. The specific examples discussed here were chosen to illustrate how PET can be used to map the regional distribution and kinetics of compounds that may or may not have abuse liability. We also discussed some morphological and functional changes associated with drug abuse and different stages of recovery following abstinence. PET measurements of functional changes in the brain have also led to the development of several treatment strategies, one of which is discussed in detail here. Information such as this becomes more than a matter of academic interest. Such knowledge can provide the bases for anticipating which compounds may be abused and which may not. It can also be used to identify biological markers or changes in brain function that are associated with progression from drug use to drug abuse and also to stage the recovery process. This new knowledge can guide legislative initiatives on the optimal duration of mandatory treatment stays, promoting long-lasting abstinence and greatly reducing the societal burden of drug abuse. Imaging can also give some insights into potential pharmacotherapeutic targets to manage the reinforcing effects of addictive compounds, as well as into protective strategies to minimize their toxic consequences

  19. Sex-Role Attitudes of Drug Abuse Treatment Counselors.

    Science.gov (United States)

    Schor, Carole

    1982-01-01

    Examined the sex-role attitude of the drug abuse treatment counselor. Found: 1) male counselors viewed clients of both sexes more negatively; 2) male clients were viewed more negatively by counselors of both sexes; 3) counselors with less education had more negative attitudes; and 4) attitudes differed with treatment program type. (Author/RC)

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

    Science.gov (United States)

    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…

  1. Adolescent Substance Abuse Treatment: Organizational Change and Quality of Care

    Science.gov (United States)

    Rieckmann, Traci; Fussell, Holly; Doyle, Kevin; Ford, Jay; Riley, Katherine J.; Henderson, Stuart

    2011-01-01

    Substance abuse treatment agencies serving youth face unique barriers to providing quality care. Interviews with 17 adolescent programs found that family engagement, community involvement, and gender and diversity issues affected treatment delivery. Programs report organizational change efforts with implications for future process improvement…

  2. Treatment of childhood sexual abuse: an updated review.

    Science.gov (United States)

    Cummings, Marissa; Berkowitz, Steven J; Scribano, Philip V

    2012-12-01

    Childhood sexual abuse (CSA) involves multiple complex factors that make the evaluation of therapeutic interventions especially complicated. PTSD prevalence rates of CSA are approximately 37 % -53 %. Several other psychiatric sequelae of CSA exist. CSA appears to disrupt brain and body physiology. One co-located service delivery model reported a 52 % linkage rate of CSA survivors with mental health treatment. This article reviews current literature on the treatment of CSA, including psychosocial interventions, pharmacotherapy, and early preventative interventions. It also provides an update on the short- and long-term sequelae of CSA and implications for future research directions. A literature search of papers published in the last 3 years was conducted using the keywords treatment, sexual abuse, childhood, epigenetics, resilience and review, and searching the following databases: PsycInfo, PubMed, Substance Abuse and Mental Health Services Administration, and Centers for Disease Control.

  3. Determinants of nonmedical use, abuse or dependence on prescription drugs, and use of substance abuse treatment.

    Science.gov (United States)

    Bali, Vishal; Raisch, Dennis W; Moffett, Maurice L; Khan, Nasreen

    2013-01-01

    Previous studies have found a negative association between health insurance and nonmedical use of prescription drugs (NMUPD), and abuse or dependence on prescription drugs (ADPD); and mixed associations between health insurance and use of substance abuse treatment (SAT). However, effect of health insurance in the specific subgroups of population is largely unknown. To estimate the relationship between health insurance and (1) NMUPD, (2) ADPD, and (3) use of SAT services among 12-64 years old, noninstitutionalized individuals and to see if these relationships are different in different subgroups of population. This study used cross-sectional survey data from 2007 National Survey on Drug Use and Health. Bivariate and multiple logistic regression analyses were conducted. In 2007, self-reported prevalence of NMUPD was approximately 10% (N=15,509,703). In multivariate analysis, NMUPD was negatively associated with health insurance, age, race other than non-Hispanic White, education, marital status, and income ($40,000-$74,999). Past year use of tobacco and alcohol were positively associated with NMUPD. Among those with private health insurance, Hispanics and individuals with family income less than $20,000 and $40,000-$74,999 were more likely prone to NMUPD than others. High school graduates with public health insurance were less likely prone to NMUPD. Approximately, 13% of nonmedical users reported ADPD (N=2,011,229). Health insurance and age were negatively associated with ADPD. However, people who were unmarried, reported fair/poor health, and used tobacco were more likely to report ADPD. Lastly, the use of substance abuse treatment programs was approximately 73% and 76% between NMUPD and ADPD population, respectively. Health insurance was not associated with use of substance abuse treatment. Individuals with high school education were 2.6 times more likely to use substance abuse treatment than the college graduates. Additionally, no significant interaction effects

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

    Science.gov (United States)

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

    2009-03-01

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

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

    Science.gov (United States)

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

    2015-04-01

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

  6. Characteristics of Transgender Individuals Entering Substance Abuse Treatment

    Science.gov (United States)

    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

  7. Epidemiology of drug abuse treatment in South Africa

    African Journals Online (AJOL)

    Texas, USA, where alcohol was found to be the primary drug of abuse in ... distributed among inpatients at 2 selected treatment centres ... group participants attributed their reasons for drug use to family ... NW provinces, where one currently finds limited data. .... full-time, 26% were unemployed, and 25% were students.

  8. Medical Marijuana Use among Adolescents in Substance Abuse Treatment

    Science.gov (United States)

    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…

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

    Science.gov (United States)

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

    2011-09-18

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

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

    Directory of Open Access Journals (Sweden)

    Akinhanmi Akinwande O

    2011-09-01

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

  11. Cocaine treatment admissions at three sentinel sites in South Africa (1997–2006: findings and implications for policy, practice and research

    Directory of Open Access Journals (Sweden)

    Plüddemann Andreas

    2007-12-01

    Full Text Available Abstract Background Accurate prevalence data on cocaine use, that points to where problems exist and the extent of these problems, is necessary to guide the formulation of effective substance abuse policy and practice. The purpose of this study was to provide surveillance information about the nature and extent of problematic cocaine use in South Africa. Methods Data were collected between January 1997 and December 2006 on admissions for drug abuse treatment through a regular monitoring system involving 56 drug treatment centres and programmes in Cape Town, Gauteng Province (Johannesburg and Pretoria and the Eastern Cape every six months as part of the South African Community Epidemiology Network on Drug Use (SACENDU. A one-page form was completed by treatment centre personnel to obtain demographic data, the patients' primary and secondary substances of abuse, the mode, frequency and age of first use of substance, and information on prior treatment. Results Treatment indicators point to a significant increase in cocaine related admissions over time in all sites, but with substantial inter-site variation, particularly in recent years. The data indicate high levels of crack cocaine use and high levels of daily usage among patients, most of whom were first time admissions. Patients with cocaine related problems continue to be predominantly male, with a mean age of around 30 years. Substantial changes in the racial profile of patients have occurred over time. Poly drug use is high with cocaine often used with alcohol, cannabis and other drugs. Conclusion These trends point to the possibility of cocaine use becoming a serious health and social issue in South Africa and demonstrate the utility of continued monitoring of cocaine treatment admissions in the future. They also highlight the need to address cocaine use in national and provincial policy planning and intervention efforts. In terms of treatment, the findings highlight the need to ensure that

  12. 29 CFR 825.119 - Leave for treatment of substance abuse.

    Science.gov (United States)

    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 conditions of §§ 825.113 through 825.115 are met. However, FMLA leave may only be taken for treatment for...

  13. Emotion regulation promotes persistence in a residential substance abuse treatment.

    Science.gov (United States)

    Hopwood, Christopher J; Schade, Nick; Matusiewicz, Alexis; Daughters, Stacey B; Lejuez, Carl W

    2015-01-01

    Emotion regulation at treatment entry was evaluated among 115 patients in an inner-city substance use residential facility who either persisted (N = 94) or discontinued treatment (N = 21). Emotion regulation capacity including emotional clarity and the ability to engage in goal-directed behavior despite emotional distress, as well as lower scores on a measure of trait-negative emotionality, were associated with treatment persistence, whereas motivational variables were not. Findings indicate the importance of regulating negative emotions for treatment engagement among substance abusers.

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

    Science.gov (United States)

    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…

  15. A methodological pilot: parenting among women in substance abuse treatment.

    Science.gov (United States)

    Lewin, Linda; Farkas, Kathleen; Niazi, Maryam

    2014-01-01

    Mothers who abuse substances are likely to have insecure emotional attachment with their children, placing their children at risk for social-emotional and psychiatric conditions. Sobriety does not inevitably improve parenting. We tested recruitment methods, audiovisual (AV) recording procedures, the protocol for identifying child abuse risk, the coding of mother-child interactions, and retention of the sample for repeated measures as the first phase in examining mother-child relational quality of women in substance abuse treatment. This innovative study involved AV recordings to capture the in-vivo mother-child interactional behaviors that were later coded and analyzed for mean scores on the 64-item Parent-Child Relational Quality Assessment. Repeated measurement was planned during treatment and two months after discharge from treatment. The pilot involved a small sample (n = 11) of mother-child (interaction behaviors were identified. Mothers showed less enthusiasm and creativity but matched their child's emotional state. The children showed appropriate motor skill items and attachment behaviors. The dyad coding showed less mutual enjoyment between the mother and child. Eight of the participants could not be located for the second measurement despite multiple contact methods. AV recordings capture rich, descriptive information that can be coded for interactional quality analysis. Repeated measurement with this cohort was not feasible, thus needing to assess for additional/more frequent contacts to maintain the sample.

  16. Effect of Weekend Admissions on the Treatment Process and Outcomes of Internal Medicine Patients

    Science.gov (United States)

    Huang, Chun-Che; Huang, Yu-Tung; Hsu, Nin-Chieh; Chen, Jin-Shing; Yu, Chong-Jen

    2016-01-01

    Abstract Many studies address the effect of weekend admission on patient outcomes. This population-based study aimed to evaluate the relationship between weekend admission and the treatment process and outcomes of general internal medicine patients in Taiwan. A total of 82,340 patients (16,657 weekend and 65,683 weekday admissions) aged ≥20 years and admitted to the internal medicine departments of 17 medical centers between 2007 and 2009 were identified from the Taiwan National Health Insurance Research Database. A generalized estimating equation (GEE) analysis was used to compare patients admitted on weekends and those admitted on weekdays. Patients who were admitted on weekends were more likely to undergo intubation (odds ratio [OR]: 1.27; 95% confidence interval [CI]: 1.16–1.39; P internal medicine patients who were admitted on weekends experienced more intensive care procedures and higher ICU admission, in-hospital mortality, and treatment cost. Intensive care utilization may serve as early indicator of poorer outcomes and a potential entry point to offer preventive intervention before proceeding to intensive treatment. PMID:26871788

  17. 28 CFR 550.56 - Community Transitional Drug Abuse Treatment Program (TDAT).

    Science.gov (United States)

    2010-07-01

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

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

    Science.gov (United States)

    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,…

  19. Abuse

    Science.gov (United States)

    ... physical injury, leave marks, or cause pain. Sexual abuse is any type of sexual contact between an adult and anyone younger than 18; between a significantly older child and a younger child; or if one person ...

  20. An Effective Web Presence for Substance Abuse Treatment Facilities.

    Science.gov (United States)

    Link, Thomas W; Hefner, Jennifer L; Ford, Eric W; Huerta, Timothy R

    2016-01-01

    Website development for health care has only been prevalent in the last two and a half decades. The first websites were electronic versions of brochures providing hardly any interaction with the consumer or potential consumer. The percentage of consumers that use the internet during the decision-making process for health care providers continues to rise. As a result, the websites of health care providers are becoming more of a representation of the facility and creating an organizational image rather than a brochure-like informational page. The purpose of this study was to analyze substance abuse treatment center's websites in the State of California with the goal of informing the management of substance abuse centers regarding an effective and inexpensive means to closing the marketing gaps in the industry. This brief research report presents the results of employing an automated web-crawler to assess website quality along five dimensions: accessibility, content, marketing, technology, and usability score. The sample mean scores for all dimensions were between 4 and 6 on a 10-point scale. On average larger facilities had higher quality websites. The low mean scores on these dimensions indicate that that substance abuse centers have significant room for improvement of their website's. Efficiently spending marketing funds to increase the effectiveness of a treatment center's website can be a low cost way for even small facilities to increase market competitiveness.

  1. Substance Abuse in Addicts Referred to Public and Private Substance Abuse Treatment Centers

    Directory of Open Access Journals (Sweden)

    Kadkhodaei M.* MSc,

    2015-06-01

    Full Text Available Aims Drug addiction is a mental, social, and economic problem that comes from abnormal and illicit consumption of substances such as alcohol, opium, hashish, and etc., making the addict psychologically and physiologically dependent to those substances. This study was designed and performed to evaluate the pattern of drug abuse change in the addicts visiting addiction treatment centers of Kashan City, Iran. Instrument & Methods This retrospective descriptive research was performed on 4066 persons referred to addiction treatment and harm reduction therapy centers, monitored by Kashan University of Medical Sciences, during 2004 to 2008. After coding, data were entered into the SPSS 16 software. Chi-square and one-way ANOVA was used to analyze the data. Findings The main reasons of the tendency to drugs were not having fun (72.5%, family problems (55% and not having knowledge (22.7%. The use of opium was the highest in all the years while the crack was used by 7.1% of drug addicts in 2004 and increased to 76% in 2007. 92.8% of drug abuses were through fumigation, 33.7% through injection, 48% orally and 8.6% through inhalants. Conclusion Youths are the most vulnerable age group to drug addiction. Easy access to illegal drugs, wrong friends, and curiosity are of the significant factors spreading drug addiction.

  2. Age differences in heroin and prescription opioid abuse among enrolees into opioid treatment programs

    Directory of Open Access Journals (Sweden)

    Fong Chunki

    2011-06-01

    Full Text Available Abstract Background In the United States, among those entering opioid treatment programs (OTPs, prescription opioid (PO abusers tend to be younger than heroin users. Admissions of older persons to OTPs have been increasing, and it is important to understand typical patterns of use among those older enrolees. Methods To disentangle the effect of age on recent heroin and PO abuse 29,114 enrolees into 85 OTPs were surveyed across 34 states from 2005-2009. OTPs where PO use was prevalent were oversampled. Results Mean age was 34; 28% used heroin only. Younger enrolees had increased odds of using POs relative to using heroin only but mixed model analysis showed that much of the total variability in type of use was attributed to variation in age between OTPs rather than within OTPs. Conclusions Organizational and cultural phenomena (e.g., OTP characteristics must be examined to better understand the context of individual characteristics (e.g., age. If nesting of enrolees within OTPs is ignored, then associations that primarily operate at the OTP level may be misinterpreted as exclusively dependent on individuals.

  3. Pena Private Freedom with psychiatric treatment and psychological for Abused

    Directory of Open Access Journals (Sweden)

    Mirza Maria Pedrosa Porto de Mendonça

    2016-06-01

    Full Text Available The research aimed to investigate the opinion of professionals in law and health areas on the profile of the sexual abuser of children within the family and the effectiveness of the type of penalty he suffers. The offender is someone who probably does not enjoy enough sanity to control its inclination to unlawful and may or may not be classified as mentally ill. The research covers the incidence and effects of this event on intra-family life. Deals with this issue in order to establish a new legal paradigm in the context of the penalties in the most private sphere of criminal law. The work aims to demonstrate the social relevance of the topic and the need for an effective regulatory sweater for sexual abusers, especially the intra-family and makes a clear proposal for legislative changes with regard to this type of crime, arguing the need to adapt the law the objective reality. It argues that psychoanalytic treatment of offenders as a means of punishment is more important than the simple deprivation of liberty. It argues that the current legislation is incipient and inadequate for such cases and this opinion supported by a significant number of experts. This is not to defend this criminal who practice sexual abuse, but to seek solutions to impunity and respect for the principle of individualization of punishment.

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

    Science.gov (United States)

    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. (c) 2015 APA, all rights reserved).

  5. Relationship of trauma exposure and substance abuse to self-reported violence among men and women in substance abuse treatment.

    Science.gov (United States)

    Clark, C Brendan; Reiland, Sarah; Thorne, Chris; Cropsey, Karen L

    2014-05-01

    Past research showed a relationship between substance abuse and aggression and past trauma and aggression. The nature of the relationships between substance use, trauma, and aggression is inconclusive. The current research hypothesized greater aggression among those with a history of substance abuse and trauma compared with those without such a history and an additive relationship between substance abuse and trauma on aggression. Participants were 615 individuals in a substance abuse treatment program for individuals under criminal justice supervision. Data were collected from face-to-face interviews and self-report measures. Univariate and multivariate analyses assessed the relationships among substance use, trauma, and aggression. Participants with a history of trauma and regular substance use reported the highest rates of homicidal ideation, problem behaviors, and person offenses. Participants in this group also reported greater desire for help managing their stress and tension, dealing with problems in their intimate relationships, developing healthier relationships in general, and learning prosocial approaches to express their feelings. Substance abusing participants who experienced trauma reported more externalizing behaviors and a greater desire for coping- and social-skills training than participants who abused substances but did not report a history of trauma. This suggests that participants in substance abuse treatment programs may have improved outcomes with the addition of components to address these issues.

  6. Perceptions of a Prison-Based Substance Abuse Treatment Program among Some Staff and Participants

    Science.gov (United States)

    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…

  7. Multidimensional Family Therapy (MDFT) for Young People in Treatment for Non-opioid Drug Abuse:

    DEFF Research Database (Denmark)

    Filges, Trine; Rasmussen, Pernille; Andersen, Ditte

    2015-01-01

    The main objectives of this review are to evaluate the current evidence on the effects of MDFT on drug abuse reduction for young people (aged 11-21 years) in treatment for non-opioid drug abuse, and if possible to examine moderators of drug abuse reduction effects, specifically analysing whether...

  8. 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.

    Science.gov (United States)

    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.

  9. Outpatient treatment of acute poisoning by substances of abuse: a prospective observational cohort study.

    Science.gov (United States)

    Vallersnes, Odd Martin; Jacobsen, Dag; Ekeberg, Øivind; Brekke, Mette

    2016-05-21

    Procedures for the clinical assessment of acute poisoning by substances of abuse should identify patients in need of hospital admission and avoid hazardous discharges, while keeping the observation time short. We assess the safety of a systematic procedure developed at the Oslo Accident and Emergency Outpatient Clinic (OAEOC). All patients 12 years and older treated for acute poisoning by substances of abuse at the OAEOC were included consecutively from October 2011 to September 2012. Data were collected on pre-set registration forms. Information on re-presentations to health services nation-wide during the first week following discharge was retrieved from the Norwegian Patient Register and from local electronic medical records. Information on fatalities was obtained from the Norwegian Cause of Death Registry. There were 2343 cases of acute poisoning by substances of abuse. The main toxic agent was ethanol in 1291 (55 %) cases, opioids in 539 (23 %), benzodiazepines in 194 (8 %), central stimulants in 132 (6 %), and gamma-hydroxybutyrate (GHB) in 105 (4 %). Median observation time was four hours. The patient was hospitalised in 391 (17 %) cases. Two patients died during the first week following discharge, both from a new opioid poisoning. Among 1952 discharges, 375 (19 %) patients re-presented at the OAEOC or a hospital within a week; 13 (0.7 %) with a diagnosis missed at the index episode, 169 (9 %) with a new poisoning, 31 (2 %) for follow-up of concomitant conditions diagnosed at index, and 162 (8 %) for unrelated events. Among the patients with missed diagnoses, five needed further treatment for the same poisoning episode, two were admitted with psychosis, one had hemorrhagic gastritis, another had fractures in need of surgery and four had minor injuries. The procedure in use at the OAEOC can be considered safe and could be implemented elsewhere. The high re-presentation rate calls for better follow-up.

  10. Influence of pretreatment coping strategies on the outcome of outpatient treatment of Danish alcohol abusers

    DEFF Research Database (Denmark)

    Bussey Rask, Marie; Jørgensen, Tina; Pinnerup Jensen, Jeanette

    2006-01-01

    An important issue regarding treatment for alcohol abuse is the high rate of relapse following treatment. In the research on treatment of alcohol abuse, the concept of coping has been proposed as a relevant factor in the relationship between relapse crises and treatment outcome. The present study...

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

    Science.gov (United States)

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

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

  12. Perception of Helpfulness among Participants in a Prison-Based Residential Substance Abuse Treatment Program

    Science.gov (United States)

    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…

  13. Research on drug abuse and addiction treatment in prisons

    OpenAIRE

    Kljajević Srđan

    2017-01-01

    The causes of drug abuse and criminal behavior are closely linked. Not surprisingly, there is a high percentage of prisoners who during sentence execution abuse or are dependent on drugs. Antisocial personality disorder can be considered a common predictor of committing criminal offenses and drug abuse. A review of studies has revealed a high prevalence of inmates who use drugs while serving a sentence. Also, prison environment represents only a new context of the continuum of drug abuse by i...

  14. Psychopharmacologic treatment of children prenatally exposed to drugs of abuse.

    Science.gov (United States)

    Hulvershorn, Leslie A; Schroeder, Kristen M; Wink, Logan K; Erickson, Craig A; McDougle, Christopher J

    2015-05-01

    This pilot study compared the pharmacologic treatment history and clinical outcomes observed in pediatric outpatients with psychiatric disorders exposed to drugs of abuse in utero to those of an age-matched, sex-matched and psychiatric disorder-matched, non-drug-exposed group. In this matched cohort study, medical records of children treated at an academic, child and adolescent psychiatry outpatient clinic were reviewed. Children with caregiver-reported history of prenatal drug exposure were compared with a non-drug-exposed control group being cared for by the same providers. Patients were rated with the Clinical Global Impressions-Severity scale (CGI-S) throughout treatment. The changes in pre-treatment and post-treatment CGI-S scores and the total number of medication trials were determined between groups. The drug-exposed group (n = 30) had a higher total number of lifetime medication trials compared with the non-drug-exposed group (n = 28) and were taking significantly more total medications, at their final assessment. Unlike the non-drug-exposed group, the drug-exposed group demonstrated a lack of clinical improvement. These results suggest that in utero drug-exposed children may be more treatment-refractory to or experience greater side effects from the pharmacologic treatment of psychiatric disorders than controls, although we cannot determine if early environment or drugs exposure drives these findings. Copyright © 2015 John Wiley & Sons, Ltd.

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

    Science.gov (United States)

    Scott, Melanie C; Easton, Caroline J

    2010-11-01

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

  16. Methadone versus buprenorphine for the treatment of opioid abuse in pregnancy: science and stigma.

    Science.gov (United States)

    Holbrook, Amber M

    2015-01-01

    The past decade has seen an increase in rates of opioid abuse during pregnancy. This clinical challenge has been met with debate regarding whether or not illicit and prescription opioid-dependent individuals require different treatment approaches; whether detoxification is preferable to maintenance; and the efficacy of methadone versus buprenorphine as treatment options during pregnancy. The clinical recommendations resulting from these discussions are frequently influenced by the comparative stigma attached to heroin abuse and methadone maintenance versus prescription opioid abuse and maintenance treatment with buprenorphine. While some studies have suggested that a subset of individuals who abuse prescription opioids may have different characteristics than heroin users, there is currently no evidence to suggest that buprenorphine is better suited to treatment of prescription opioid abuse than methadone. Similarly, despite its perennial popularity, there is no evidence to recommend detoxification as an efficacious approach to treatment of opioid dependence during pregnancy. While increased access to treatment is important, particularly in rural areas, there are multiple medical and psychosocial reasons to recommend comprehensive substance abuse treatment for pregnant women suffering from substance use disorders rather than office-based provision of maintenance medication. Both methadone and buprenorphine are important treatment options for opioid abuse during pregnancy. Methadone may still remain the preferred treatment choice for some women who require higher doses for stabilization, have a higher risk of treatment discontinuation, or who have had unsuccessful treatment attempts with buprenorphine. As treatment providers, we should advocate to expand available treatment options for pregnant women in all States.

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

    Directory of Open Access Journals (Sweden)

    Shekarchizadeh Hajar

    2012-06-01

    Full Text Available Abstract 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.

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

    Science.gov (United States)

    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

  19. American Youths' Access to Substance Abuse Treatment: Does Type of Treatment Facility Matter?

    Science.gov (United States)

    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…

  20. Residential Treatment for Sexually Abusive Youth: An Assessment of Treatment Outcomes

    Science.gov (United States)

    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…

  1. Substance Abuse Treatment and Domestic Violence. Treatment Improvement Protocol (TIP) Series 25.

    Science.gov (United States)

    Cook, Paddy; Gartner, Constance Grant; Markl, Lise; Henderson, Randi; Brooks, Margaret K.; Wesson, Donald; Dogoloff, Mary Lou; Vitzthum, Virginia; Hayes, Elizabeth

    The major goal of this TIP, on the best practice guidelines to improve the treatment of substance abuse, is to provide clinicians, educators, and paraprofessionals with the latest findings concerning domestic violence. The information is intended to educate providers about the needs and behaviors of batterers and survivors, and how to tailor…

  2. Which Factors Affect the Hospital Re-admission After Treatment Approaches to Urethral Strictures?

    Directory of Open Access Journals (Sweden)

    Reha Girgin

    2017-12-01

    Full Text Available Objective: To investigate patient- and procedure-related factors associated with hospital re-admission following urethral manipulations for the treatment of urethral strictures. Materials and Methods: Data of patients who underwent dilation or internal urethrotomy for urethral strictures between 2011 and 2016 were retrospectively analyzed. Patients who were admitted to our institute for any reason within one month after hospital discharge were evaluated. The patient- and procedure-related factors affecting the readmission rates were revealed by multiple binary logistic regression using stepwise backward elinimination. Results: The average age of 76 male patients was 61.7±14.4 years. The mean maximal flow rate at preoperative uroflowmetry was 6.01±4.3 and the median American Society of Anesthesiologists score was 2.38. The process was the first for 45 (59.2% patients, the second for 16 (21.1% patients, the third for 9 (11.8% patients, and the fourth for 6 (7.9% patients. Amplatz dilators, cold knife and Ho:YAG laser were used in 50%, 27.6% and 22.4% of patients, respectively. The mean length of hospital stay was 0.89±0.31 days, and the complication rate was 19.7% (15/76. The mean urethral catheter dwell time was 8.9±14.2 day. Overall, the procedure was successful in 61 (80.3% patients and failed (Qmax <15 mL/sec in 19.7% of the cases. Fifteen (19.7% patients were re-admitted, while 2 (2.6% patients among them were re-hospitalized for further treatment. Comorbidity and age were independent predictors of re-admission. Conclusion: We found that younger age and lower comorbidities predicted hospital re-admission following procedures for urethral strictures.

  3. A Distance Education Model for Training Substance Abuse Treatment Providers in Cognitive-Behavioral Therapy

    Science.gov (United States)

    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…

  4. Alcohol abuse and related disorders treatment of alcohol dependence

    Directory of Open Access Journals (Sweden)

    Yu. P. Sivolap

    2014-01-01

    Full Text Available Alcohol abuse and alcoholism are the leading causes of worse health and increased mortality rates. Excessive alcohol consumption is the third leading cause of the global burden of diseases and a leading factor for lower lifespan and higher mortality. Alcohol abuse decreases working capacity and efficiency and requires the increased cost of the treatment of alcohol-induced disorders, which entails serious economic losses. The unfavorable medical and social consequences of excessive alcohol use determine the importance of effective treatment for alcoholism. The goals of rational pharmacotherapy of alcohol dependence are to enhance GABA neurotransmission, to suppress glutamate neurotransmission, to act on serotonin neurotransmission, to correct water-electrolyte balance, and to compensate for thiamine deficiency. Alcoholism treatment consists of two steps: 1 the prevention and treatment of alcohol withdrawal syndrome and its complications (withdrawal convulsions and delirium alcoholicum; 2 antirecurrent (maintenance therapy. Benzodiazepines are the drugs of choice in alleviating alcohol withdrawal and preventing its convulsive attacks and delirium alcoholicum. Diazepam and chlordiazepoxide are most commonly used for this purpose; the safer drugs oxazepam and lorazepam are given to the elderly and patients with severe liver lesions. Anticonvulsants having normothymic properties, such as carbamazepine, valproic acid, topiramate, and lamotrigine, are a definite alternative to benzodiazepines. The traditional Russian clinical practice (clearance detoxification has not a scientific base or significant impact on alcohol withdrawal-related states in addicts. Relapse prevention and maintenance therapy for alcohol dependence are performed using disulfiram, acamprosate, and naltrexone; since 2013 the European Union member countries have been using, besides these agents, nalmefene that is being registered in Russia. Memantine and a number of other

  5. Counselor Treatment of Coexisting Domestic Violence and Substance Abuse: A Qualitative Study.

    Science.gov (United States)

    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)

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

    Science.gov (United States)

    Martin, Harold P.

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

  7. [Current situation on new psychoactive substances abuse among methadone maintenance treatment patients in China].

    Science.gov (United States)

    Cheng, Z; Dai, M M; Cao, X B

    2018-04-10

    Methadone maintenance treatment (MMT) greatly contributed to the successful outcomes of prevention and control on both AIDS and drug abuse in China. However, the features on drug abuse changed in the past decades, and the prevalence of new psychoactive substances abuse potentially somehow offset the achievement of MMT. This paper concised the information on research and surveys of this issue that targeting on the current situation, characteristics, related factors and relevant public health problem on new psychoactive substances abuse, among patients who have been on MMT, in China.

  8. Predictors of Relapse for American Indian Women after Substance Abuse Treatment

    Science.gov (United States)

    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…

  9. Encopresis and Sexual Abuse in a Sample of Boys in Residential Treatment.

    Science.gov (United States)

    Morrow, Jan; And Others

    1997-01-01

    This study of 23 boys (ages 6 to 14) in a residential psychiatric treatment program found nine of the boys were encopretic (27 times the incidence of encopresis in the general population of boys 10-12). Seven of the nine boys had histories of sexual abuse by males, suggesting that encopresis may be a marker of sexual abuse. (DB)

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

    Science.gov (United States)

    Broadhurst, Diane D.; MacDicken, Robert A.

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

  11. Social capital and job satisfaction among substance abuse treatment employees.

    Science.gov (United States)

    Tsounis, Andreas; Niakas, Dimitris; Sarafis, Pavlos

    2017-02-15

    Job satisfaction is an important predictor for management and clinical ratios. Although it is accepted that is affected by many aspects, the influence of social capital remains to be determined. The main purpose of the article is to examine the relationship between job satisfaction and individual social capital for employees offering services in the treatment of addiction. A cross-sectional study was conducted on 239 employees from 14 therapeutic programs at KETEA (Therapy Center for Dependent Individuals in Greece) (KETHEA). A revised Greek Version of the Social Capital Questionnaire (SCQ-G) for the individual social capital measurement, and of the Job Satisfaction Survey (JSS) for the job satisfaction measurement, were used. Individual Social Capital ranged in medium levels. We observed a significant positive association between social capital and its' different aspects and gender, age, place of residence and working experience. Men, older employees, those who lived in smaller places, and those working more years, reached higher levels of individual social capital. Concerning overall job satisfaction most of the participants were ambivalent (61.5%), while 21.8% were satisfied and 16.7% were dissatisfied. Concerning its separate aspects, 77% were least satisfied with pay, 69.9% were least satisfied with advancement opportunities, 60.3% were least satisfied with fringe benefits, 85.8% were most satisfied with the nature of their work, 80.8% with their relationship with colleagues, and 77.8% were satisfied with supervision. Total Job Satisfaction was positively associated with place of residence and monthly salary. A significant positive correlation between social capital and job satisfaction was also observed. Early evidence suggests that social capital is associated with job satisfaction of employees providing services in the treatment of substance abuse. Further research, regarding social capital on job satisfaction, is suggested. We need to design and implement

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

    Science.gov (United States)

    2010-07-01

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

  13. National Survey of Substance Abuse Treatment Services (N-SSATS-2013)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  14. National Survey of Substance Abuse Treatment Services (N-SSATS-2010)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  15. National Survey of Substance Abuse Treatment Services (N-SSATS-2014)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  16. National Survey of Substance Abuse Treatment Services (N-SSATS-2012)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  17. National Survey of Substance Abuse Treatment Services (N-SSATS-2003)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  18. National Survey of Substance Abuse Treatment Services (N-SSATS-2006)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  19. National Survey of Substance Abuse Treatment Services (N-SSATS-2000)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  20. National Survey of Substance Abuse Treatment Services (N-SSATS-2002)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  1. National Survey of Substance Abuse Treatment Services (N-SSATS-2008)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  2. National Survey of Substance Abuse Treatment Services (N-SSATS-2009)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  3. National Survey of Substance Abuse Treatment Services (N-SSATS-2005)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  4. National Survey of Substance Abuse Treatment Services (N-SSATS-2007)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  5. National Survey of Substance Abuse Treatment Services (N-SSATS-2004)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  6. A plan analysis of pedophile sexual abusers' motivations for treatment: a qualitative pilot study.

    Science.gov (United States)

    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.

  7. National Survey of Substance Abuse Treatment Services (N-SSATS-1997-2011)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  8. National Survey of Substance Abuse Treatment Services (N-SSATS-2011)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...

  9. Readiness and barriers to adopt evidence-based practices for substance abuse treatment in Mexico

    OpenAIRE

    Horigian, Viviana E.; Espinal, Paula S.; Alonso, Elizabeth; Verdeja, Rosa E.; Duan, Rui; Usaga, Ingrid M.; Pérez-López, Alejandro; Marín-Navarrete, Rodrigo; Feaster, Daniel J.

    2016-01-01

    ABSTRACT: Introduction: Evidence shows a lag in adoption of evidence-based practices (EBPs) for substance abuse treatment and supports the need for studying the factors involved in this worldwide problem. Objective: This study aimed to assess the readiness and barriers to adopt EBPs for substance abuse in a sample of outpatient treatment centers of a newly created Mexican Clinical Trials Network. Method: An online survey was administered to directors (n = 8) and clinicians (n = 40) from se...

  10. Correlates of substance abuse treatment completion among disadvantaged communities in Cape Town, South Africa

    Directory of Open Access Journals (Sweden)

    Pasche Sonja

    2010-03-01

    Full Text Available Abstract Background Completion of substance abuse treatment is a proximal indicator of positive treatment outcomes. To design interventions to improve outcomes, it is therefore important to unpack the factors contributing to treatment completion. To date, substance abuse research has not examined the factors associated with treatment completion among poor, disadvantaged communities in developing countries. This study aimed to address this gap by exploring client-level factors associated with treatment completion among poor communities in South Africa. Methods Secondary data analysis was conducted on cross-sectional survey data collected from 434 persons residing in poor communities in Cape Town, South Africa who had accessed substance abuse treatment in 2006. Results Multiple regression analyses revealed that therapeutic alliance, treatment perceptions, abstinence-specific social support, and depression were significant partial predictors of treatment completion. Conclusions Findings suggest that treatment completion rates of individuals from poor South African communities can be enhanced by i improving perceptions of substance abuse treatment through introducing quality improvement initiatives into substance abuse services, ii strengthening clients' abstinence-oriented social networks and, iii strengthening the counselor-client therapeutic alliance.

  11. [Prescription drug abuse in elderly psychiatric patients].

    Science.gov (United States)

    Wetterling, Tilman; Schneider, Barbara

    2012-08-01

    Due to demographic changes there will be a fraction of elderly patients with substance use disorders. However, only a few data have been published about elderly abusers of prescription drugs. Since substance abuse is frequently comorbid with psychiatric disorders, treatment in a psychiatric hospital is often needed. In this explorative study elderly people with prescription drug abuse who required psychiatric inpatient treatment should be characterized. This study was part of the gerontopsychiatry study Berlin (Gepsy-B), an investigation of the data of all older inpatients (≥ 65 years) admitted to a psychiatric hospital within a period of 3 years. Among 1266 documented admissions in 110 cases (8.7 %) (mean age: 75.7 ± 7.1 years) prescription drug abuse, mostly of benzodiazepines was diagnosed. Females showed benzodiazepine abuse more often than males. In only a small proportion of the cases the reason for admission was withdrawal of prescribed drugs. 85.5 % suffered from psychiatric comorbidity, mostly depression. As risk factors for abuse depressive symptoms (OR: 3.32) as well as concurrent nicotine (OR: 2.69) or alcohol abuse (OR: 2.14) were calculated. Psychiatric inpatient treatment was primarily not necessary because of prescription drug abuse but because of other psychopathological symptoms. © Georg Thieme Verlag KG Stuttgart · New York.

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

    Science.gov (United States)

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

    2011-04-01

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

  13. 3 R's in the Marital Treatment of Alcohol Abuse.

    Science.gov (United States)

    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…

  14. The Treatment of Wife Abuse in Recent Social Science Literature.

    Science.gov (United States)

    Wardell, Laurie; And Others

    This paper reviews the social science literature dealing with gender relations in marriage and the issues of wife abuse. It is argued that the old anti-woman biases of the literature have not really diminished under the impact of feminism. The sexist assumptions and victim-blaming focus of the new battery literature are examined through…

  15. Child Sexual Abuse Suspicions: Treatment Considerations during Investigation

    Science.gov (United States)

    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…

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

    Science.gov (United States)

    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,…

  17. An investigation of scale effects in family substance abuse treatment programs

    Directory of Open Access Journals (Sweden)

    Lee A James

    2010-07-01

    Full Text Available Abstract This short report investigates scale effects in family substance abuse treatment programs. In Massachusetts, the family substance abuse treatment programs were much more costly than other adult residential treatment models. State officials were concerned that the "scale" or size of these programs (averaging just eight families was too small to be economical. Although the sample size (just nine programs was too small to permit reliable inference, the data clearly signalled the importance of "scale effects" in these family substance abuse treatment programs. To further investigate scale effects in family substance abuse treatment programs, data from the Center for Substance Abuse Treatment's (CSAT's Residential Women and Children and Pregnant and Postpartum Women (RWC-PPW Demonstration were re-analyzed, focusing on the relationship between cost per family-day and the estimated average family census. This analysis indicates strong economies of scale up until an average family census of about 14, and less apparent scale effects beyond that point. In consideration of these and other study findings, a multidisciplinary interagency team redesigned the Massachusetts' family treatment program model. The new programs are larger than the former family treatment programs, with each new program having capacity to treat 11 to 15 families depending on family makeup.

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

    Directory of Open Access Journals (Sweden)

    Richter Kimber P

    2006-08-01

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

  19. Effect of Weekend Admissions on the Treatment Process and Outcomes of Internal Medicine Patients: A Nationwide Cross-Sectional Study.

    Science.gov (United States)

    Huang, Chun-Che; Huang, Yu-Tung; Hsu, Nin-Chieh; Chen, Jin-Shing; Yu, Chong-Jen

    2016-02-01

    Many studies address the effect of weekend admission on patient outcomes. This population-based study aimed to evaluate the relationship between weekend admission and the treatment process and outcomes of general internal medicine patients in Taiwan.A total of 82,340 patients (16,657 weekend and 65,683 weekday admissions) aged ≥20 years and admitted to the internal medicine departments of 17 medical centers between 2007 and 2009 were identified from the Taiwan National Health Insurance Research Database. A generalized estimating equation (GEE) analysis was used to compare patients admitted on weekends and those admitted on weekdays.Patients who were admitted on weekends were more likely to undergo intubation (odds ratio [OR]: 1.27; 95% confidence interval [CI]: 1.16-1.39; P internal medicine patients who were admitted on weekends experienced more intensive care procedures and higher ICU admission, in-hospital mortality, and treatment cost. Intensive care utilization may serve as early indicator of poorer outcomes and a potential entry point to offer preventive intervention before proceeding to intensive treatment.

  20. Inequitable access to substance abuse treatment services in Cape Town, South Africa

    Directory of Open Access Journals (Sweden)

    Louw Johann

    2010-11-01

    Full Text Available Abstract Background Despite high levels of substance use disorders in Cape Town, substance abuse treatment utilization is low among people from disadvantaged communities in Cape Town, South Africa. To improve substance abuse treatment utilization, it is important to identify any potential barriers to treatment initiation so that interventions to reduce these barriers can be implemented. To date, substance abuse research has not examined the factors associated with substance abuse treatment utilization within developing countries. Using the Behavioural Model of Health Services Utilization as an analytic framework, this study aimed to redress this gap by examining whether access to substance abuse treatment is equitable and the profile of variables associated with treatment utilization for people from poor communities in Cape Town, South Africa. Methods This study used a case-control design to compare 434 individuals with substance use disorders from disadvantaged communities who had accessed treatment with 555 controls who had not accessed treatment on a range of predisposing, treatment need and enabling/restricting variables thought to be associated with treatment utilization. A hierarchical logistic regression was conducted to assess the unique contribution that the need for treatment, predisposing and enabling/restricting variable blocks made on substance abuse treatment utilization. Results Findings revealed that non-need enabling/restricting variables accounted for almost equal proportions of the variance in service utilization as the need for treatment variables. These enabling/restricting variables also attenuated the influence of the treatment need and predisposing variables domains on chances of treatment utilization. Several enabling/restricting variables emerged as powerful partial predictors of utilization including competing financial priorities, geographic access barriers and awareness of treatment services. Perceived severity of

  1. Perceptions of Organizational Functioning in Substance Abuse Treatment Facilities in South Africa

    Science.gov (United States)

    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…

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

    Science.gov (United States)

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

    1992-01-01

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

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

    Science.gov (United States)

    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,…

  4. Substance Abuse-Specific Knowledge Transfer or Loss? Treatment Program Turnover versus Professional Turnover among Substance Abuse Clinicians

    Science.gov (United States)

    Eby, Lillian T.; Curtis, Sara L.

    2014-01-01

    This longitudinal study investigated the extent to which substance abuse (SA) clinician turnover is associated with SA-specific knowledge loss due to change in professions (professional turnover) versus SA-specific knowledge transfer due to movement from one SA clinical setting to another (treatment program turnover). For this study, clinicians had to voluntarily leave their current treatment program. Eligible clinicians completed a quantitative survey while employed and a qualitative post-employment exit interview 1 year later. Compared to those that exited the SA profession (N = 99), clinicians who changed treatment programs (N = 120) had greater SA-specific formal knowledge and were more likely to be personally in recovery. No differences were found between the two groups in terms of SA-specific practical knowledge. PMID:25115318

  5. Organizational factors and collaboration and integration activities in criminal justice and drug abuse treatment agencies.

    Science.gov (United States)

    Lehman, Wayne E K; Fletcher, Bennett W; Wexler, Harry K; Melnick, Gerald

    2009-08-01

    Despite strong interest in improving collaborations between correctional and substance abuse treatment organizations, there is a lack of empirical data describing the existing practices. The current study used a national survey of correctional administrators to examine organizational factors related to cross-agency collaboration and integration activities between corrections and substance abuse treatment organizations. Using a measure of collaboration that scaled cross-agency activities from less structured, informal networking and coordination to more structured and formalized levels of cooperation and collaboration, we found that different correctional settings (e.g., community corrections, jails, prisons) differed significantly in terms of their collaborative activities with substance abuse treatment agencies. We also found that the organizational characteristics that were associated with different levels of collaboration and integration differed across the correctional settings. Further research is needed to better understand how and why correctional agencies decide to formalize collaborative arrangements with treatment agencies and whether these efforts lead to more favorable outcomes.

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

    Science.gov (United States)

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

    2009-12-01

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

  7. Traumatic experiences and re-victimization of female inmates undergoing treatment for substance abuse.

    Science.gov (United States)

    Mejía, Bertha; Zea, Paloma; Romero, Martha; Saldívar, Gabriela

    2015-02-09

    In the past decade, several studies have focused on the treatment needs of female inmates with substance abuse problems. An important finding has been that these women are more likely to report histories of sexual, physical, and emotional abuse-at rates varying from 77% to 90%. The trauma resulting from this kind of abuse is a key contributing factor in behavioral problems in adolescence and subsequent delinquency, substance abuse, and criminality in adulthood. This was a retrospective clinical study. A convenience sample of 112 women who entered the program's treatment groups consecutively for one year form part of the study. Information on traumatic events was obtained using some questions from the Initial Trauma Review. It explores whether the participant experienced physical abuse, sexual abuse, disasters, automobile accidents, or witnessed violence under the age of 18. It also examines experiences as an adult, including sexual and physical abuse, attacks by others who are not intimate partners, and abuse by authorities. Revictimization in sexual abuse was found in 78.1% of participants. Significant differences were identified between women who had experienced a traumatic sexual event from a person five years their senior before the age of 18 and then suffered from sexual violence as an adult, and women who had never undergone either of these events (x(2) = 11.3, df 112/1, p = abuse, the figure was 82.17%. Differences were observed between women who were revictimized through physical abuse before and after the age of 18 (x(2) = 5.91, df 112/1, p = child and subsequently physical violence from their parents, and women who had not undergone either of these events (x(2) = 3.48, df 112/1, p = <.05). Investment in treatment in these areas during the prison sentence and after release may contribute to preventing these women from become repeat offenders. Creating sources of work and halfway houses that continue the program to prevent relapses

  8. Can MDMA play a role in the treatment of substance abuse?

    Science.gov (United States)

    Jerome, Lisa; Schuster, Shira; Yazar-Klosinski, B Berra

    2013-03-01

    A wider array of treatments are needed for people with substance abuse disorders. Some psychedelic compounds have been assessed as potential substance abuse treatments with promising results. MDMA may also help treat substance abuse based on shared features with psychedelic compounds and recent reports indicating that MDMAassisted psychotherapy can reduce symptoms of PTSD. Narrative reports and data from early investigations found that some people reduced or eliminated their substance use after receiving MDMA, especially in a therapeutic setting. MDMA is a potent monoamine releaser with sympathomimetic effects that may indirectly activate 5-HT2A receptors. It increases interpersonal closeness and prosocial feelings, potentially through oxytocin release. Findings suggest that ecstasy, material represented as containing MDMA, is associated with deleterious long-term effects after heavy lifetime use, including fewer serotonin transporter sites and impaired verbal memory. Animal and human studies demonstrate moderate abuse liability for MDMA, and this effect may be of most concern to those treating substance abuse disorders. However, subjects who received MDMA-assisted psychotherapy in two recent clinical studies were not motivated to seek out ecstasy, and tested negative in random drug tests during follow-up in one study. MDMA could either directly treat neuropharmacological abnormalities associated with addiction, or it could indirectly assist with the therapeutic process or reduce symptoms of comorbid psychiatric conditions, providing a greater opportunity to address problematic substance use. Studies directly testing MDMA-assisted psychotherapy in people with active substance abuse disorder may be warranted.

  9. Attachment as an organizer of behavior: implications for substance abuse problems and willingness to seek treatment

    Directory of Open Access Journals (Sweden)

    Troutman Beth

    2006-11-01

    Full Text Available Abstract Background Attachment theory allows specific predictions about the role of attachment representations in organizing behavior. Insecure attachment is hypothesized to predict maladaptive emotional regulation whereas secure attachment is hypothesized to predict adaptive emotional regulation. In this paper, we test specific hypotheses about the role of attachment representations in substance abuse/dependence and treatment participation. Based on theory, we expect divergence between levels of maladaptive functioning and adaptive methods of regulating negative emotions. Methods Participants for this study consist of a sample of adoptees participating in an ongoing longitudinal adoption study (n = 208. The Semi-Structured Assessment of the Genetics of Alcohol-II 41 was used to determine lifetime substance abuse/dependence and treatment participation. Attachment representations were derived by the Adult Attachment Interview [AAI; 16]. We constructed a prior contrasts reflecting theoretical predictions for the association between attachment representations, substance abuse/dependence and treatment participation. Results Logistic regression was used to test our hypotheses. As predicted, individuals classified as dismissing, preoccupied or earned-secure reported the highest rates of substance abuse/dependence. Individuals classified as dismissing reported significantly lower rates of treatment participation despite their high rates of substance abuse/dependence. As expected, the continuous-secure group reported lowest rates of both substance abuse/dependence and treatment participation. Conclusion The findings from this study identify attachment representations as an influential factor in understanding the divergence between problematic substance use and treatment utilization. The findings further imply that treatment may need to take attachment representations into account to promote successful recovery.

  10. Drugs of abuse modulate dopaminergic neurotransmission : effects on exocytosis and neurotransmitter receptor function

    NARCIS (Netherlands)

    Hondebrink, L.

    2011-01-01

    An extensive amount of literature is available on drugs of abuse. However, current knowledge on cellular and molecular mechanisms of actions is insufficient and hampers treatment of intoxicated patients. Drugs of abuse cause 100.000 hospital admissions yearly only in the US. Therefore, we

  11. Patient-related factors and circumstances surrounding decisions to forego life-sustaining treatment, including intensive care unit admission refusal.

    Science.gov (United States)

    Reignier, Jean; Dumont, Romain; Katsahian, Sandrine; Martin-Lefevre, Laurent; Renard, Benoit; Fiancette, Maud; Lebert, Christine; Clementi, Eva; Bontemps, Frederic

    2008-07-01

    To assess decisions to forego life-sustaining treatment (LST) in patients too sick for intensive care unit (ICU) admission, comparatively to patients admitted to the ICU. Prospective observational cohort study. A medical-surgical ICU. Consecutive patients referred to the ICU during a one-yr period. None. Of 898 triaged patients, 147 were deemed too well to benefit from ICU admission. Decisions to forego LST were made in 148 of 666 (22.2%) admitted patients and in all 85 patients deemed too sick for ICU admission. Independent predictors of decisions to forego LST at ICU refusal rather than after ICU admission were: age; underlying disease; living in an institution; preexisting cognitive impairment; admission for medical reasons; and acute cardiac failure, acute central neurologic illness, or sepsis. Hospital mortality after decisions to forego LST was not significantly different in refused and admitted patients (77.5% vs. 86.5%; p = .1). Decisions to forego LST were made via telephone in 58.8% of refused patients and none of the admitted patients. Nurses caring for the patient had no direct contact with the ICU physicians for 62.3% of the decisions in refused patients, whereas meetings between nurses and physicians occurred in 70.3% of decisions to forego LST in the ICU. Patients or relatives were involved in 28.2% of decisions to forego LST at ICU refusal compared with 78.4% of decisions to forego LST in ICU patients (p refused patients (vs. none of admitted patients) and were associated with less involvement of nurses and relatives compared with decisions in admitted patients. Further work is needed to improve decisions to forego LST made under the distinctive circumstances of triage.

  12. From benzos to berries: treatment offered at an Aboriginal youth solvent abuse treatment centre relays the importance of culture.

    Science.gov (United States)

    Dell, Colleen Anne; Seguin, Maureen; Hopkins, Carol; Tempier, Raymond; Mehl-Madrona, Lewis; Dell, Debra; Duncan, Randy; Mosier, Karen

    2011-02-01

    First Nations and Inuit youth who abuse solvents are one of the most highly stigmatized substance-abusing groups in Canada. Drawing on a residential treatment response that is grounded in a culture-based model of resiliency, this article discusses the cultural implications for psychiatry's individualized approach to treating mental disorders. A systematic review of articles published in The Canadian Journal of Psychiatry during the past decade, augmented with a review of Canadian and international literature, revealed a gap in understanding and practice between Western psychiatric disorder-based and Aboriginal culture-based approaches to treatment and healing from substance abuse and mental disorders. Differing conceptualizations of mental health and substance abuse are discussed from Western psychiatric and Aboriginal worldviews, with a focus on connection to self, community, and political context. Applying an Aboriginal method of knowledge translation-storytelling-experiences from front-line workers in a youth solvent abuse treatment centre relay the difficulties with applying Western responses to Aboriginal healing. This lends to a discussion of how psychiatry can capitalize on the growing debate regarding the role of culture in the treatment of Aboriginal youth who abuse solvents. There is significant need for culturally competent psychiatric research specific to diagnosing and treating First Nations and Inuit youth who abuse substances, including solvents. Such understanding for front-line psychiatrists is necessary to improve practice. A health promotion perspective may be a valuable beginning point for attaining this understanding, as it situates psychiatry's approach to treating mental disorders within the etiology for Aboriginal Peoples.

  13. Meeting the substance abuse treatment needs of lesbian, bisexual and transgender women: implications from research to practice

    Directory of Open Access Journals (Sweden)

    Stevens S

    2012-02-01

    Full Text Available Sally StevensSouthwest Institute for Research on Women (SIROW and Department of Gender and Women’s Studies (GWS, University of Arizona, Tucson, AZ, USAAbstract: Research on the incidence, etiology and substance abuse treatment needs of lesbian, bisexual and transgender (LBT women is limited. Most research indicates higher levels of alcohol and drug abuse among these populations compared to their heterosexual counterparts, with recent research indicating that substance abuse is a particular concern for transgender individuals and an increasing problem among younger LBT individuals. Risk factors and reasons for substance abuse among sexual minority women are similar to those of heterosexual women, yet are substantially complicated by issues of family rejection and lack of social support, stigma and minority stress, as well as abuse and harassment. Historically, substance abuse prevention, early intervention, and clinical treatment programs were designed to meet the needs of the sexual majority population with relatively few programs designed to incorporate the specific needs of sexual minorities. This article reviews findings from previous studies and utilizes new data collected from community-based and residential substance abuse treatment programs to (1 examine issues relevant to LBT women and substance use, and (2 make recommendations for tailoring substance abuse treatment programs to meet the needs of these populations.Keywords: lesbian, bisexual, transgender, substance abuse, family rejection, social support, stigma, minority stress, abuse, harassment

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

    Directory of Open Access Journals (Sweden)

    Chernoff Miriam

    2006-09-01

    Full Text Available Abstract 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

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

    Science.gov (United States)

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

    2016-01-01

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

  16. Does comorbid alcohol and substance abuse affect electroconvulsive therapy outcome in the treatment of mood disorders?

    Science.gov (United States)

    Moss, Lori; Vaidya, Nutan

    2014-03-01

    Antidepressant medications remain the principal agents used to treat patients with mood disorders, although 30% to 40% of these patients do not improve. One of the factors associated with poor medication response is alcohol and substance abuse. Persons with mood disorders are at the greatest risk for suicide, and alcoholism is a significant additional risk factor. Electroconvulsive therapy (ECT) is shown to be the most effective treatment for major depression especially when associated with psychosis, catatonia, and suicide intent. However, similar to most antidepressant trials, patients with depression and comorbid alcohol and substance abuse are excluded from ECT efficacy studies. Through a retrospective chart review, we compared response to ECT in patients with mood disorder and comorbid alcohol and drug abuse to those with mood disorder only. From 2004 to 2010, 80 patients with mood disorder received ECT. Fifty of these had comorbid alcohol or drug abuse. Using a 10-item psychopathology scale, we compared pre- and post-ECT symptom severity between the 2 groups. Outcome was determined by measuring a decrease in the pre-ECT and post-ECT score using Wilcoxon rank tests, with statistical significance at P = 0.05. There was no difference between the 2 groups in most demographics, ECT medication, or seizure quality. There was no difference in ECT outcome between those with comorbid alcohol abuse and those without based on percent decrease in pre- and post-ECT symptom scores (abuse: mean [SD], 0.89 [0.2] vs nonabuse: mean [SD], 0.93 [0.16]; Wilcoxon, 1332; P = 0.086). When we compared those who met the criteria for alcohol or drug dependence (19 patients) with those with no abuse, there was a trend for the dependence group to not do as well (dependence: mean [SD], 0.83 [0.25] vs nonabuse: mean [SD], 0.93 [0.16]; Wilcoxon, 405; P = 0.053). Those with combined drug and alcohol abuse (18 patients) did have a significantly worse outcome (combined: mean [SD], 0.82 [0

  17. Individual and group-based parenting programmes for the treatment of physical child abuse and neglect.

    Science.gov (United States)

    Barlow, J; Johnston, I; Kendrick, D; Polnay, L; Stewart-Brown, S

    2006-07-19

    Child physical abuse and neglect are important public health problems and recent estimates of their prevalence suggest that they are considerably more common than had hitherto been realised. Many of the risk factors for child abuse and neglect are not amenable to change in the short term. Intervening to change parenting practices may, however, be important in its treatment. Parenting programmes are focused, short-term interventions aimed at improving parenting practices in addition to other outcomes (many of which are risk factors for child abuse e.g. parental psychopathology, and parenting attitudes and practices), and may therefore be useful in the treatment of physically abusive or neglectful parents. To assess the efficacy of group-based or one-to-one parenting programmes in addressing child physical abuse or neglect. A range of biomedical and social science databases were searched including MEDLINE, EMBASE, CINAHL, PsychINFO, Sociofile, Social Science Citation Index, ASSIA, the Cochrane Library, Campbell Library (including SPECTR and CENTRAL), National Research Register (NRR) and ERIC, from inception to May 2005. Only randomised controlled trials or randomised studies that compared two treatments were included. Studies had to include at least one standardised instrument measuring some aspect of abusive or neglectful parenting. In the absence of studies using objective assessments of child abuse, studies reporting proxy measures of abusive parenting were included. Only studies evaluating the effectiveness of standardised group-based or one-to-one parenting programmes aimed at the treatment of physical child abuse or neglect were included. Studies were also only eligible for inclusion if they had targeted parents of children aged 0-19 years who had been investigated for physical abuse or neglect. The treatment effect for each outcome in each study was standardised by dividing the mean difference in post-intervention scores for the intervention and treatment

  18. Severe cytomegalovirus infections in immunocompetent patients at admission as dengue mimic: successful treatment with intravenous ganciclovir.

    Science.gov (United States)

    Tirumala, Suhasini; Behera, Bijayini; Lingala, Shilpa; Kumar, B Vijay; Mishra, Pradeep Kumar; Gurunath, J M; HariCharan; Kartik; Naresh

    2012-11-01

    Cytomegalovirus (CMV) infection is associated with adverse clinical outcomes in immunosuppressed persons. The incidence and association of CMV reactivation with adverse clinical outcomes in critically ill persons lacking evidence of immunosuppression at ICU admission has received great attention in the practice of critical care medicine. Critically ill patients in ICU who had associated risk factors such as mechanical ventilation, severe sepsis, or blood transfusion are more prone to CMV activation, which in turn led to increased mortality and morbidity in terms of increased ICU stay, longer duration of mechanical ventilation, and higher rates of nosocomial infections. However, severe CMV as initial presentation mimicking dengue infection is rare. We recently came across seven cases with positive CMV serology at ICU admission, which we discuss in the light of current literature. Copyright © 2012 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

  19. 38 CFR 17.83 - Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation.

    Science.gov (United States)

    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 and...

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

    Science.gov (United States)

    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…

  1. Pretreatment for substance-abusing people with intellectual disabilities : Intervening on autonomous motivation for treatment entry

    NARCIS (Netherlands)

    Frielink, N.; Schuengel, C.; Kroon, A.; Embregts, P.J.C.M.

    2015-01-01

    Background Despite a lack of consensus regarding prevalence rates of substance abuse, people with intellectual disabilities (ID) on average use substances slightly less often than their non-disabled peers. However, their use of substances is more often problematic. Avoidance of treatment is a

  2. Pretreatment for substance-abusing people with intellectual disabilities: Intervening on autonomous motivation for treatment entry

    NARCIS (Netherlands)

    Frielink, N.; Schuengel, C.; Kroon, A.; Embregts, P.C.J.M.

    2015-01-01

    Background: Despite a lack of consensus regarding prevalence rates of substance abuse, people with intellectual disabilities (ID) on average use substances slightly less often than their non-disabled peers. However, their use of substances is more often problematic. Avoidance of treatment is a

  3. Substance Abuse Treatment Outcomes: A Multi-Site Study of Male and Female Prison Programs

    Science.gov (United States)

    Pelissier, Bernadette; Motivans, Mark; Rounds-Bryant, Jennifer L.

    2005-01-01

    The present study examined whether there were program differences with respect to post-release outcomes in 20 federal in-prison substance abuse programs which used a cognitive-behavioral treatment approach. Recidivism and post-release drug use were examined for a sample of 1,343 individuals--1,065 men and 278 women. Discrete time proportional…

  4. Cost-Effectiveness of Connecticut's In-Prison Substance Abuse Treatment

    Science.gov (United States)

    Daley, Marilyn; Love, Craig T.; Shepard, Donald S.; Petersen, Cheryl B.; White, Karen L.; Hall, Frank B.

    2004-01-01

    Over the past two decades, the criminal justice population in the US has grown by over 200%, most of this due to an increase in drug-involved offenders. Although there is good evidence that prison-based substance abuse treatment programs can be effective in reducing rearrest, few cost-effectiveness studies have been conducted. Using data from the…

  5. Factors Associated with Treatment Completion and Progress among Intrafamilial Sexual Abusers.

    Science.gov (United States)

    Chaffin, Mark

    1992-01-01

    Thirty-six father-daughter/stepdaughter sexual abusers were followed over the course of a two-year outpatient treatment program. Results supported the importance of pretreatment personality assessment and suggested that involvement of the criminal justice system does not interfere with, and may help, therapeutic progress. (Author/DB)

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

    Science.gov (United States)

    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…

  7. Inpatient Treatment for Early Sexually Abused Adults: A Naturalistic 12-Month Follow-Up Study

    NARCIS (Netherlands)

    Jepsen, E.K.K.; Langeland, W.; Sexton, H.; Heir, T.

    2014-01-01

    To date, most of the inpatient outcome studies among early traumatized individuals lack data on dissociative disorders. More research is needed to evaluate whether severely dissociative patients can improve following specialized inpatient treatment for chronic childhood abuse. The objectives of this

  8. Child Abuse and Multiple Personality Disorders: Review of the Literature and Suggestions for Treatment.

    Science.gov (United States)

    Coons, Philip M.

    1986-01-01

    Multiple personality disorder is associated with a high incidence of physical and sexual abuse during childhood. While difficult to diagnose, multiple personality is easier to treat if diagnosed early in childhood or adolescence. Treatment for multiple personality focuses on establishing trust and communicating with and integrating the…

  9. Markers of Marijuana Use Outcomes within Adolescent Substance Abuse Group Treatment

    Science.gov (United States)

    Engle, Brett; Macgowan, Mark J.; Wagner, Eric F.; Amrhein, Paul C.

    2010-01-01

    Objectives: Despite their popularity, little is known about what distinguishes effective from ineffective or even iatrogenic adolescent group interventions. Methods: Audio recordings and transcripts from 19, 8-10 session, school-based treatment groups comprised of 108, substance abusing 10- to 19-year olds were analyzed. "Group leader empathy" was…

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

    Science.gov (United States)

    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…

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  13. Is substance abuse treatment providing services to the right population?

    Science.gov (United States)

    Ward, Kelly

    2005-01-01

    This study examined the relationship between treatment retention, and drug severity level in a therapeutic community setting for drug and alcohol treatment. Treatment retention is significant because length of time in treatment has been shown to correlate with success after treatment that impacts everyone. The design of this study was exploratory, descriptive, and cross-sectional. Data were collected in 2000 from a convenience sample of 18 to 25 year-old, primarily low-income and minority addicts who were currently in a therapeutic community in New Jersey, USA. The participants were then tracked for 90 days as to their status in the program and staff completed a motivation measure. Results indicated that severity of addiction was significant to treatment retention.

  14. Day-care treatment for multiple drug abusing adolescents: social factors linked with completing treatment.

    Science.gov (United States)

    Feigelman, W

    1987-01-01

    By identifying some of the social correlates linked with completing day-care drug abuse treatment, the present study has sought to broaden understanding of how drug rehabilitations are effected. As the findings have demonstrated, completing care is a result of a complex array of causes and their interaction. The disposition of the entering patient (i.e., their determination and other strengths) has a great bearing on treatment outcome. It is also a result of the patient's family, their motivations, resources and perseverance in enduring a long course of demanding therapeutic interventions. In addition, it is the product of meanings shared and transmitted between the patient's family and the treatment staff. Patients and their families project positive attitudes about the value of the therapeutic enterprise as well as a compliant demeanor. As staff recognize that patients and parents are acting cooperatively, then such perceptions tend to create self-fulfilling prophecies. The data has established that older adolescent patients are more likely to possess the motivational resources needed for program completion than younger patients. Apparently, self-referred patients are also more inclined to meet the demands of program requirements than those referred by the courts or other outside social agencies, although the differences fell short of the .05 level of statistical significance. Those completing the program are less likely to be diagnosed as depressed at intake. Parental characteristics comprise another group of variables that are related to treatment completion. Parents of higher occupational rank, who have had mental health care for themselves, and who are of Jewish ethnicity appear to possess useful strengths for meeting program challenges. The pattern of spouse mutuality in dealing with a child's needs as it exists preceding and during treatment seems to be another useful asset for successfully getting through this form of treatment. While parents with the

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

    Directory of Open Access Journals (Sweden)

    Kelly Peter J

    2012-02-01

    Full Text Available Abstract Background A large proportion of people attending residential alcohol and other substance abuse treatment have a co-occurring mental illness. Empirical evidence suggests that it is important to treat both the substance abuse problem and co-occurring mental illness concurrently and in an integrated fashion. However, the majority of residential alcohol and other substance abuse services do not address mental illness in a systematic way. It is likely that computer delivered interventions could improve the ability of substance abuse services to address co-occurring mental illness. This protocol describes a study in which we will assess the effectiveness of adding a computer delivered depression and substance abuse intervention for people who are attending residential alcohol and other substance abuse treatment. Methods/Design Participants will be recruited from residential rehabilitation programs operated by the Australian Salvation Army. All participants who satisfy the diagnostic criteria for an alcohol or other substance dependence disorder will be asked to participate in the study. After completion of a baseline assessment, participants will be randomly assigned to either a computer delivered substance abuse and depression intervention (treatment condition or to a computer-delivered typing tutorial (active control condition. All participants will continue to complete The Salvation Army residential program, a predominantly 12-step based treatment facility. Randomisation will be stratified by gender (Male, Female, length of time the participant has been in the program at the commencement of the study (4 weeks or less, 4 weeks or more, and use of anti-depressant medication (currently prescribed medication, not prescribed medication. Participants in both conditions will complete computer sessions twice per week, over a five-week period. Research staff blind to treatment allocation will complete the assessments at baseline, and then 3, 6, 9

  16. Anorexia nervosa and childhood sexual abuse: Treatment outcomes of intensive enhanced cognitive behavioural therapy.

    Science.gov (United States)

    Calugi, Simona; Franchini, Cecilia; Pivari, Silvia; Conti, Maddalena; El Ghoch, Marwan; Dalle Grave, Riccardo

    2018-04-01

    Sexual abuse has been widely studied as a risk factor in anorexia nervosa, but data on its influence on treatment outcomes are scarce. Hence, we compared short- and long-term outcomes of inpatient enhanced cognitive-behavioural therapy (CBT-E) in patients with anorexia nervosa who had and had not suffered sexual abuse. Eighty-one patients were recruited, and body mass index (BMI), Eating Disorder Examination, Brief Symptom Inventory, and Work and Social Adjustment Scale scores were recorded before and after treatment, and at 6- and 12-month follow-ups. Twenty patients (24.7%) reported experiencing childhood sexual abuse before anorexia nervosa onset, while 61 (75.3%) reported none. Both groups displayed similar characteristics before treatment, and similarly large increases in BMI, eating-disorder, general psychopathology, and work and social functioning from baseline to 12-month follow-up. Based on these findings, childhood sexual abuse does not appear to compromise outcomes in patients with anorexia nervosa treated via intensive CBT-E. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Adoption of Evidence-Based Practices Among Substance Abuse Treatment Providers*

    Science.gov (United States)

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

    2009-01-01

    This research was conducted at a Substance Abuse Forum designed to address local community needs by focusing on Evidence-Based Practices (EBPs) in addiction treatment. The purpose of the study was to assess substance abuse treatment professionals’ readiness to adopt EBPs, experience with EBPs, and attitudes toward EBPs, as well as agency support for EBPs. A total of 119 addiction treatment providers completed pre-test measures, and 82% completed a post-test. Eighty-three percent of participants reported using some EBPs in the past year, and 75% reported currently using EBPs. Participants who were currently licensed or certified in addictions had less negative attitudes toward EBPs than those without credentials. While respondents reported agency support for EBPs, most expressed interest in further training. This study underscores the movement toward EBPs in addiction treatment and the need for effective dissemination and training in this area. PMID:18724657

  18. A Qualitative Exploration of Drug Abuse Relapse Following Treatment

    Science.gov (United States)

    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…

  19. Hospital admissions for dental treatment among children with cleft lip and/or palate born between 1997 and 2003: an analysis of Hospital Episode Statistics in England.

    Science.gov (United States)

    Fitzsimons, Kate J; Copley, Lynn P; Smallridge, Jacqueline A; Clark, Victoria J; van der Meulen, Jan H; Deacon, Scott A

    2014-05-01

    Children with clefts have an increased tendency for dental anomalies and caries. To determine the pattern of hospital admissions for dental treatment during primary dentition among children with clefts. Cohort study based on Hospital Episode Statistics, an administrative database of all admissions to National Health Service hospitals in England. Patients born alive between 1997 and 2003 who had both a cleft diagnosis and cleft repair were included. The number of hospital admissions for surgical removal of teeth, simple extraction of teeth, and restoration of teeth before the age of seven was examined. Eight hundred and fifty-eight hospital admissions for dental treatment among 6551 children (dental treatment. The presence of additional anomalies, having a more severe cleft type, and living in relatively deprived areas increased the risk of hospital admission. Factors increasing the risk of hospital admission among cleft children should be taken into account when planning services. Efforts to reduce the number of hospital admissions should be focused on disease prevention, particularly among those most at risk of caries. © 2013 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Substance abuse treatment response in a Latino sample: the influence of family conflict.

    Science.gov (United States)

    Fish, Jessica N; Maier, Candice A; Priest, Jacob B

    2015-02-01

    Latino Americans report underutilization of treatment and poor treatment response for substance use and abuse compared to other racial/ethnic groups; thus, it is important to assess factors that contribute to these disparities. The current study objective was to assess the influence of family conflict on substance abuse treatment response in a sample of Latino Americans using two different yet complementary analyses. First, ordinary least squares regression was used to assess the association between overall family conflict and pre- and post-treatment substance use. Second, repeated measures latent class analysis was used to identify groups based on family member conflict and timing of conflict during treatment. Findings indicated that family conflict contributed unique variance to concurrent substance use; however pre-treatment family conflict was not related to post-treatment outcomes. Results also identified three distinct family conflict groups: no/low conflict, pre-treatment conflict, and post-treatment conflict who differed in pre- and post-treatment substance use. Post hoc investigation revealed that those who experienced pre-treatment conflict but low post-treatment conflict showed the greatest decrease in substance use. Findings highlight the importance of considering family conflict during all stages of treatment for Latino American substance users. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. VA residential substance use disorder treatment program providers' perceptions of facilitators and barriers to performance on pre-admission processes.

    Science.gov (United States)

    Ellerbe, Laura S; Manfredi, Luisa; Gupta, Shalini; Phelps, Tyler E; Bowe, Thomas R; Rubinsky, Anna D; Burden, Jennifer L; Harris, Alex H S

    2017-04-04

    In the U.S. Department of Veterans Affairs (VA), residential treatment programs are an important part of the continuum of care for patients with a substance use disorder (SUD). However, a limited number of program-specific measures to identify quality gaps in SUD residential programs exist. This study aimed to: (1) Develop metrics for two pre-admission processes: Wait Time and Engagement While Waiting, and (2) Interview program management and staff about program structures and processes that may contribute to performance on these metrics. The first aim sought to supplement the VA's existing facility-level performance metrics with SUD program-level metrics in order to identify high-value targets for quality improvement. The second aim recognized that not all key processes are reflected in the administrative data, and even when they are, new insight may be gained from viewing these data in the context of day-to-day clinical practice. VA administrative data from fiscal year 2012 were used to calculate pre-admission metrics for 97 programs (63 SUD Residential Rehabilitation Treatment Programs (SUD RRTPs); 34 Mental Health Residential Rehabilitation Treatment Programs (MH RRTPs) with a SUD track). Interviews were then conducted with management and front-line staff to learn what factors may have contributed to high or low performance, relative to the national average for their program type. We hypothesized that speaking directly to residential program staff may reveal innovative practices, areas for improvement, and factors that may explain system-wide variability in performance. Average wait time for admission was 16 days (SUD RRTPs: 17 days; MH RRTPs with a SUD track: 11 days), with 60% of Veterans waiting longer than 7 days. For these Veterans, engagement while waiting occurred in an average of 54% of the waiting weeks (range 3-100% across programs). Fifty-nine interviews representing 44 programs revealed factors perceived to potentially impact performance in

  2. [Five years of ROM in substance abuse treatment centres in the Netherlands].

    Science.gov (United States)

    Oudejans, S C C; Schippers, G M; Spits, M E; Stollenga, M; van den Brink, W

    2012-01-01

    Three substance abuse treatment centres set up a benchmarking project for routine outcome management (ROM) of structured cognitive behavioral treatments for outpatients with a substance use disorder. To present the results of five years benchmarking. All patients were included at intake and the follow-up assessment was performed by a call-center nine months later. Twice a year aggregated data were fed back to management and treatment teams. Since 2005, clinical outcome data, including substance abuse data, have been collected for more than half of all 15.786 treated patients. At follow-up, nine months after intake, 23% was abstinent, 28% reported moderate substance use and 49% reported excessive substance use. The Dutch centres for the treatment of substance abuse were successful in setting up ROM projects to monitor and compare the development and the effects of outpatient addiction treatments. The clinical results are acceptable and correspond to the results of the American project called match. It is not yet clear whether the biannual feedback of aggregated outcomes to management and treatment teams has contributed to the creation of learning organisations, but it has provided transparency and has made it possible for teams to learn from the outcomes.

  3. Reasons for dropout from drug abuse treatment: symptoms, personality, and motivation.

    Science.gov (United States)

    Ball, Samuel A; Carroll, Kathleen M; Canning-Ball, Monica; Rounsaville, Bruce J

    2006-02-01

    Previous research has identified risk factors for early attrition from substance abuse treatment, but has not assessed reasons for dropout from the client's perspective. Interview and self-report assessment data were collected from 24 clients who prematurely terminated outpatient treatment to evaluate their subjective reasons for dropping out and the association of these reasons with demographic and clinical variables. Items from scales indicating problems with client motivation or conflicts with program staff were the most commonly endorsed. The severity of participant's symptoms and logistical problems interfering with appointments were less commonly reported as reasons for dropping out. Demographic, substance abuse, and motivational stage indicators were infrequently associated with subjective reasons for dropout. In contrast, indicators of maladaptive personality functioning were strongly associated with many reasons for dropping out, especially concerns about privacy and boundary issues within the program. Results from this preliminary evaluation will guide the development of an instrument and intervention focused on dropout risk factors and treatment reengagement.

  4. Substance Abuse Counselors’ Recovery Status and Self-Schemas: Preliminary Implications for Empirically Supported Treatment Implementation

    Science.gov (United States)

    Nielson, Elizabeth M.

    2016-01-01

    Purpose The purpose of this paper is to better understand the relationship between substance abuse counselors’ personal recovery status, self-schemas, and willingness to use empirically supported treatments for substance use disorders. Methods A phenomenological qualitative study enrolled 12 practicing substance abuse counselors. Results Within this sample, recovering counselors tended to see those who suffer from addiction as qualitatively different from those who do not and hence themselves as similar to their patients, while nonrecovering counselors tended to see patients as experiencing a specific variety of the same basic human struggles everyone experiences, and hence also felt able to relate to their patients’ struggles. Discussion Since empirically supported treatments may fit more or less neatly within one or the other of these viewpoints, this finding suggests that counselors’ recovery status and corresponding self-schemas may be related to counselor willingness to learn and practice specific treatments. PMID:28626597

  5. Substance Abuse Counselors' Recovery Status and Self-Schemas: Preliminary Implications for Empirically Supported Treatment Implementation.

    Science.gov (United States)

    Nielson, Elizabeth M

    2016-01-01

    The purpose of this paper is to better understand the relationship between substance abuse counselors' personal recovery status, self-schemas, and willingness to use empirically supported treatments for substance use disorders. A phenomenological qualitative study enrolled 12 practicing substance abuse counselors. Within this sample, recovering counselors tended to see those who suffer from addiction as qualitatively different from those who do not and hence themselves as similar to their patients, while nonrecovering counselors tended to see patients as experiencing a specific variety of the same basic human struggles everyone experiences, and hence also felt able to relate to their patients' struggles. Since empirically supported treatments may fit more or less neatly within one or the other of these viewpoints, this finding suggests that counselors' recovery status and corresponding self-schemas may be related to counselor willingness to learn and practice specific treatments.

  6. Who Benefits from Gender Responsive Treatment? Accounting for Abuse History on Longitudinal Outcomes for Women in Prison.

    Science.gov (United States)

    Saxena, Preeta; Messina, Nena; Grella, Christine E

    2014-04-01

    This study explores outcome variation among women offenders who participated in gender-responsive substance abuse treatment (GRT). In order to identify subgroups of participants that may differentially benefit from this treatment, secondary analyses examined the interaction between randomization into GRT and a history of abuse (physical/sexual) on depression and number of substances used post- treatment. The sample consisted of 115 incarcerated women assessed at baseline and 6- and 12-months post parole. Longitudinal regression showed that women reporting abuse randomized into GRT had significantly reduced odds of depression ( OR = .29, p < .05, 95% CI = .10 - .86) and lowered rates of number of substances used ( IRR = .52, p < .05, 95% CI = 0.28-0.98), in comparison to those who reported abuse and were randomized to the non-GRT group. GRT for women offenders who have experienced prior abuse would maximize the benefits of the trauma-informed, gender-sensitive intervention.

  7. HIV/AIDS, Drug Abuse Treatment, and the Correctional System.

    Science.gov (United States)

    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…

  8. New Treatment for Drug-Abusing Women Offenders in Virginia.

    Science.gov (United States)

    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,…

  9. Early Childhood Interventionists' Perceptions of the Child Abuse Prevention and Treatment Act: Provider Characteristics and Organizational Climate

    Science.gov (United States)

    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…

  10. Hospital admission and mortality rates in anorexia nervosa: experience from an integrated medical-psychiatric outpatient treatment.

    Science.gov (United States)

    De Filippo, E; Signorini, A; Bracale, R; Pasanisi, F; Contaldo, F

    2000-12-01

    To evaluate the effectiveness of an integrated medical-psychiatric treatment of major eating disorders. Historical cohort study. Outpatient Unit for Protein Energy Malnutrition of the Department of Clinical and Experimental Medicine, "Federico II" University of Naples, time of study: January 1994 to December 1997 PARTICIPANTS: 147 female patients with restrictive or bulimic anorexia nervosa (mean age 19.8 +/- 13.7, BMI 14.7 +/- 2.1 Kg/m2) consecutively attending the outpatient unit between January 1994 and December 1997. Hospitalization and mortality rates were evaluated up to Jan 1999 with a minimum follow-up of 18 months. There were 23 admissions to the Clinical Nutrition ward for 19 patients (i.e. 12.9%) mostly due to severe protein energy malnutrition, and 2 deaths, only 1 strictly related to anorexia (mortality rate 0.7%). Integrated outpatient medical-psychiatric treatment for major eating disorders is an effective and inexpensive procedure that reduces mortality and admissions due to medical complications in the medium term.

  11. Condom use assessment of persons in drug abuse treatment.

    Science.gov (United States)

    Ross, Dana; Schumacher, Joseph E

    2004-12-01

    The purpose of this study was to objectively and quantitatively assess individual skill level of male condom use. This study developed a reliable and face valid assessment of correct male condom use based on Centers for Disease Control and Prevention criteria. Participants (N= 163) were recruited from persons in treatment for cocaine addiction. Condom use was assessed on the basis of correct completion of eight discrete steps. An overall score of 40% correct condom use indicated the need for training in this sample. Assessment showed training needs especially related to steps involving reduction of ejaculate leakage and steps related to potential hazards of nonoxynol-9 use. Frequency of condom use was also assessed; there was no correlation between frequency of condom use and condom use skill. Drug addiction treatment programs are encouraged to incorporate HIV risk reduction programs that teach condom use skills and use the CUDOS as an empirical measure of condom skill acquisition.

  12. Utilization of communication technology by patients enrolled in substance abuse treatment.

    Science.gov (United States)

    McClure, Erin A; Acquavita, Shauna P; Harding, Emily; Stitzer, Maxine L

    2013-04-01

    Technology-based applications represent a promising method for providing efficacious, widely available interventions to substance abuse treatment patients. However, limited access to communication technology (i.e., mobile phones, computers, internet, and e-mail) could significantly impact the feasibility of these efforts, and little is known regarding technology utilization in substance abusing populations. A survey was conducted to characterize utilization of communication technology in 266 urban, substance abuse treatment patients enrolled at eight drug-free, psychosocial or opioid-replacement therapy clinics. Survey participants averaged 41 years of age and 57% had a yearly household income of less than $15,000. The vast majority reported access to a mobile phone (91%), and to SMS text messaging (79%). Keeping a consistent mobile phone number and yearly mobile contract was higher for White participants, and also for those with higher education, and enrolled in drug-free, psychosocial treatment. Internet, e-mail, and computer use was much lower (39-45%), with younger age, higher education and income predicting greater use. No such differences existed for the use of mobile phones however. Concern regarding the digital divide for marginalized populations appears to be disappearing with respect to mobile phones, but still exists for computer, internet, and e-mail access and use. Results suggest that mobile phone and texting applications may be feasibly applied for use in program-client interactions in substance abuse treatment. Careful consideration should be given to frequent phone number changes, access to technology, and motivation to engage with communication technology for treatment purposes. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  13. Prefrontal cortex and drug abuse vulnerability: translation to prevention and treatment interventions.

    Science.gov (United States)

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

    2011-01-01

    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 humans. 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 (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. Copyright © 2010 Elsevier B.V. All rights reserved.

  14. Predicting Time Spent in Treatment in a Sample of Danish Survivors of Child Sexual Abuse.

    Science.gov (United States)

    Fletcher, Shelley; Elklit, Ask; Shevlin, Mark; Armour, Cherie

    2017-07-01

    The aim of this study was to identify significant predictors of length of time spent in treatment. In a convenience sample of 439 Danish survivors of child sexual abuse, predictors of time spent in treatment were examined. Assessments were conducted on a 6-month basis over a period of 18 months. A multinomial logistic regression analysis revealed that the experience of neglect in childhood and having experienced rape at any life stage were associated with less time in treatment. Higher educational attainment and being male were associated with staying in treatment for longer periods of time. These factors may be important for identifying those at risk of terminating treatment prematurely. It is hoped that a better understanding of the factors that predict time spent in treatment will help to improve treatment outcomes for individuals who are at risk of dropping out of treatment at an early stage.

  15. Understanding the etiology of prescription opioid abuse: implications for prevention and treatment.

    Science.gov (United States)

    Rigg, Khary K; Murphy, John W

    2013-07-01

    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.

  16. An historical review of racial bias in prison-based substance abuse treatment design

    OpenAIRE

    Kerrison, EM

    2017-01-01

    © 2017 Taylor & Francis. This study leverages critical race and legal epidemiological frameworks to illustrate the race-based historical evolution of U.S. rehabilitation paradigms directed at imprisoned heroin and opioid users. What began as a racist early-20th-century federal antinarcotic trafficking effort has since assumed a state-based treatment agenda whose programmatic operations are largely based in correctional settings disproportionately reserved for poor substance abusers of color...

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

    Science.gov (United States)

    Legha, Rupinder Kaur; Novins, Douglas

    2012-07-01

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

  18. Examining human rights and mental health among women in drug abuse treatment centers in Afghanistan

    Directory of Open Access Journals (Sweden)

    Abadi MH

    2012-04-01

    Full Text Available Melissa Harris Abadi1, Stephen R Shamblen1, Knowlton Johnson1, Kirsten Thompson1, Linda Young1, Matthew Courser1, Jude Vanderhoff1, Thom Browne21Pacific Institute for Research and Evaluation – Louisville Center, Louisville, KY, USA; 2United States Department of State, Bureau of International Narcotics and Law Enforcement, Washington, DC, USAAbstract: 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.Keywords: Afghanistan, women, human rights, mental health, drug abuse treatment

  19. Examining human rights and mental health among women in drug abuse treatment centers in Afghanistan.

    Science.gov (United States)

    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.

  20. A Comparison of Daily Versus Weekly Electronic Cigarette Users in Treatment for Substance Abuse.

    Science.gov (United States)

    Gubner, Noah R; Pagano, Anna; Tajima, Barbara; Guydish, Joseph

    2018-04-02

    This research examined electronic cigarette (e-cigarette) use by individuals in treatment for substance abuse, a population with a high prevalence of tobacco use and poor smoking cessation outcomes. We surveyed 1127 individuals from 24 substance abuse treatment centers across the United States. Bivariate analyses and logistic regression were used to examine factors associated with daily (N = 87) versus weekly (N = 81) e-cigarette use. Among the full sample, 59.8% reported any lifetime use of e-cigarettes, with 23.6% reporting past 30-day use. Daily e-cigarette users were more likely to have used second-generation, tank-type e-cigarettes, χ2(1,N = 165) = 11.54, p = .001, used more flavors overall, t(168) = 2.15, p = .03, and were more likely to report using their e-cigarette continuously throughout the day, χ2(4,N = 168) = 16.7, p = .002, compared to weekly e-cigarette users. Over half (57.7%) of the daily and weekly e-cigarette users reported having an e-cigarette device that broke. The logistic regression model adjusting for clinic type and days with poor mental health found that daily e-cigarette users were significantly more likely than weekly e-cigarette users to be from methadone clinics (adjusted odds ratio [AOR] = 2.40, p = .04), and former smokers (AOR = 6.37, p users in substance abuse treatment were more likely to be from methadone clinics and former cigarette smokers. However, the majority (73.6%) of daily e-cigarette users were current cigarette smokers. E-cigarette device type reliability (eg, breakage) may be an important factor to consider among drug treatment and other populations with lower socioeconomic status. This study found several differences in the device type, flavors, and use characteristics of daily versus weekly e-cigarette users. While majority of e-cigarette users in substance abuse treatment were current cigarette smokers, daily e-cigarette users were more likely to be former cigarette smokers. Administrators of substance abuse

  1. The effectiveness of the Minnesota Model approach in the treatment of adolescent drug abusers.

    Science.gov (United States)

    Winters, K C; Stinchfield, R D; Opland, E; Weller, C; Latimer, W W

    2000-04-01

    The treatment outcome of drug-abusing adolescents treated with a 12-Step approach. The study compares drug use outcome data at 6 and 12 months post-treatment among three groups of adolescents: those who completed treatment, those who did not and those on a waiting list. Also, among treatment completers, residential and outpatient samples were compared on outcome. The treatment site is located in the Minneapolis/St Paul area of Minnesota. Two hundred and forty-five drug clinic-referred adolescents (12-18 years old), all of whom met at least one DSM-III-R substance dependence disorder. One hundred and seventy-nine subjects received either complete or incomplete 12-Step, Minnesota Model treatment and 66 were waiting list subjects. In addition to demographics and clinical background variables, measures included treatment involvement, treatment setting and drug use frequency at intake and follow-up. Absolute and relative outcome analyses indicated that completing treatment was associated with far superior outcome compared to those who did not complete treatment or receive any at all. The percentage of treatment completers who reported either abstinence or a minor lapse for the 12 months following treatment was 53%, compared to 15 and 28% for the incompleter and waiting list groups, respectively. Favorable treatment outcome for drug abuse was about two to three times more likely if treatment was completed. Also, there were no outcome differences between residential and outpatient groups. Alcohol was the most common drug used during the follow-up period, despite cannabis being the preferred drug at intake.

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

    Science.gov (United States)

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

    2007-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  4. Perceptions about recovery needs and drug-avoidance recovery behaviors among youth in substance abuse treatment.

    Science.gov (United States)

    Gonzales, Rachel; Anglin, M Douglas; Glik, Deborah C; Zavalza, Christina

    2013-01-01

    This study used mixed methods to explore youth attitudes about recovery-related needs and important drug-avoidance behaviors after treatment. Focus groups were conducted with 118 substance using youth in treatment (four residential and 10 outpatient settings) throughout Los Angeles County. The average age was 17.4 (SD = 2.9); 78.3% were male, 66.1% Latino; and most were in treatment for primary marijuana (40.9%) or methamphetamine (30.4%) abuse. Quantitatve results from the drug-avoidance activity survey identified the following factors youth rated as important to their recovery after treatment: lifestyle improvement activities (95.7%); changing personal drug behaviors (89.6%); drug environment/culture change activities (82.5%); with the least important being therapeutic activities (78.5%). Qualitative findings from focus groups that asked what youth think are important for recovery programs to address after treatment revealed the following four areas: (1) recovery promotion to developmentally appropriate activities (95%); (2) facilitating the use of coping skills to deal with stress (85%); (3) offering alternative recovery support options (not just abstinence only) (75%); and (4) continuing to provide substance use education (65%). Findings highlight essential aspects of recovery in terms of need and drug-avoidance behaviors considered important to youth in treatment. Such information will help to better address clinical and recovery support models aimed at relapse prevention to ensure that the perceived problems of substance-abusing youth are adequately met.

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

    Science.gov (United States)

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

    2013-07-01

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

  6. Improving quality of care in substance abuse treatment using five key process improvement principles

    Science.gov (United States)

    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

  7. Employed men and women substance abusers: job troubles and treatment outcomes.

    Science.gov (United States)

    Slaymaker, Valerie J; Owen, Patricia L

    2006-12-01

    The majority of U.S. adults with substance abuse or dependence are gainfully employed. However, little is known about outcomes among stably employed people in treatment for substance dependence. Participants (N = 212) entering a residential treatment program completed the Addiction Severity Index (ASI) at intake and 6 and 12 months follow-up. Significant improvements were seen in absenteeism, number of employment problem days, and whether their job was in jeopardy 12 months later. Overall, 65% were retained by their original employer. ASI composite alcohol, drug, legal, family, and psychiatric scores also improved significantly. Continuous abstinence was achieved by 65% and 51% at 6 and 12 months, respectively. Although less likely to be referred to treatment by their employer, women responded to treatment as well as men, reporting similar abstinence rates and overall quality of life during the year following discharge from treatment.

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

    Science.gov (United States)

    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.

  9. "Transcend": initial outcomes from a posttraumatic stress disorder/substance abuse treatment program.

    Science.gov (United States)

    Donovan, B; Padin-Rivera, E; Kowaliw, S

    2001-10-01

    This paper describes the development of a comprehensive treatment program for combat veterans diagnosed with posttraumatic stress disorder (PTSD) and substance abuse (SA). Outcome data are presented on 46 male patients who completed treatment between 1996 and 1998. The treatment approach, defined by a detailed manual, integrates elements of cognitive-behavioral skills training, constructivist theory approaches, SA relapse prevention strategies, and peer social support into a group-focused program. The Clinician-Administered PTSD Scale (CAPS) and the Addiction Severity Index (ASI) were used to assess treatment effectiveness at discharge and 6- and 12-month follow-up. Significant symptom changes revealed on CAPS and ASI scores at discharge and follow-up are analyzed. Discussion focuses on hypotheses regarding treatment effectiveness, study limitations, and suggestions for further research.

  10. Predictors of mental health-related acute service utilisation and treatment costs in the 12 months following an acute psychiatric admission.

    Science.gov (United States)

    Siskind, Dan; Harris, Meredith; Diminic, Sandra; Carstensen, Georgia; Robinson, Gail; Whiteford, Harvey

    2014-11-01

    A key step in informing mental health resource allocation is to identify the predictors of service utilisation and costs. This project aims to identify the predictors of mental health-related acute service utilisation and treatment costs in the year following an acute public psychiatric hospital admission. A dataset containing administrative and routinely measured outcome data for 1 year before and after an acute psychiatric admission for 1757 public mental health patients was analysed. Multivariate regression models were developed to identify patient- and treatment-related predictors of four measures of service utilisation or cost: (a) duration of index admission; and, in the year after discharge from the index admission (b) acute psychiatric inpatient bed-days; (c) emergency department (ED) presentations; and (d) total acute mental health service costs. Split-sample cross-validation was used. A diagnosis of psychosis, problems with living conditions and prior acute psychiatric inpatient bed-days predicted a longer duration of index admission, while prior ED presentations and self-harm predicted a shorter duration. A greater number of acute psychiatric inpatient bed-days in the year post-discharge were predicted by psychosis diagnosis, problems with living conditions and prior acute psychiatric inpatient admissions. The number of future ED presentations was predicted by past ED presentations. For total acute care costs, diagnosis of psychosis was the strongest predictor. Illness acuity and prior acute psychiatric inpatient admission also predicted higher costs, while self-harm predicted lower costs. The development of effective models for predicting acute mental health treatment costs using existing administrative data is an essential step towards a workable activity-based funding model for mental health. Future studies would benefit from the inclusion of a wider range of variables, including ethnicity, clinical complexity, cognition, mental health legal status

  11. Impact of dissociation and interpersonal functioning on inpatient treatment for early sexually abused adults

    Directory of Open Access Journals (Sweden)

    Ellen K. K. Jepsen

    2013-12-01

    Full Text Available Background: Little is known about the possible predictors of treatment outcome in early chronically sexually abused adults. The current study aimed to investigate what impact initial levels of dissociation and pre-treatment negative change in interpersonal functioning have on treatment response after 3 months of first-phase trauma inpatient treatment as well as after a period of 1 year the patients returned to their usual lives. Methods: The sample comprised 48 inpatients with childhood sexual abuse histories and mixed trauma-related disorders who were examined at discharge and prospectively followed up for a period of 1 year under naturalistic conditions. Outcome variables were general psychiatric symptoms and interpersonal problems as measured with the Symptom Check List-Revised (SCL-R and the Inventory of Interpersonal Problems (IIP Circumplex. Results: The central findings were that pathological dissociation and deterioration in interpersonal functioning prior to admittance predicted general psychiatric symptom levels and interpersonal problems at the end of treatment and at 1-year follow-up. Pathological dissociation, involving memory and identity problems, alone predicted negative outcome at the end of treatment. The findings at 1-year follow-up indicate that it is not pathological dissociation in isolation that affects outcomes, but rather the interaction between dissociation and change in interpersonal functioning prior to treatment. Conclusion: These findings indicate the need of addressing dissociation and interpersonal problems in treatment planning and favor an integrated treatment approach for complex trauma patients. Future research should investigate whether and how this leads to better outcome, including long-term maintenance of gains after the end of treatment.

  12. [Supervision of junior doctors and allocation of work tasks regarding admissions and further treatment of acute admitted patients.

    DEFF Research Database (Denmark)

    Folkestad, Lars; Brabrand, Mikkel; Hallas, Peter

    2010-01-01

    INTRODUCTION: It is being debated whether medical staff working at the emergency departments with acute admission services dealing with medical patients have the required professional competence level. It has not previously been documented which doctors see the acute admissions initially at emerg......INTRODUCTION: It is being debated whether medical staff working at the emergency departments with acute admission services dealing with medical patients have the required professional competence level. It has not previously been documented which doctors see the acute admissions initially...... for help from a senior colleague. Udgivelsesdato: 2010-May-31...

  13. Assessment and Treatment of Abuse Risk in Opioid Prescribing for Chronic Pain

    Directory of Open Access Journals (Sweden)

    Robert N. Jamison

    2011-01-01

    Full Text Available 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.

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

    Science.gov (United States)

    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. © The Author(s) 2011.

  15. The Prevalence of Sexual Abuse and Its Impact on the Onset of Drug Use among Adolescents in Therapeutic Community Drug Treatment.

    Science.gov (United States)

    Hawke, Josephine M.; Jainchill, Nancy; De Leon, George

    2000-01-01

    Describes the prevalence of sexual abuse among adolescents (N=938) admitted to residential therapeutic communities for treatment of substance abuse and related disorders. Results indicate that approximately one-third of the sample reported histories of sexual abuse. Prevalence rates were significantly higher for girls than for boys. History of…

  16. Sexual abuse

    Directory of Open Access Journals (Sweden)

    Iztok Takač

    2012-11-01

    Conclusions: Effective and efficient treatment of victims of sexual abuse requires a systematic approach to the patient, starting with a thorough history, and continuing with a clinical investigation, diagnosis, treatment and prevention of the consequences of sexual abuse. The complete management must include sampling of any potential biological traces from the body of the victim. The key to success is a coordinated cooperation with investigators and forensics.

  17. The impact of childhood sexual abuse on the outcome of intensive trauma-focused treatment for PTSD.

    Science.gov (United States)

    Wagenmans, Anouk; Van Minnen, Agnes; Sleijpen, Marieke; De Jongh, Ad

    2018-01-01

    Background : It is assumed that PTSD patients with a history of childhood sexual abuse benefit less from trauma-focused treatment than those without such a history. Objective : To test whether the presence of a history of childhood sexual abuse has a negative effect on the outcome of intensive trauma-focused PTSD treatment. Method : PTSD patients, 83% of whom suffered from severe PTSD, took part in a therapy programme consisting of 2 × 4 consecutive days of Prolonged Exposure (PE) and EMDR therapy (eight of each). In between sessions, patients participated in sport activities and psycho-education sessions. No prior stabilization phase was implemented. PTSD symptom scores of clinician-administered and self-administered measures were analysed using the data of 165 consecutive patients. Pre-post differences were compared between four trauma groups; patients with a history of childhood sexual abuse before age 12 (CSA), adolescent sexual abuse (ASA; i.e. sexual abuse between 12 and 18 years of age), sexual abuse (SA) at age 18 and over, or no history of sexual abuse (NSA). Results : Large effect sizes were achieved for PTSD symptom reduction for all trauma groups (Cohen's d  = 1.52-2.09). For the Clinical Administered PTSD Scale (CAPS) and the Impact of Event Scale (IES), no differences in treatment outcome were found between the trauma (age) groups. For the PTSD Symptom Scale Self Report (PSS-SR), there were no differences except for one small effect between CSA and NSA. Conclusions : The results do not support the hypothesis that the presence of a history of childhood sexual abuse has a detrimental impact on the outcome of first-line (intensive) trauma-focused treatments for PTSD.

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

    Science.gov (United States)

    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.

  19. The influence of treatment attendance on subsequent aggression among severely mentally ill substance abusers.

    Science.gov (United States)

    Zhuo, Yue; Bradizza, Clara M; Maisto, Stephen A

    2014-01-01

    The interrelationships between severe mental illness, substance use, and aggression are of longstanding importance with implications for community treatment programs, treatment research and public policy. Through the analysis of longitudinal data collected from 278 patients over a 6-month period following admission to an outpatient dual diagnosis treatment program, this study examined the association between dual diagnosis treatment attendance and subsequent aggression among individuals diagnosed with both a severe mental illness and a substance use disorder. We also tested substance use and psychiatric symptoms as mediators of this treatment-aggression relationship. The results of structural equation modeling analyses indicated that dual diagnosis treatment was associated with lower levels of subsequent aggression. Mediational analyses indicated that greater treatment involvement was associated with reduced substance use, which was associated with lower levels of aggression; thus, substance use was found to mediate the relationship between dual diagnosis treatment and aggression. Surprisingly, severity of psychiatric symptoms did not predict later aggression. These findings suggest that targeting substance use reduction in treatment may have the additional benefit of reducing the risk of later aggression among dual diagnosis patients. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Social exclusion, personal control, self-regulation, and stress among substance abuse treatment clients.

    Science.gov (United States)

    Cole, Jennifer; Logan, T K; Walker, Robert

    2011-01-01

    The purpose of this study was to examine the relationship of social exclusion, personal control, and self-regulation to perceived stress among individuals who participated in publicly funded substance abuse treatment. Participants entered treatment between June 2006 and July 2007 and completed a 12-month follow-up survey by telephone (n=787). The results of the OLS regression analysis indicate that individuals with greater social exclusion factors (e.g. greater economic hardship, lower subjective social standing, greater perceived discrimination), lower perceived control of one's life, and lower self-regulation had higher perceived stress. Furthermore, a significant interaction was found suggesting a stress-buffering effect of personal control between subjective social standing and perceived stress. Interestingly, income status was not significantly related to perceived stress, while economic hardship, which assesses participants' inability to meet basic expenses, was significantly associated with perceived stress. Future research should examine how to integrate the AA/NA teaching about powerlessness and its role in recovery with the importance of increased personal control and self-control in decreasing perceived stress. Implications for future research and substance abuse treatment are discussed. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  1. The specifics of opiate abuse in women as a basis of prevention programs and treatment

    Directory of Open Access Journals (Sweden)

    Raketić Diana

    2013-01-01

    Full Text Available The aim of this research is to determine the specifics of opiate addiction in women in our environment, so as to create a specific plan of action in preventing and treatment opiate addiction in women based on the conducted description and results analysis. The sample consists of 32 examinees. Sociodempgraphic questionnaire and widely applied ASI structured interview (McLellan, Cacciola, 1982 were used. The results are in accordance with foreign research. 62.5% of opiate addicted women live with someone who is a drug addict, either as a family member or a partner. 40.6% of the examinees were physically abused, 21.9% were sexually abused as well, and 43.7% were positive for HCV. Positive criminal status and doing illegal business were present in 56% of the examinees. 56.3% of the examinees reported depression, while 84.4% are anxious. 65.6% are unemployed. Research results indicate some significant specifics of opiate addiction in women, with regard to which valuable recommendations for prevention and treatment can be made in our environment. Prevention and treatment must be multidisciplinary with the emphasis on the preserved capacities and the development of positive behavior in opiate addicted women.

  2. Sex-specific substance abuse treatment for female healthcare professionals: implications.

    Science.gov (United States)

    Koos, Erin; Brand, Michael; Rojas, Julio; Li, Ji

    2014-01-01

    Gender plays a significant role in the development and treatment of substance abuse disorders. Sex-specific treatment for girls and women has recurrently proven more effective, with better outcomes than traditional treatment. Research on impaired healthcare professionals (HCPs) has largely focused on men, garnering little attention for women and sex differences. With the increasing numbers of female HCPs, it is imperative to identify potential sex differences that may have implications for treatment. Our study compared a convenience sample of male and female HCPs with substance abuse disorders treated in an outpatient program to identify sex differences that may have implications for treatment. Our sample consisted of 96 HCPs (54 men, 42 women) and 17 non-healthcare professional (N-HCP) women. All of the participants were evaluated using the program's clinical interview and the Personality Assessment Inventory (PAI). Chart review data contained categorical variables, qualitative variables, diagnoses, and psychological test scores. A second analysis was conducted through two separate comparisons: the PAI results of comparing impaired female HCPs with impaired male HCPs and the PAI results of comparing impaired female HCPs with impaired female N-HCPs. Statistically significant differences indicated more male participants received prior treatment and more intensive treatment than female participants. More female subjects reported being diagnosed as having a comorbid psychiatric condition and taking psychotropic medications. Several statistically significant differences in the PAI scores were found. Among female HCPs, elevations were found in anxiety, depression, paranoia, and borderline personality disorder. Substantive differences, although not statistically significant, were elevations in somatic complaints and anxiety disorders in female HCPs. In the comparison of female HCPs and N-HCPs, the only statistically significant difference was the significantly higher

  3. LESSONS FROM THE EVALUATION OF A PUBLIC OUT-PATIENT SUBSTANCE ABUSE TREATMENT PROGRAMME IN THE WESTERN CAPE

    Directory of Open Access Journals (Sweden)

    Strebel, Anna

    2013-05-01

    Full Text Available Substance abuse is widely regarded as a major health and social problem in South Africa, and particularly in the Western Cape (Corrigall, Ward, Stinson, Struthers, Frantz, Lund, Flisher & Joska, 2007; Myers, Fakier & Louw, 2009. The complex nature of patterns of substance abuse, as well as the particular problems associated with this abuse, has implications for the development and implementation of treatment interventions. The most common primary drug of abuse in the Western Cape amongst patients admitted to treatment programmes is methamphetamine (known locally as “tik” (Dada, Plüddemann, Parry, Vawda & Fourie, 2012. The previous decade saw a dramatic rise in methamphetamine (hereafter indicated as MA use, particularly among youths, with over half the patients in treatment for MA abuse being younger than 25 years (Plüddemann, Parry, Dada, Bhana, Bachoo & Fourie, 2010. MA is also often used in combination with other drugs, and this prevalence of poly-substance abuse needs to be taken into account in the planning of services (Harker, Kader, Myers, Falkier, Parry, Flisher, Peltzer, Ramlagan & Davids, 2008.

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

    Science.gov (United States)

    Cohn, Amy; Najavits, Lisa M

    2014-04-01

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

  5. Family treatment for bipolar disorder and substance abuse in late adolescence.

    Science.gov (United States)

    Miklowitz, David J

    2012-05-01

    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. © 2012 Wiley Periodicals, Inc.

  6. Personal networks of women in residential and outpatient substance abuse treatment.

    Science.gov (United States)

    Kim, HyunSoo; Tracy, Elizabeth; Brown, Suzanne; Jun, MinKyoung; Park, Hyunyong; Min, Meeyoung; McCarty, Chris

    This study compared compositional, social support, and structural characteristics of personal networks among women in residential (RT) and intensive outpatient (IOP) substance abuse treatment. The study sample included 377 women from inner-city substance use disorder treatment facilities. Respondents were asked about 25 personal network members known within the past 6 months, characteristics of each (relationship, substance use, types of support), and relationships between each network member. Differences between RT women and IOP women in personal network characteristics were identified using Chi-square and t -tests. Compared to IOP women, RT women had more substance users in their networks, more network members with whom they had used substances and fewer network members who provided social support. These findings suggest that women in residential treatment have specific network characteristics, not experienced by women in IOP, which may make them more vulnerable to relapse; they may therefore require interventions that target these specific network characteristics in order to reduce their vulnerability to relapse.

  7. Co-occurring Mental Disorders in Substance Abuse Treatment: the Current Health Care Situation in Germany.

    Science.gov (United States)

    Dauber, Hanna; Braun, Barbara; Pfeiffer-Gerschel, Tim; Kraus, Ludwig; Pogarell, Oliver

    2018-01-01

    Aim of this study was to investigate the current health care situation for patients with co-occurring mental disorders in addiction treatment. Therefore, data from the German Substance Abuse Treatment System ( N  = 194,406) was analysed with regard to the prevalence of comorbid mental disorders, treatment characteristics and outcomes of patients with comorbid psychiatric diagnosis. In outpatient setting, the prevalence of comorbid diagnoses was considerably lower (4.6%) than in inpatient setting (50.7%), but mood and anxiety disorders were the most prevalent additional diagnoses in both settings. In the treatment of patients with these comorbid disorders, we found higher rates of complementary internal and external (psychiatric) treatment, more co-operations and referrals after treatment, and positive treatment process outcomes. Findings indicate that the knowledge of an additional diagnosis influences the health care provision of affected patients and can therefore be seen as the essential precondition for providing adequate and comprehensive treatment. This highlights the importance of a sufficient consideration and diagnostic assessment of mental disorders in addiction treatment to further improve the health care situation of comorbid patients.

  8. The impact of an educational program on recognition, treatment and report of child abuse.

    Science.gov (United States)

    Ferrara, Pietro; Gatto, Antonio; Manganelli, Nunzia Pia; Ianniello, Francesca; Amodeo, Maria Elisa; Amato, Maria; Giardino, Ida; Chiaretti, Antonio

    2017-08-14

    Pediatricians play a crucial role in the identification and management of child abuse and neglect (CAN) but they often don't have a formal specialized training. We analysed retrospectively data about patients, 0 - 18 years of age, victims of CAN between 1 April 2005 and 30 April 2015. The aim of the study was to evaluate the effect of a multidisciplinary educational program, "CAN: prevention strategies, individuation and treatment", on the knowledge, case recognition, treatment and follow-up of physicians of Gemelli University Hospital in Rome, regarding physical, sexual abuse and neglect. This program, in 3 different editions biannually, respectively in May-July 2010, November-January 2012 and February-May 2014, was based on 4 sessions, each one of 2 days. Considering the number of victims of CAN between 2005 and 2015 we observed 66 cases of maltreatment. We divided the study population in 2 groups: group A, before the educational programs, patients evaluated from 1 April 2005 to 30 July 2010; group B, after the educational program from 1 August 2010 to 30 April 2015. We observed 23 children in group A and 43 children in group B with an improvement of 87%. Analyzing our data about sex, nationality, type of perpetrators, we found that: 37/66 (56%) of children were females compared to 29/66 (44%) males; 41/66 (62%) of children came from Italy compared to 25/66 (38%) of foreign children; 52/66 (79%) of the perpetrators of abuse were parents or family members compared to acquaintances 10/66 (15%) and to strangers 4/66 (6%). Considering the prevalence of CAN, the need to develop clinically competent clinicians and the improving of residency education in child maltreatment is imperative. Improving the clinical skills of pediatricians to identify and evaluate CAN may lead to reduce morbidity and mortality of these children.

  9. Effects of Admission and Treatment Strategies of DWI Courts on Offender Outcomes

    Science.gov (United States)

    Sloan, Frank A.; Chepke, Lindsey M.; Davis, Dontrell V.; Acquah, Kofi; Zold-Kilbourne, Phyllis

    2013-01-01

    Purpose The purpose of this study is to classify DWI courts on the basis of the mix of difficult cases participating in the court (casemix severity) and the amount of involvement between the court and participant (service intensity). Using our classification typology, we assess how casemix severity and service intensity are associated with program outcomes. We expected that holding other factors constant, greater service intensity would improve program outcomes while a relatively severe casemix would result in worse program outcomes. Methods The study used data from 8 DWI courts, 7 from Michigan and 1 from North Carolina. Using a 2-way classification system based on court casemix severity and program intensity, we selected participants in 1 of the courts, and alternatively 2 courts as reference groups. Reference group courts had relatively severe casemixes and high service intensity. We used propensity score matching to match participants in the other courts to participants in the reference group court programs. Program outcome measures were the probabilities of participants’: failing to complete the court’s program; increasing educational attainment; participants improving employment from time of program enrollment; and re-arrest. Results For most outcomes, our main finding was that higher service intensity is associated with better outcomes for court participants, as anticipated, but a court’s casemix severity was unrelated to study outcomes. Conclusions Our results imply that devoting more resources to increasing duration of treatment is productive in terms of better outcomes, irrespective of the mix of participants in the court’s program PMID:23416679

  10. A longitudinal study of organizational formation, innovation adoption, and dissemination activities within the National Drug Abuse Treatment Clinical Trials Network.

    Science.gov (United States)

    Roman, Paul M; Abraham, Amanda J; Rothrauff, Tanja C; Knudsen, Hannah K

    2010-06-01

    The National Institute on Drug Abuse established the National Drug Abuse Treatment Clinical Trials Network (CTN) to conduct trials of promising substance abuse treatment interventions in diverse clinical settings and to disseminate results of these trials. This article focuses on three dimensions of CTN's organizational functioning. First, a longitudinal dataset is used to examine CTN's formation as a network of interorganizational interaction among treatment practitioners and researchers. Data indicate strong relationships of interaction and trust, but a decline in problem-centered interorganizational interaction over time. Second, adoption of buprenorphine and motivational incentives among CTN's affiliated community treatment programs (CTPs) is examined over three waves of data. Although adoption is found to increase with CTPs' CTN participation, there is only modest evidence of widespread penetration and implementation. Third, CTPs' pursuit of the CTN's dissemination goals are examined, indicating that such organizational outreach activities are underway and likely to increase innovation diffusion in the future.

  11. Long-term residential substance abuse treatment for women: lessons learned from Israel

    Directory of Open Access Journals (Sweden)

    Schori M

    2012-02-01

    Full Text Available Maayan Schori1, Yaffa Sapir2, Eli Lawental31School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA, USA; 2Central School for the Training of Social Welfare Workers, Ministry of Social Affairs and Social Services, Tel Aviv, Israel; 3Department of Social Work, Tel-Hai College, Upper Galilee, IsraelBackground: Policymakers and treatment providers must consider the role of gender when designing effective treatment programs for female substance abusers. This study had two aims. First, to examine female substance abusers' perceptions regarding factors that contribute to their retention (and therefore positive treatment outcomes in a women-only therapeutic community in Northern Israel. Second, to explore pretreatment internal and external factors including demographic, personal and environmental factors, factors associated with substance use and with the treatment process, and networks of support that contribute to retention and abstinence.Methods: The study was a conducted using a mixed methods approach. Semi-structured qualitative interviews examining perceptions towards treatment were conducted in five focus groups (n = 5 per group; total n = 25. Intake assessments and a battery of questionnaires examining pretreatment internal and external factors related to treatment retention and abstinence were collected from 42 women who were treated in the program during the 2 year study period. Twenty-three women who completed the 12 month program were compared to the 19 women who did not, using chi-square for categorical variables and t-tests for continuous variables. Nineteen of the 23 women who completed the questionnaires also completed a post-treatment follow-up questionnaire.Results: A content analysis of the interviews revealed five central themes: factors associated with treatment entry; impact of treatment in a women-only setting; significant aspects of treatment; difficulties with the setting; prospects for the future

  12. Psychiatric comorbidity and gender difference among treatment-seeking heroin abusers in Taiwan.

    Science.gov (United States)

    Chiang, Shu-Chuan; Chan, Hung-Yu; Chang, Yuan-Ying; Sun, Hsiao-Ju; Chen, Wei J; Chen, Chih-Ken

    2007-02-01

    The objectives of the present study were to estimate the psychiatric comorbidity of Taiwanese heroin users seeking treatment and to identify the gender differences in psychiatric comorbidity and drug use behavior. Subjects were interviewed using a structured questionnaire on drug use behavior and the Mini International Neuropsychiatric Interview for psychiatric disorders. Of the subjects, 58.5% of the male and 62.5% of the female subjects had at least one non-substance-use axis I psychiatric disorder or antisocial personality disorder. Compared to male subjects, female subjects were younger, were less educated, had higher rates of unemployment and had earlier onset of illicit drug use. Female subjects were 11-fold more likely than male subjects to exhibit suicidal behavior. Among heroin abusers in the present study, female subjects were more widely exposed to unfavorable social factors and had substantially higher incidence of suicidal behavior than male subjects. Drug treatment centers should be aware of these gender differences and pay particular attention to comorbid depressive disorders and suicidal behavior of female heroin abusers.

  13. Continuous quality improvement in substance abuse treatment facilities: How much does it cost?

    Science.gov (United States)

    Hunt, Priscillia; Hunter, Sarah B; Levan, Deborah

    2017-06-01

    Continuous quality improvement (CQI) has grown in the U.S. since the 1970s, yet little is known about the costs to implement CQI in substance abuse treatment facilities. This paper is part of a larger group randomized control trial in a large urban county evaluating the impact of Plan-Study-Do-Act (PDSA)-CQI designed for community service organizations (Hunter, Ober, Paddock, Hunt, & Levan, 2014). Operated by one umbrella organization, each of the eight facilities of the study, four residential and four outpatient substance abuse treatment facilities, selected their own CQI Actions, including administrative- and clinical care-related Actions. Using an activity-based costing approach, we collected labor and supplies and equipment costs directly attributable to CQI Actions over a 12-month trial period. Our study finds implementation of CQI and meeting costs of this trial per facility were approximately $2000 to $10,500 per year ($4500 on average), or $10 to $60 per admitted client. We provide a description of the sources of variation in these costs, including differing intensity of the CQI Actions selected, which should help decision makers plan use of PDSA-CQI. Copyright © 2017. Published by Elsevier Inc.

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

    Science.gov (United States)

    Schwartz, I M

    1989-11-01

    It has been estimated that as many as 12%-15% of the nations 63 million children are in need of mental health treatment. We have a responsibility to do everything we can to see to it that these children receive the services they need. Unfortunately, there is mounting evidence that a significant proportion of our health care resources are being misspent on the unnecessary and inappropriate hospitalization of children and youths in psychiatric and substance abuse treatment programs. More alarming is the evidence of poor quality programs, abusive practices, and greed. The intense competition to capture a "share of the market" and turn a profit or keep a nonprofit hospital from closing its doors is contributing to unprofessional and unethical advertising and public relations practices. In the end these practices will reflect poorly on the broader mental health and health care community. Hopefully, the stakeholders in the system will recognize these problems and assume a leadership role in turning the situation around. If not, we can expect intervention from forces outside the system (e.g., courts, elected public officials, public interest groups, the business community, and child advocates).

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

    Science.gov (United States)

    Macy, Rebecca J; Goodbourn, Melissa

    2012-10-01

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

  16. Changes in the treatment of abused children: a retrospective review of a practice.

    Science.gov (United States)

    Tsaltas, M O

    1994-01-01

    Using the population of sexually abused children from three periods of my practice, I have described changes in my practice of play therapy over the past 30 years. These changes have come about in part due to the pioneering work of psychiatrists specializing in studies of development in children not designated as emotionally disturbed or mentally ill (Chess and Thomas, 1986; Greenspan, 1981; Winnicott, 1953, 1965, 1971) as well those who have described treatment techniques and theoretical constructs of the experience of traumatized children (Finkelhor and Browne, 1985; Terr, 1991). Because of these convincing works, I have been able to shorten treatment, and shift my goals from direct efforts at unconscious conflict resolution to the more indirect but more effective method of re-establishing maturational tracks through involvement of families, dialogue with children in multiple play techniques as well as words, and to plan ahead for these traumatized children. It remains to be seen what the eventual outcome of this change in treatment will be. Although I always ask families and children to keep in touch even by postcard, only about 20% of them do. Naturally, these are families that are doing well. I am not sure that this necessarily means the other 80% are not doing well but I simply do not know. Because all of these patients are known to one authority or another (police, Rape Centers, courts and Department of Welfare) it should be possible to plan long-term studies of treatment outcome at the time of the initial contact. It seems important enough to me to do this because betrayed trust has a very long lag time before its full effects may be seen in the adults these children become. Because there are so many cases of child abuse, defining the relative effectiveness and efficacy of different kinds of treatment could be useful in managing what is, in effect, a public health problem.

  17. Ethical Implications in Vaccine Pharmacotherapy for Treatment and Prevention of Drug of Abuse Dependence.

    Science.gov (United States)

    Carfora, Anna; Cassandro, Paola; Feola, Alessandro; La Sala, Francesco; Petrella, Raffaella; Borriello, Renata

    2018-03-01

    Different immunotherapeutic approaches are in the pipeline for the treatment of drug dependence. "Drug vaccines" aim to induce the immune system to produce antibodies that bind to drugs and prevent them from inducing rewarding effects in the brain. Drugs of abuse currently being tested using these new approaches are opioids, nicotine, cocaine, and methamphetamine. In human clinical trials, "cocaine and nicotine vaccines" have been shown to induce sufficient antibody levels while producing few side effects. Studies in humans, determining how these vaccines interact in combination with their target drug, are underway. However, although vaccines can become a reasonable treatment option for drugs of abuse, there are several disadvantages that must be considered. These include i) great individual variability in the formation of antibodies, ii) the lack of protection against a structurally dissimilar drug that produces the same effects as the drug of choice, and iii) the lack of an effect on the drug desire that may predispose an addict to relapse. In addition, a comprehensive overview of several crucial ethical issues has not yet been widely discussed in order to have not only a biological approach to immunotherapy of addiction. Overall, immunotherapy offers a range of possible treatment options: the pharmacological treatment of addiction, the treatment of overdoses, the prevention of toxicity to the brain or the heart, and the protection of the fetus during pregnancy. So far, the results obtained from a small-scale experiment using vaccines against cocaine and nicotine suggest that a number of important technical challenges still need to be overcome before such vaccines can be approved for clinical use.

  18. A Longitudinal Study of Child Maltreatment and Mental Health Predictors of Admission to Psychiatric Residential Treatment Facilities

    Directory of Open Access Journals (Sweden)

    Roderick A. Rose

    2017-09-01

    Full Text Available The child welfare system is an access point for children’s mental health services. Psychiatric residential treatment facilities (PRTFs are the most restrictive, and most expensive setting for children to receive long-term care. Given the high rates of behavioral health concerns among maltreated children in out-of-home care, research is needed to examine the factors that predict entry in PRTFs among children investigated for maltreatment. This exploratory study used cross-sector administrative records linked across multiple systems, including child welfare records and Medicaid claims, from a single state over a five-year period (n = 105,982. Cox proportional hazards modeling was used to predict entry into a PRTF. After controlling for many factors, PRTF entry was predicted by diagnosis code indicating a trauma-related condition, antipsychotic medication prescriptions, and entry into lower levels of out-of-home care, supporting the view that youth are admitted to PRTFs largely due to clinical need. However, PRTF admission is also associated with characteristics of their experiences with the social service system, primarily foster care placement stability and permanency. Implications for practice and research are discussed.

  19. What Adolescents Need to Prevent Relapse after Treatment for Substance Abuse: A Comparison of Youth, Parent, and Staff Perspectives

    Science.gov (United States)

    Acri, Mary C.; Gogel, Leah P.; Pollock, Michele; Wisdom, Jennifer P.

    2012-01-01

    Objective: Little is known about what factors and supports youths identify as important for their sustained recovery after substance abuse treatment, and if their caregivers and treatment staff identify similar needs. The purpose of this study was to explore what youths, caregivers, and staff perceive as important to remain substance free after…

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

    Science.gov (United States)

    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…

  1. Evidence-based treatment for adult women with child abuse-related Complex PTSD: a quantitative review

    NARCIS (Netherlands)

    Dorrepaal, Ethy; Thomaes, Kathleen; Hoogendoorn, Adriaan W.; Veltman, Dick J.; Draijer, Nel; van Balkom, Anton J. L. M.

    2014-01-01

    Effective first-line treatments for posttraumatic stress disorder (PTSD) are well established, but their generalizability to child abuse (CA)-related Complex PTSD is largely unknown. A quantitative review of the literature was performed, identifying seven studies, with treatments specifically

  2. Specific job anxiety in comparison to general psychosomatic symptoms at admission, discharge and six months after psychosomatic inpatient treatment.

    Science.gov (United States)

    Muschalla, Beate; Linden, Michael

    2012-01-01

    Job anxiety is a severe problem in many patients with chronic mental disorders, as it usually results in specific participation problems in the workplace and long-term sick leave. The aim of this study was to explore the development of sick leave in dependence on general psychosomatic complaints and job anxiety from admission to a psychosomatic inpatient treatment until 6 months after discharge. A convenience sample of 91 patients, suffering from multiple mental disorders, filled in self-rating questionnaires on job anxiety (Job Anxiety Scale) and on general psychosomatic symptom load (Symptom Checklist-90-Revised) at the beginning, the end, and 6 months after discharge from an inpatient psychosomatic treatment. Additionally, sick leave status and employment status were assessed before and 6 months after the treatment. 15.4% of 91 patients were on sick leave before inpatient treatment and at follow-up (SS group), 20.9% were fit for work at intake and follow-up (FF group), 6.6% were fit for work initially and on sick leave later (FS group), and 57.1% on sick leave first and working at follow-up (SF group). In regard to general psychosomatic complaints, there were initially high scores on the SCL, a marked reduction during inpatient treatment, and a bouncing back to initial levels at follow-up for all 4 patient groups. SS and FS patients showed the highest scores at intake and follow-up. Concerning job anxiety, SS patients had the highest scores at all three assessments, while FF patients had significantly lower scores, with only low variation between assessments. SF patients started with comparatively high scores of job anxiety, which even increased before reentering work, but decreased in the follow-up period when they were confronted with work again. FS patients started low (like the FF patients) at intake, reduced their job anxiety further till discharge, but increased to higher scores at follow-up. General psychosomatic symptom load and job anxiety show a

  3. The Use of Art and Music Therapy in Substance Abuse Treatment Programs

    Science.gov (United States)

    Aletraris, Lydia; Paino, Maria; Edmond, Mary Bond; Roman, Paul M.; Bride, Brian E.

    2014-01-01

    While the implementation of evidence-based practices (EBPs) in the treatment of substance use disorders (SUD) has attracted substantial research attention, little consideration has been given to parallel implementation of complementary and alternative medical (CAM) practices. Using data from a nationally representative sample (N = 299) of U.S. substance abuse treatment programs, this study modeled organizational factors falling in the domains of patient characteristics, treatment ideologies, and structural characteristics, associated with the use of art therapy and music therapy. We found that 36.8% of treatment programs offered art therapy and 14.7% of programs offered music therapy. Programs with a greater proportion of women were more likely to use both therapies, and programs with larger proportions of adolescents were more likely to offer music therapy. In terms of other treatment ideologies, programs’ use of Motivational Enhancement Therapy (MET) was positively related to offering art therapy, while use of Contingency Management (CM) was positively associated with offering music therapy. Finally, our findings showed a significant relationship between requiring 12-step meetings and the use of both art therapy and music therapy. With increasing use of CAM in a diverse range of medical settings, and recent federal legislation likely to reduce barriers in accessing CAM, the inclusion of CAM in addiction treatment is growing in importance. Our findings suggest treatment programs may be utilizing art and music therapies to address unique patient needs of women and adolescents. PMID:25514689

  4. The use of art and music therapy in substance abuse treatment programs.

    Science.gov (United States)

    Aletraris, Lydia; Paino, Maria; Edmond, Mary Bond; Roman, Paul M; Bride, Brian E

    2014-01-01

    Although the implementation of evidence-based practices in the treatment of substance use disorders has attracted substantial research attention, little consideration has been given to parallel implementation of complementary and alternative medical (CAM) practices. Using data from a nationally representative sample (N = 299) of U.S. substance abuse treatment programs, this study modeled organizational factors falling in the domains of patient characteristics, treatment ideologies, and structural characteristics, associated with the use of art therapy and music therapy. We found that 36.8% of treatment programs offered art therapy and 14.7% of programs offered music therapy. Programs with a greater proportion of women were more likely to use both therapies, and programs with larger proportions of adolescents were more likely to offer music therapy. In terms of other treatment ideologies, programs' use of Motivational Enhancement Therapy was positively related to offering art therapy, whereas use of contingency management was positively associated with offering music therapy. Finally, our findings showed a significant relationship between requiring 12-step meetings and the use of both art therapy and music therapy. With increasing use of CAM in a diverse range of medical settings and recent federal legislation likely to reduce barriers in accessing CAM, the inclusion of CAM in addiction treatment is growing in importance. Our findings suggest treatment programs may be utilizing art and music therapies to address unique patient needs of women and adolescents.

  5. Decision-making authority and substance abuse treatment for adolescents: a survey of state laws.

    Science.gov (United States)

    Lallemont, Tori; Mastroianni, Anna; Wickizer, Thomas M

    2009-04-01

    State laws concerning decision-making authority for voluntary inpatient substance abuse (SA) treatment of minors may be a potential barrier to appropriate treatment. We sought to identify and classify relevant laws related to the provision of voluntary inpatient SA treatment to adolescents 12 to 17 years (minors) as an exploratory assessment to improve understanding of how these laws might affect treatment decisions. In summer 2006, we conducted a survey of statutes, regulations, and legal cases in the 50 states and the District of Columbia regarding the authority of parents (or guardians) and minors to make treatment decisions for voluntary inpatient SA treatment. All 50 states have laws applicable to voluntary inpatient SA treatment for adolescents, and the laws vary significantly throughout the nation. If a minor and parent disagree about SA treatment, some states defer to the decision-making authority of the minor, whereas other states defer to the parent. Most significantly, the majority of states fail to specify whether the minor's or the parent's decision will control in the event of a conflict. The lack of clarity in state laws regarding decision-making authority for voluntary inpatient SA treatment of minors may create a potential barrier to treatment for adolescents, especially those with more serious SA problems. This lack of clarity could lead to confusion among parents, adolescents, healthcare professionals, and treatment facilities, and ultimately could result in a failure to treat adolescents in need of medical attention. Policymakers should ensure that state laws clearly specify procedures to enable treatment if a conflict arises between adolescents and parents, including procedures to ensure that the due process rights of adolescents are protected.

  6. Workforce Diversity in Outpatient Substance Abuse Treatment: The Role of Leaders’ Characteristics

    Science.gov (United States)

    Guerrero, Erick G.

    2012-01-01

    Although the outpatient substance abuse treatment field has seen an increase in referrals of African American and Latino clients, there have been limited changes in the diversity of the workforce. This discordance may exacerbate treatment disparities experienced by these clients. Program leaders have significant influence to leverage resources to develop staff diversity. Analysis of panel data from 1995 to 2005 showed that the most significant predictors of diversity were the characteristics of leaders. In particular, programs with managers with racially and ethnically concordant backgrounds and their education level were positively related to the percentage of Latino and African American staff. A high percentage of African American staff was positively associated with managers’ tenure, but inversely related to licensed directors. Diversification of the field has increased, yet efforts have not matched increases in client diversity. Implications for health care reform legislation seeking to improve cultural competence through diversification of the workforce are discussed. PMID:22658932

  7. Workforce diversity in outpatient substance abuse treatment: the role of leaders' characteristics.

    Science.gov (United States)

    Guerrero, Erick G

    2013-02-01

    Although the outpatient substance abuse treatment field has seen an increase in referrals of African American and Latino clients, there have been limited changes in the diversity of the workforce. This discordance may exacerbate treatment disparities experienced by these clients. Program leaders have significant influence to leverage resources to develop staff diversity. Analysis of panel data from 1995 to 2005 showed that the most significant predictors of diversity were the characteristics of leaders. In particular, programs with managers with racially and ethnically concordant backgrounds and their education level were positively related to the percentage of Latino and African American staff. A high percentage of African American staff was positively associated with managers' tenure, but inversely related to licensed directors. Diversification of the field has increased, yet efforts have not matched increases in client diversity. Implications for health care reform legislation seeking to improve cultural competence through diversification of the workforce are discussed. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Fixed and dynamic predictors of treatment process in therapeutic communities for substance abusers in Belgium.

    Science.gov (United States)

    Goethals, Ilse; Vanderplasschen, Wouter; Vandevelde, Stijn; Broekaert, Eric

    2012-10-11

    Research on substance abuse treatment services in general reflects substantial attention to the notion of treatment process. Despite the growing popularity of process studies, only a few researchers have used instruments specifically tailored to measure the therapeutic community (TC) treatment process, and even fewer have investigated client attributes in relation to early TC treatment process experiences. The aim of the current study is to address this gap by exploring clients' early in-treatment experiences and to determine the predictors that are related to the treatment process, using a TC-specific multidimensional instrument. Data was gathered among 157 adults in five TCs in Flanders (Belgium). Descriptive statistics were used to explore clients' early in-treatment experiences and multiple linear regressions were conducted to determine the fixed and dynamic predictors of Community Environment and Personal Development and Change (two indicators of TC treatment process). Clients reveal a more positive first-month response to TC social processes than to personal-development processes that require self-reflection and insight. The variance in clients' ratings of Community Environment was primarily due to dynamic client factors, while the variance in clients' ratings of Personal Development and Change was only related to fixed client factors. Suitability for treatment was the strongest predictor of Community Environment ratings, whereas a judicial referral more strongly predicted Personal Development and Change scores. Special attention should be devoted to suitability for treatment as part of motivational assessment as this seems to be a very strong predictor of how clients react to the initiation stage of TC treatment. To help improve clients' (meta-)cognitive skills needed to achieve insight and self-reflection and perhaps speed up the process of recovery, the authors suggest the introduction of (meta-)cognitive training strategies in the pre-program and/or the

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

    Science.gov (United States)

    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

  10. The comparition of Personality Patterns, irrational beliefs and impulsivity in males with with drug abuse disorder under Treatment

    Directory of Open Access Journals (Sweden)

    samere asadi

    2015-03-01

    Full Text Available Objective: the aim of this research was to determine the difference between personality Patterns, irrational beliefs and impulsivity in men with drug abuse disorder under Treatment. Method: in this casual- comparative research, 80 men ( 40 males with drug abuse under Treatment and 40 of normal males that were selected with available sampling .Groups were matched in terms of demoghraphy characteristics ( age, sexuality, education level and marital status and were valued with means of Eysenk Perceived Stress Inventory, Jonze Irrational Beliefs Scale and Baret Impulsivity Inventory. Results: The result of variance analysis showed that addicts compared to normal people, get more scores on extraversion, neuroticism and psychosis. Addicts group had Higher men scores in irrational beliefs compare of other group. There was significant difference between groups in impulsivity and impulsivity in addicts persons is the most. Conclussion: The traits of Personality, irrational beliefs and Unrealistic and high level impulsivity are factors that propel individuals toward more drug abuse and finally addict and aiming this factors in individuals with abuse disorder under Treatment can lead to prevent of Substance Abuse Relapse.

  11. Effects of Methadone Maintenance Treatment on Decision-Making Processes in Heroin-Abusers: A Cognitive Modeling Analysis

    Directory of Open Access Journals (Sweden)

    Arash Khodadadi

    2010-05-01

    Full Text Available A B S T R A C TIntroduction: Although decision-making processes have become a principal target of study among addiction researchers, few researches are published according to effects of different treatment methods on the cognitive processes underlying decision making up to now. Utilizing cognitive modeling method, in this paper we examine the effects of Methadone maintenance treatment (MMT on cognitive processes underlying decision-making disorders in heroin-abusers. Methods: For this purpose, for the first time, we use the balloon analog risk task (BART to assess the decision-making ability of heroin-abusers before and after treatment and compare it to the non heroin-dependent subjects. Results: Results demonstrate that heroin-abusers show more risky behavior than other groups. But, there is no difference between the performance of heroin-abusers after 6 months of MMT and control group. Modeling subjects’ behavior in BART reveals that poor performance in heroin-abusers is due to reward-dependency and insensitivity to evaluation. Discussion: Results show that 6 months of MMT decreases reward-dependency and increases sensitivity to evaluation.

  12. Pharmacologically-mediated reactivation and reconsolidation blockade of the psychostimulant-abuse circuit: A novel treatment strategy

    Science.gov (United States)

    Lee, Tong H.; Szabo, Steven T.; Fowler, J. Corey; Mannelli, Paolo; Mangum, O. Barry; Beyer, Wayne F.; Patkar, Ashwin; Wetsel, William C.

    2012-01-01

    Psychostimulant abuse continues to present legal, socioeconomic and medical challenges as a primary psychiatric disorder, and represents a significant comorbid factor in major psychiatric and medical illnesses. To date, monotherapeutic drug treatments have not proven effective in promoting long-term abstinence in psychostimulant abusers. In contrast to clinical trials utilizing monotherapies, combinations of dopamine (DA) agonists and selective 5-HT3, 5HT2A/2C, or NK1 antagonists have shown robust efficacy in reversing behavioral and neurobiological alterations in animal models of psychostimulant abuse. One important temporal requirement for these treatments is that the 5-HT or NK1 receptor antagonist be given at a critical time window after DA agonist administration. This requirement may reflect a necessary dosing regimen towards normalizing underlying dysfunctional neural circuits and “addiction memory” states. Indeed, chronic psychostimulant abuse can be conceptualized as a consolidated form of dysfunctional memory maintained by repeated drug- or cue-induced reactivation of neural circuit and subsequent reconsolidation. According to this concept, the DA agonist given first may reactivate this memory circuit, thereby rendering it transiently labile. The subsequent antagonist is hypothesized to disrupt reconsolidation necessary for restabilization, thus leading progressively to a therapeutically-mediated abolishment of dysfunctional synaptic plasticity. We propose that long-term abstinence in psychostimulant abusers may be achieved not only by targeting putative mechanistic pathways, but also by optimizing drug treatment regimens designed to disrupt the neural processes underlying the addicted state. PMID:22356892

  13. Predictors of residential treatment retention among individuals with co-occurring substance abuse and mental health disorders.

    Science.gov (United States)

    Choi, Sam; Adams, Susie M; MacMaster, Samuel A; Seiters, John

    2013-01-01

    A significant number of individuals with co-occurring substance abuse and mental health disorders do not engage, stay, and/or complete residential treatment. The purpose of this study is to identify factors during the initial phase of treatment which predict retention in private residential treatment for individuals with co-occurring substance use and mental health disorders. The participants were 1,317 individuals with co-occurring substance abuse and mental health disorders receiving treatment at three residential treatment centers located in Memphis, TN, Malibu, CA, and Palm Springs, CA. Bivariate analysis and logistic regression were utilized to identify factors that predict treatment retention at 30 days. The findings indicate a variety of factors including age, gender, types of drug, Addiction Severity Index Medical and Psychiatric scores, and readiness to change. These identified factors could be incorporated into pretreatment assessments, so that programs can initiate preventive measures to decrease attrition and improve treatment outcomes.

  14. Behavioral Couples Treatment for Substance Use Disorder: Secondary Effects on the Reduction of Risk for Child Abuse.

    Science.gov (United States)

    Kelley, Michelle L; Bravo, Adrian J; Braitman, Abby L; Lawless, Adrienne K; Lawrence, Hannah R

    2016-03-01

    Risk for child abuse was examined prior to and after behavioral couples treatment (BCT) among 61 couples in which one or both parents were diagnosed with substance use disorder (SUD). All couples were residing with one or more school-age children. Mothers and fathers completed pretreatment, post-intervention, and 6-month post-intervention follow-up assessments. Results of piecewise latent growth models tested whether the number of BCT sessions attended and number of days abstinent from drugs and alcohol influenced relationship satisfaction and its growth over time, and in turn if relationship satisfaction and change in relationship satisfaction influenced risk for child abuse. For both mothers and fathers, attending more BCT sessions lead to a direct increase in relationship satisfaction, which in turn led to stronger reductions in risk for child abuse. This effect was maintained from the post-intervention through the 6-month post-intervention follow-up. For fathers, number of days abstinent significantly influenced reduction in child abuse potential at post-intervention via relationship satisfaction. This indirect effect was not present for mothers. The overall benefits of BCT on mothers' and fathers' risk for child abuse suggest that BCT may have promise in reducing risk for child abuse among couples in which one or both parents have SUD. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2014-01-01

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

  16. Barriers to accessing substance abuse treatment in Mexico: national comparative analysis by migration status

    Science.gov (United States)

    2014-01-01

    Background We examined Mexican migrants’ perceived barriers to entering substance abuse treatment and potential differences by gender. Methods This study analyzed a subset of household data collected in Mexico in 2011 via the Encuesta Nacional de Adicciones (National Survey of Addictions). A sample of 1,143 individuals who reported using illicit drugs was analyzed using multivariate negative binomial models to determine direct and moderated relationships of gender, migrant status, and drug dependence with perceived barriers to accessing treatment. Results Significant findings included disparities in drug dependence by migrant status. Compared with non-migrant men, women who have traveled to the United States was associated with fewer (1.3) barriers to access treatment. Fewer barriers to access care were associated with individuals residing in other regions of the country, compared to those living in Mexico City. Conclusions Drug dependence, gender, migration status and regional location are factors associated with access to needed treatment. Implications for health care policy to develop treatment services infrastructure and for future research are discussed in the context of ongoing drug policy reform in Mexico. PMID:25074067

  17. Cigarette Smoking During Substance Use Disorder Treatment: Secondary Outcomes from a National Drug Abuse Treatment Clinical Trials Network study.

    Science.gov (United States)

    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

    2015-06-01

    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. 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). 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. 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. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. A reinforcement-based therapeutic workplace for the treatment of drug abuse: six-month abstinence outcomes.

    Science.gov (United States)

    Silverman, K; Svikis, D; Robles, E; Stitzer, M L; Bigelow, G E

    2001-02-01

    This study evaluated a novel drug abuse treatment, the Therapeutic Workplace. In this treatment, patients are paid to perform jobs or to participate in job training. Salary is linked to abstinence by requiring patients to provide drug-free urine samples to gain access to the workplace. Pregnant and postpartum drug abuse patients (N = 40) were randomly assigned to a Therapeutic Workplace or usual care control group. Therapeutic Workplace participants were invited to work 3 hr every weekday for 6 months and could earn up to $4,030 in vouchers for abstinence, workplace attendance, and performance. On average, 45% of participants attended the workplace per day. Relative to controls, the Therapeutic Workplace nearly doubled patients' abstinence from opiates and cocaine (33% vs. 59% of thrice-weekly urine samples drug negative, respectively, p Workplace can effectively treat heroin and cocaine abuse in pregnant and postpartum women.

  19. Accelerating cocaine metabolism as an approach to the treatment of cocaine abuse and toxicity

    Science.gov (United States)

    Schindler, Charles W; Goldberg, Steven R

    2012-01-01

    One pharmacokinetic approach to the treatment of cocaine abuse and toxicity involves the development of compounds that can be safely administered to humans and that accelerate the metabolism of cocaine to inactive components. Catalytic antibodies have been developed and shown to accelerate cocaine metabolism, but their catalytic efficiency for cocaine is relatively low. Mutations of human butyrylcholinesterase and a bacterial cocaine esterase found in the soil of coca plants have also been developed. These compounds accelerate cocaine metabolism and antagonize the behavioral and toxic effects of cocaine in animal models. Of these two approaches, the human butyrylcholinesterase mutants show the most immediate promise as they would not be expected to evoke an immune response in humans. PMID:22300096

  20. Managerial capacity and adoption of culturally competent practices in outpatient substance abuse treatment organizations.

    Science.gov (United States)

    Guerrero, Erick G

    2010-12-01

    The field of cultural competence is shifting its primary emphasis from enhancement of counselors' skills to management, organizational policy, and processes of care. This study examined managers' characteristics associated with adoption of culturally competent practices in the nation's outpatient substance abuse treatment field. Findings indicate that in 1995, supervisors' cultural sensitivity played the most significant role in adopting practices, such as matching counselors and clients based on race and offering bilingual services. Staff's exposure to cross-cultural training increased from 1995 to 2005. In this period, positive associations were found between managers' cultural sensitivity and connection with the community and staff receiving cross-cultural training and the number of training hours completed. However, exposure to and investment in this training were negatively correlated with managers' formal education. Health administration policy should consider the extent to which the decision makers' education, community involvement, and cultural sensitivity contribute to building culturally responsive systems of care. Copyright © 2010 Elsevier Inc. All rights reserved.

  1. How Serious of a Problem is Staff Turnover in Substance Abuse Treatment? A Longitudinal Study of Actual Turnover1

    Science.gov (United States)

    Eby, Lillian T.; Burk, Hannah; Maher, Charleen P.

    2010-01-01

    In the substance abuse treatment field, the annual turnover rate is cited as being anywhere between 19 and 50 percent (Johnson & Roman, 2002; Gallon, Gabriel, & Knudsen, 2003; Knudsen et al., 2003; McLellan et al., 2003). However, no research to date has evaluated these claims by tracking turnover longitudinally using organizational turnover data from substance abuse treatment centers. This research presents the results of a longitudinal study designed to systematically examine actual turnover among counselors and clinical supervisors. Twenty-seven geographically dispersed treatment organizations, serving a wide range of clients in the public and private sector, provided data for the study over a two year time span (2008–2009). The annual turnover rate was 33.2% for counselors and 23.4% for clinical supervisors. For both groups the majority of turnover was voluntary (employee-initiated). Specific reasons for turnover were largely consistent across the two groups, with the most common reason being a new job or new opportunity. The findings are discussed in terms of the unique employment context of substance abuse treatment. Practical recommendations are also discussed to help stem the tide of turnover in the field of substance abuse treatment. PMID:20675097

  2. How serious of a problem is staff turnover in substance abuse treatment? A longitudinal study of actual turnover.

    Science.gov (United States)

    Eby, Lillian T; Burk, Hannah; Maher, Charleen P

    2010-10-01

    In the substance abuse treatment field, the annual turnover rate is cited as being anywhere between 19% and 50% (J.A. Johnson & P.M. Roman, 2002; S.L. Gallon, R.M. Gabriel, J.R.W. Knudsen, 2003; H.K. Knudsen, J.A. Johnson, & P.M. Roman, 2003; A.T. McLellan, D. Carise, & H.D. Kleber, 2003). However, no research to date has evaluated these claims by tracking turnover longitudinally using organizational turnover data from substance abuse treatment centers. This research presents the results of a longitudinal study designed to systematically examine actual turnover among counselors and clinical supervisors. Twenty-seven geographically dispersed treatment organizations, serving a wide range of clients in the public and private sector, provided data for the study over a 2-year time span (2008-2009). The annual turnover rate was 33.2% for counselors and 23.4% for clinical supervisors. For both groups, the majority of turnover was voluntary (employee-initiated). Specific reasons for turnover were largely consistent across the two groups, with the most common reason being a new job or new opportunity. The findings are discussed in terms of the unique employment context of substance abuse treatment. Practical recommendations are also discussed to help stem the tide of turnover in the field of substance abuse treatment. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  3. Trends in sociodemographic and drug abuse variables in patients with alcohol and drug use disorders in a Nigerian treatment facility.

    Science.gov (United States)

    Adamson, T A; Onifade, P O; Ogunwale, A

    2010-01-01

    Globally, patterns of the use of psychoactive substances have been changing. To evaluate the trend in two five year periods, 1992 to 1997 versus 2002 to 2007, of alcohol and substance use disorders and associated variables in patients admitted to a drug abuse treatment facility. This was a comparative cross-sectional study involving all patients admitted into Drug Abuse Treatment, Education, and Research (DATER), Unit of the Neuropsychiatric Hospital, Aro, Nigeria within the study period. All subjects had a structured psychiatric interview, a physical examination, laboratory investigations and DATER Questionnaire protocols that elicited socio-demographic, drug and family variables. The patients in 2002 to 2007 versus those of 1992 to 1997 were younger (chi squared 13.29; p,0.01). More last borns were using drugs by 2002 to 2007 (chi squared, 11.37; p,0.01). Cannabis was the most abused drug in 2002 to 2007 (53.5%) as compared to cocaine (44%) in 1992 to 1997 (chi squared 35.5; p,0.001). Polydrug abuse was high in the two periods but significantly the drug combination changed to cannabis in combination with alcohol in 2002 to 2007 as against cocaine in combination with opiates in 1992 to 1997 chi squared 45.3, p 0.001). More patients had co-morbid psychiatric disorders in 2000 to 2007 (67.6% as against 38.5% in 1992 to 1999 chi squared 28.32, p,0.001). In both periods, co-morbidity associated with cannabis use rather than any other drug of abuse as the odds ratio was greater than one. The findings in the trend in the two five year periods underscore the imperatives of continuous evaluation of the drug abuse patient population in treatment which may help drive changes in treatment inputs.

  4. Changes in the sexual self-schema of women with a history of childhood sexual abuse following expressive writing treatment.

    Science.gov (United States)

    Pulverman, Carey S; Boyd, Ryan L; Stanton, Amelia M; Meston, Cindy M

    2017-03-01

    Sexual self-schemas are cognitive generalizations about the sexual self that influence the processing of sexually pertinent information and guide sexual behavior. Until recently sexual self-schemas were exclusively assessed with self-report instruments. Recent research using the meaning extraction method, an inductive method of topic modeling, identified 7 unique themes of sexual self-schemas: family and development, virginity, abuse, relationship, sexual activity, attraction, and existentialism from essays of 239 women (Stanton, Boyd, Pulverman, & Meston, 2015). In the current study, these themes were used to examine changes in theme prominence after an expressive writing treatment. Women (n = 138) with a history of childhood sexual abuse completed a 5-session expressive writing treatment, and essays on sexual self-schemas written at pretreatment and posttreatment were examined for changes in themes. Women showed a reduction in the prominence of the abuse, family and development, virginity, and attraction themes, and an increase in the existentialism theme. This study supports the validity of the 7 themes identified by Stanton and colleagues (2015) and suggests that expressive writing may aid women with a history of sexual abuse to process their abuse history such that it becomes a less salient aspect of their sexual self-schemas. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  5. Technology transfer for the implementation of a clinical trials network on drug abuse and mental health treatment in Mexico.

    Science.gov (United States)

    Horigian, Viviana E; Marín-Navarrete, Rodrigo A; Verdeja, Rosa E; Alonso, Elizabeth; Perez, María A; Fernández-Mondragón, José; Berlanga, Carlos; Medina-Mora, María Elena; Szapocznik, José

    2015-09-01

    Low- and middle-income countries (LMIC) lack the research infrastructure and capacity to conduct rigorous substance abuse and mental health effectiveness clinical trials to guide clinical practice. A partnership between the Florida Node Alliance of the United States National Drug Abuse Treatment Clinical Trials Network and the National Institute of Psychiatry in Mexico was established in 2011 to improve substance abuse practice in Mexico. The purpose of this partnership was to develop a Mexican national clinical trials network of substance abuse researchers and providers capable of implementing effectiveness randomized clinical trials in community-based settings. A technology transfer model was implemented and ran from 2011-2013. The Florida Node Alliance shared the "know how" for the development of the research infrastructure to implement randomized clinical trials in community programs through core and specific training modules, role-specific coaching, pairings, modeling, monitoring, and feedback. The technology transfer process was bi-directional in nature in that it was informed by feedback on feasibility and cultural appropriateness for the context in which practices were implemented. The Institute, in turn, led the effort to create the national network of researchers and practitioners in Mexico and the implementation of the first trial. A collaborative model of technology transfer was useful in creating a Mexican researcher-provider network that is capable of changing national practice in substance abuse research and treatment. Key considerations for transnational technology transfer are presented.

  6. Customizing monoclonal antibodies for the treatment of methamphetamine abuse: current and future applications.

    Science.gov (United States)

    Peterson, Eric C; Gentry, W Brooks; Owens, S Michael

    2014-01-01

    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 suggests a scientific vision for how intact monoclonal antibody (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 and single-chain variable fragments 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 METH is the disease target instead of vulnerable central nervous system networks of receptors, binding sites, and neuronal connections. © 2014 Elsevier Inc. All rights reserved.

  7. Substance abuse and batterer programmes in California, USA: factors associated with treatment outcomes.

    Science.gov (United States)

    Timko, Christine; Valenstein, Helen; Stuart, Gregory L; Moos, Rudolf H

    2015-11-01

    The association between substance abuse and intimate partner violence is quite robust. A promising area to improve treatment for the dual problems of substance abuse and violence perpetration is the identification of client characteristics and organisational and programme factors as predictors of health outcomes. Therefore, we examined associations of client, organisational and programme factors with outcomes in community health settings. Directors of 241 substance use disorder programmes (SUDPs) and 235 batterer intervention programmes (BIPs) reported outcomes of programme completion and substance use and violence perpetration rates at discharge; data collection and processing were completed in 2012. SUDPs having more female, non-white, younger, uneducated, unemployed and lower income clients reported lower completion rates. In SUDPs, private, for-profit programmes reported higher completion rates than public or private, non-profit programmes. SUDPs with lower proportions of their budgets from government sources, and higher proportions from client fees, reported better outcomes. Larger SUDPs had poorer programme completion and higher substance use rates. Completion rates in SUDPs were higher when clients could obtain substance- and violence-related help at one location, and programmes integrated violence-prevention contracting into care. In BIPs, few client, organisational and programme factors were associated with outcomes, but the significant factors associated with programme completion were consistent with those for SUDPs. Publicly owned and larger programmes, and SUDPs lacking staff to integrate violence-related treatment, may be at risk of poorer client outcomes, but could learn from programmes that perform well to yield better outcomes. © 2014 John Wiley & Sons Ltd.

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

    Science.gov (United States)

    Camp, J M; Finkelstein, N

    1997-01-01

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

  9. Predicting substance-abuse treatment providers' communication with clients about medication assisted treatment: a test of the theories of reasoned action and planned behavior.

    Science.gov (United States)

    Roberto, Anthony J; Shafer, Michael S; Marmo, Jennifer

    2014-01-01

    The purpose of this investigation is to determine if the theory of reasoned action (TRA) and theory of planned behavior (TPB) can retrospectively predict whether substance-abuse treatment providers encourage their clients to use medicated-assisted treatment (MAT) as part of their treatment plan. Two-hundred and ten substance-abuse treatment providers completed a survey measuring attitudes, subjective norms, perceived behavioral control, intentions, and behavior. Results indicate that substance-abuse treatment providers have very positive attitudes, neutral subjective norms, somewhat positive perceived behavioral control, somewhat positive intentions toward recommending MAT as part of their clients' treatment plan, and were somewhat likely to engage in the actual behavior. Further, the data fit both the TRA and TPB, but with the TPB model having better fit and predictive power for this target audience and behavior. The theoretical and practical implications for the developing messages for substance-abuse treatment providers and other health-care professionals who provide treatment to patients with substance use disorders are discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Thiamine for prevention and treatment of Wernicke-Korsakoff Syndrome in people who abuse alcohol.

    Science.gov (United States)

    Day, Ed; Bentham, Peter W; Callaghan, Rhiannon; Kuruvilla, Tarun; George, Sanju

    2013-07-01

    Autopsy studies suggest that Wernicke-Korsakoff syndrome (WKS) is not a rare disorder, particularly in individuals who abuse alcohol. Thiamine has been established as the treatment of choice for over 50 years, but uncertainty remains about appropriate dosage and duration. Current practice guidelines are based on case reports and clinical experience. This is an update of a review first published in 2004 and last updated in 2008. • To assess the efficacy of thiamine in preventing and treating the manifestations of WKS due to excess alcohol consumption. • To determine the optimum form, dose and duration of thiamine treatment for this indication. ALOIS, the Specialized Register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG), The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL and LILACS were searched on 6 September 2012 using the term thiamine OR aneurine. ALOIS contains records from all major health care databases (The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, LILACS) as well as from many trial databases and grey literature sources. Any randomised trials comparing thiamine with alternative interventions or comparing different thiamine regimens (varying in formulation, dose or duration of administration). All abstracts were independently inspected by two reviewers (ED and PWB), and relevant articles were retrieved and assessed for methodological quality using criteria provided in the Cochrane Handbook for Systematic Reviews of Interventions. Two studies were identified that met the inclusion criteria, but only one contained sufficient data for quantitative analysis. Ambrose (2001) randomly assigned participants (n = 107) to one of five doses of intramuscular thiamine and measured outcomes after 2 days of treatment. We compared the lowest dose (5 mg/day) with each of the other four doses. A significant difference favoured 200 mg/day compared with the 5-mg/day dose in determining the number of trials needed to meet inclusion criteria

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

    Science.gov (United States)

    Cheng, Tyrone C; Lo, Celia C

    2014-01-01

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

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

    Science.gov (United States)

    Humphreys, Keith

    1998-01-01

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

  13. Targeted Expansion Project for Outreach and Treatment for Substance Abuse and HIV Risk Behaviors in Asian and Pacific Islander Communities

    Science.gov (United States)

    Nemoto, Tooru; Iwamoto, Mariko; Kamitani, Emiko; Morris, Anne; Sakata, Maria

    2011-01-01

    Access to culturally competent HIV/AIDS and substance abuse treatment and prevention services is limited for Asian and Pacific Islanders (APIs). Based on the intake data for a community outreach project in the San Francisco Bay Area (N = 1,349), HIV risk behaviors were described among the targeted API risk groups. The self-reported HIV prevalence…

  14. Wireless Technologies, Ubiquitous Computing and Mobile Health: Application to Drug Abuse Treatment and Compliance with HIV Therapies.

    Science.gov (United States)

    Boyer, Edward W; Smelson, David; Fletcher, Richard; Ziedonis, Douglas; Picard, Rosalind W

    2010-06-01

    Beneficial advances in the treatment of substance abuse and compliance with medical therapies, including HAART, are possible with new mobile technologies related to personal physiological sensing and computational methods. When incorporated into mobile platforms that allow for ubiquitous computing, these technologies have great potential for extending the reach of behavioral interventions from clinical settings where they are learned into natural environments.

  15. Using Case-Mix Adjustment Methods To Measure the Effectiveness of Substance Abuse Treatment: Three Examples Using Client Employment Outcomes.

    Science.gov (United States)

    Koenig, Lane; Fields, Errol L.; Dall, Timothy M.; Ameen, Ansari Z.; Harwood, Henrick J.

    This report demonstrates three applications of case-mix methods using regression analysis. The results are used to assess the relative effectiveness of substance abuse treatment providers. The report also examines the ability of providers to improve client employment outcomes, an outcome domain relatively unexamined in the assessment of provider…

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

    Science.gov (United States)

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

    2008-12-01

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

  17. A Study of the Trend and Extent of Drug Abuse Among Drug ...

    African Journals Online (AJOL)

    The findings show that drug-abusers are predominantly males, single, unskilled workers, traders, unemployed and civil servants. Psychiatric hospitals and rehabilitation centres served as treatment centres for participants with previous admission records. Drug therapy, psychotherapy and occupational therapy were the ...

  18. Addiction and Women Gender Differences Concerning Drug Abuse and its Treatment

    Directory of Open Access Journals (Sweden)

    Fatemeh Safari

    2003-05-01

    Full Text Available This article focuses on the quantitative grounds for the emergence and spread of addiction among women, its medical, social and psychological problems, impediments for the treatment of addiction among women as well as gender differences concerning drug abuse and its treatment. This article is a translation of a statistical research on addiction among women and a number of other researches. Based on conclusions drawn from the said researches, women become inclined to addiction mostly by their husbands due to their cordial relationships. Moreover, the negative attitudes of peer groups can overshadow girls and women more than boys and men. From the viewpoint of psychological disorders, the relationship between disorders resulting from psychological pressure after an incident and addiction is stronger among girls and women compared to boys and men. Addiction among women in addition to certain ailments such as malnutrition, hypertension and cancer, can expose them to dangerous diseases such as Hepatitis and AIDS. There is more possibility for addicted women to be infected with AIDS and other sexually transmitted diseases compared to men and they are more exposed to female ailments compared to other women. As far as treatment impediments are concerned, women face a greater social stigma due to their addiction compared to men. Social approach considering addicted women as an indecent person is a major impediment for their treatment. Taking care of the child is also another obstacle for their treatment. There is less possibility for women to receive support from their families for quitting their addiction compared to men. Treatment programs also unwantedly may create obstacles for the treatment of women such as financial constraints, administrative bureaucracy, concentration of treatment programs for men and lack of sensitivity towards women’s addiction. The psychological impediments to treatment include internalizing the notion that addiction is a

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

    Science.gov (United States)

    Kramer, R M

    1998-12-01

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

  20. National Institute on Drug Abuse International Program: improving opioid use disorder treatment through international research training.

    Science.gov (United States)

    Gust, Steven W; McCormally, Judy

    2018-07-01

    For more than 25 years, the National Institute on Drug Abuse (NIDA) has supported research-training programs, establishing a global research network and expanding the knowledge base on substance use disorders. International research to inform approaches to opioid addiction is particularly important and relevant to the United States, where opioid misuse, addiction, and overdose constitute an emerging public health crisis. This article summarizes the NIDA International Program and illustrates its impact by reviewing recent articles about treatment approaches for opioid use disorders (OUD). Studies in several countries have demonstrated the effectiveness of physician office-based opioid substitution therapies. Other research has demonstrated the effectiveness of different formulations and doses of the opioid antagonist naltrexone, as well as different approaches to providing naloxone to treat opioid overdose. Continuing research into implementation of evidence-based treatment in international settings with limited resources is applicable to US regions that face similar structural, legal, and fiscal constraints. The current review describes international research on OUD treatment and opioid overdose, most coauthored by former NIDA fellows. The findings from outside the United States have important implications for best practices domestically and in other countries that are experiencing increases in OUD prevalence and related overdose deaths.

  1. Review of the efficacy of treatments for bipolar disorder and substance abuse.

    Science.gov (United States)

    Secades-Álvarez, Adrián; Fernández-Rodríguez, Concepción

    The aim of this study was to provide a descriptive overview of different psychological and pharmacological interventions used in the treatment of patients with bipolar disorder and substance abuse, in order to determine their efficacy. A review of the current literature was performed using the databases Medline and PsycINFO (2005-2015). A total of 30 experimental studies were grouped according to the type of therapeutic modality described (pharmacological 19; psychological 11). Quetiapine and valproate have demonstrated superiority on psychiatric symptoms and a reduction in alcohol consumption, respectively. Group psychological therapies with education, relapse prevention and family inclusion have also been shown to reduce the symptomatology and prevent alcohol consumption and dropouts. Although there seems to be some recommended interventions, the multicomponent base, the lack of information related to participants during treatment, experimental control or the number of dropouts of these studies suggest that it would be irresponsible to assume that there are well established treatments. Copyright © 2016. Publicado por Elsevier España, S.L.U.

  2. The Effect of Using Assessment Instruments on Substance-abuse Outpatients' Adherence to Treatment: a Multi-centre Randomised Controlled Trial

    Directory of Open Access Journals (Sweden)

    Broekaert Eric

    2011-05-01

    Full Text Available Abstract Background Drop-out is an important problem in the treatment of substance use disorder. The focus of this study was to investigate the effectiveness of within treatment assessment with feedback directly to patients with multiple substance use disorder on outpatient individual treatment adherence. Feedback consisted of personal resources' and readiness to change status and progress that facilitate or hinder change, thereby using graphical representation. Methods Informed consent was obtained from both the control and experimental groups to be involved in research and follow-up. Following Zelen's single consent design, baseline participants (n = 280 were randomised (sample-size-estimation: 80%power, p=.05, 2-sided and treatment consent was obtained from those allocated to the experiment (n = 142. In both groups, equal numbers of patients did not attend sessions after allocation. So, 227 persons were analyzed according to intention-to-treat analysis (ITT: experiment n = 116;control n = 111. Excluding refusals 211 participants remained for per-protocol analysis (PP: experiment n = 100; control n = 111, The study was conducted in five outpatient treatment-centres of a large network (De Sleutel in Belgium. Participants were people with multiple substance use disorder -abuse and dependence- who had asked for treatment and who had been advised to start individual treatment after a standardised admission assessment with the European Addiction Severity Index. The experimental condition consisted of informing the patient about the intervention and of subsequent assessments plus feedback following a protocol within the first seven sessions. Assessments were made with the Readiness to Change Questionnaire and the Personal Resources Diagnostic System. The control group received the usual treatment without within treatment assessment with feedback. The most important outcome measure in this analysis of the study was the level of adherence to treatment

  3. Prescription Opioid Usage and Abuse Relationships: An Evaluation of State Prescription Drug Monitoring Program Efficacy

    Directory of Open Access Journals (Sweden)

    Richard M. Reisman

    2009-01-01

    Full Text Available Context The dramatic rise in the use of prescription opioids to treat non-cancer pain has been paralleled by increasing prescription opioid abuse. However, detailed analyses of these trends and programs to address them are lacking. Objective To study the association between state shipments of prescription opioids for medical use and prescription opioid abuse admissions and to assess the effects of state prescription drug monitoring programs (PDMPs on prescription opioid abuse admissions. Design and Setting A retrospective ecological cohort study comparing state prescription opioid shipments (source: Automation of Reports and Consolidated Orders Systems database and inpatient admissions for prescription opioid abuse (source: Treatment Episode Data Set in 14 states with PDMPs (intervention group and 36 states without PDMPs (control group for the period 1997–2003. Results From 1997 to 2003, oxycodone, morphine, and hydrocodone shipments increased by 479%, 100%, and 148% respectively. Increasing prescription oxycodone shipments were significantly associated with increasing prescription opioid admission rates (p < 0.001. PDMP states had significantly lower oxycodone shipments than the control group. PDMP states had less increase in prescription opioid admissions per year (p = 0.063. A patient admitted to an inpatient drug abuse rehabilitation program in a PDMP state was less likely to be admitted for prescription opioid drug abuse (Odds ratio = 0.775, 95% Confidence Interval 0.764–0.785. Conclusions PDMPs appear to decrease the quantity of oxycodone shipments and the prescription opioid admission rate for states with these programs. Overall, opioid shipments rose significantly in PDMP states during the study period indicating a negligible “chilling effect” on physician prescribing.

  4. Differential responsiveness to a parenting intervention for mothers in substance abuse treatment.

    Science.gov (United States)

    Paris, Ruth; Herriott, Anna; Holt, Melissa; Gould, Karen

    2015-12-01

    This study examines the relationship between levels of psychological distress in substance-dependent mothers and their differential response to a dyadic parent-child intervention. A sample of 66 mothers who were receiving treatment for substance abuse, as well as a simultaneous parenting intervention, were interviewed pre and post-treatment on measures of psychological distress, adult and child trauma history, parental reflective functioning, and child social-emotional development. Additionally, clinicians provided assessments of the parent-child relationships. As anticipated, trauma histories for mothers and children, children's social emotional development, and parental reflective functioning were associated with aspects of maternal psychological distress. Kruskal-Wallis and subsequent Wilcoxson signed rank tests revealed that women with highest levels of baseline psychological distress showed significant improvements in psychological functioning post-treatment while women with moderately elevated levels of psychological distress did not. Women who were most distressed at baseline showed increased levels of parental reflective functioning post-treatment while women with moderate and lower levels of baseline psychological distress showed improvements on clinician-rated assessments of parent-child relationships. Chi Square analyses showed that parents who endorsed the highest levels of distress at baseline reported that their children's risk status regarding social-emotional development decreased post-treatment. Despite similarities in substance dependence, mothers in this sample had different needs and outcomes in the context of this parenting intervention due to variation in mental health. Given this variation, parenting interventions for substance-dependent mothers need to account for the individual differences in levels of psychological distress. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Psychedelics as medicines for substance abuse rehabilitation: evaluating treatments with LSD, Peyote, Ibogaine and Ayahuasca.

    Science.gov (United States)

    Winkelman, Michael

    2014-01-01

    Substances known as psychedelics, hallucinogens and entheogens have been employed in ethnomedical traditions for thousands of years, but after promising uses in the 1950's and 1960's they were largely prohibited in medical treatment and human research starting in the 1970's as part of the fallout from the war on drugs. Nonetheless, there are a number of studies which suggest that these substances have potential applications in the treatment of addictions. While these substances are generally classified as Schedule I, alleging no established medical uses and a high drug abuse potential, there is nonetheless evidence indicating they might be safe and effective tools for short term interventions in addictions treatment. Evidence suggests that the psychedelics have a much greater safety profile than the major addictive drugs, having extremely low levels of mortality, and producing little if any physical dependence. This paper reviews studies evaluating the use of LSD, peyote, ibogaine and ayahuasca in the treatment of dependencies and the possible mechanisms underlying the indications of effectiveness. Evidence suggests that these substances help assist recovery from drug dependency through a variety of therapeutic mechanisms, including a notable "after-glow" effect that in part reflects their action on the serotonin neurotransmitter system. Serotonin has been long recognized as central to the psychedelics' well-known phenomenological, physical, emotional and cognitive dynamics. These serotonin-based dynamics are directly relevant to treatment of addiction because of depressed serotonin levels found in addict populations, as well as the role of serotonin as a neuromodulators affecting many other neurotransmitter systems.

  6. A genetic network model of cellular responses to lithium treatment and cocaine abuse in bipolar disorder

    Directory of Open Access Journals (Sweden)

    Keller Benjamin J

    2010-11-01

    Full Text Available Abstract Background Lithium is an effective treatment for Bipolar Disorder (BD and significantly reduces suicide risk, though the molecular basis of lithium's effectiveness is not well understood. We seek to improve our understanding of this effectiveness by posing hypotheses based on new experimental data as well as published data, testing these hypotheses in silico, and posing new hypotheses for validation in future studies. We initially hypothesized a gene-by-environment interaction where lithium, acting as an environmental influence, impacts signal transduction pathways leading to differential expression of genes important in the etiology of BD mania. Results Using microarray and rt-QPCR assays, we identified candidate genes that are differentially expressed with lithium treatment. We used a systems biology approach to identify interactions among these candidate genes and develop a network of genes that interact with the differentially expressed candidates. Notably, we also identified cocaine as having a potential influence on the network, consistent with the observed high rate of comorbidity for BD and cocaine abuse. The resulting network represents a novel hypothesis on how multiple genetic influences on bipolar disorder are impacted by both lithium treatment and cocaine use. Testing this network for association with BD and related phenotypes, we find that it is significantly over-represented for genes that participate in signal transduction, consistent with our hypothesized-gene-by environment interaction. In addition, it models related pharmacogenomic, psychiatric, and chemical dependence phenotypes. Conclusions We offer a network model of gene-by-environment interaction associated with lithium's effectiveness in treating BD mania, as well as the observed high rate of comorbidity of BD and cocaine abuse. We identified drug targets within this network that represent immediate candidates for therapeutic drug testing. Posing novel

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

    OpenAIRE

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

    2008-01-01

    This study examined suicide ideation, attempts, and subsequent mental health service among a sample of 948 youth from substance abuse treatment facilities across the U.S. Youth were surveyed at intake and every three months for a one year period. Thirty percent of youth reported ideating in at least one interview and 12% reported attempting suicide; almost half reported receiving outpatient mental health treatment at least once and close to one-third reported being on prescription drugs for a...

  8. Influence networks among substance abuse treatment clinics: implications for the dissemination of innovations.

    Science.gov (United States)

    Johnson, Kimberly; Quanbeck, Andrew; Maus, Adam; Gustafson, David H; Dearing, James W

    2015-09-01

    Understanding influence networks among substance abuse treatment clinics may speed the diffusion of innovations. The purpose of this study was to describe influence networks in Massachusetts, Michigan, New York, Oregon, and Washington and test two expectations, using social network analysis: (1) Social network measures can identify influential clinics; and (2) Within a network, some weakly connected clinics access out-of-network sources of innovative evidence-based practices and can spread these innovations through the network. A survey of 201 clinics in a parent study on quality improvement provided the data. Network measures and sociograms were obtained from adjacency matrixes created by UCINet. We used regression analysis to determine whether network status relates to clinics' adopting innovations. Findings suggest that influential clinics can be identified and that loosely linked clinics were likely to join the study sooner than more influential clinics but were not more likely to have improved outcomes than other organizations. Findings identify the structure of influence networks for SUD treatment organizations and have mixed results on how those structures impacted diffusion of the intervention under study. Further study is necessary to test whether use of knowledge of the network structure will have an effect on the pace and breadth of dissemination of innovations.

  9. 78 FR 53789 - Technology Innovations for Substance Abuse and Mental Health Treatment Conference & Related...

    Science.gov (United States)

    2013-08-30

    ... OFFICE OF NATIONAL DRUG CONTROL POLICY Technology Innovations for Substance Abuse and Mental... National Drug Control Policy. ACTION: Notice. Location: Eisenhower Executive Office Building, South Court....m.-1:00 p.m. SUMMARY: The Office of National Drug Control Policy (ONDCP) and the Substance Abuse and...

  10. Behavior of pharmaceuticals and drugs of abuse in a drinking water treatment plant (DWTP) using combined conventional and ultrafiltration and reverse osmosis (UF/RO) treatments

    Energy Technology Data Exchange (ETDEWEB)

    Boleda, Ma Rosa [AGBAR-Aiguees de Barcelona, Gral Batet 5-7, 08028 Barcelona (Spain); Galceran, Ma Teresa [University of Barcelona, Department Analytical Chemistry, Av. Diagonal 647, 08028 Barcelona (Spain); Ventura, Francesc, E-mail: fventura@agbar.es [AGBAR-Aiguees de Barcelona, Gral Batet 5-7, 08028 Barcelona (Spain)

    2011-06-15

    The behavior along the potabilization process of 29 pharmaceuticals and 12 drugs of abuse identified from a total of 81 compounds at the intake of a drinking water treatment plant (DWTP) has been studied. The DWTP has a common treatment consisting of dioxychlorination, coagulation/flocculation and sand filtration and then water is splitted in two parallel treatment lines: conventional (ozonation and carbon filtration) and advanced (ultrafiltration and reverse osmosis) to be further blended, chlorinated and distributed. Full removals were reached for most of the compounds. Iopromide (up to 17.2 ng/L), nicotine (13.7 ng/L), benzoylecgonine (1.9 ng/L), cotinine (3.6 ng/L), acetaminophen (15.6 ng/L), erythromycin (2.0 ng/L) and caffeine (6.0 ng/L) with elimination efficiencies {>=}94%, were the sole compounds found in the treated water. The advanced treatment process showed a slightly better efficiency than the conventional treatment to eliminate pharmaceuticals and drugs of abuse. - Highlights: > The presence of pharmaceuticals and drugs of abuse in surface water was demonstrated. > Elimination in both potabilization processes reached levels >99% for most compounds. > Four pharmaceuticals and three drugs of abuse survived the potabilization process. - The efficiency of potabilization processes to eliminate or transform pharmaceuticals and illicit drugs is evaluated.

  11. Behavior of pharmaceuticals and drugs of abuse in a drinking water treatment plant (DWTP) using combined conventional and ultrafiltration and reverse osmosis (UF/RO) treatments

    International Nuclear Information System (INIS)

    Boleda, Ma Rosa; Galceran, Ma Teresa; Ventura, Francesc

    2011-01-01

    The behavior along the potabilization process of 29 pharmaceuticals and 12 drugs of abuse identified from a total of 81 compounds at the intake of a drinking water treatment plant (DWTP) has been studied. The DWTP has a common treatment consisting of dioxychlorination, coagulation/flocculation and sand filtration and then water is splitted in two parallel treatment lines: conventional (ozonation and carbon filtration) and advanced (ultrafiltration and reverse osmosis) to be further blended, chlorinated and distributed. Full removals were reached for most of the compounds. Iopromide (up to 17.2 ng/L), nicotine (13.7 ng/L), benzoylecgonine (1.9 ng/L), cotinine (3.6 ng/L), acetaminophen (15.6 ng/L), erythromycin (2.0 ng/L) and caffeine (6.0 ng/L) with elimination efficiencies ≥94%, were the sole compounds found in the treated water. The advanced treatment process showed a slightly better efficiency than the conventional treatment to eliminate pharmaceuticals and drugs of abuse. - Highlights: → The presence of pharmaceuticals and drugs of abuse in surface water was demonstrated. → Elimination in both potabilization processes reached levels >99% for most compounds. → Four pharmaceuticals and three drugs of abuse survived the potabilization process. - The efficiency of potabilization processes to eliminate or transform pharmaceuticals and illicit drugs is evaluated.

  12. Impact of anti-tumour necrosis factor α treatment on admissions to hospital and days of sick leave in patients with ankylosing spondylitis

    OpenAIRE

    Listing, J; Brandt, J; Rudwaleit, M; Zink, A; Sieper, J; Braun, J

    2004-01-01

    Methods: The data of a 2 year open extension study of a 12 week, double blind, randomised, placebo controlled trial, in which all patients with AS were treated with 5 mg/kg infliximab, were used to investigate the effect of anti-TNF treatment on admissions to hospital and days of sick leave. All patients were interviewed at baseline and at regular intervals during the study to collect this information by questionnaires. Patients who completed 2 years of treatment (n = 49) and those who did no...

  13. Reducing Sex under the Influence of Drugs or Alcohol for Patients in Substance Abuse Treatment

    Science.gov (United States)

    Calsyn, Donald A.; Crits-Christoph, Paul; Hatch-Maillette, Mary A.; Doyle, Suzanne R.; Song, Yong S.; Coyer, Susan; Pelta, Sara

    2009-01-01

    Aims In a previous report, the effectiveness of the Real Men Are Safe (REMAS) intervention in reducing the number of unprotected sexual occasions among male drug abuse treatment patients was demonstrated. A secondary aim of REMAS was to reduce the frequency with which men engage in sex under the influence (SUI) of drugs or alcohol. Design Men in methadone maintenance (n=173) or outpatient psychosocial treatment (n=104) completed assessments at baseline, 3- and 6-months post intervention. Participants were randomly assigned to attend either REMAS (five sessions containing information, motivational exercises and skills training, including one session specifically targeting reducing SUI), or HIV education (HIV-Ed; one session containing HIV prevention information). SUI during the most recent sexual event served as the primary outcome in a repeated measures logistic regression model. Findings Men assigned to the REMAS condition reporting SUI at the most recent sexual event decreased from 36.8% at baseline to 25.7% at 3 months compared to a increase from 36.9% to 38.3% in the HIV-Ed condition (tintervention=−2.16, p=.032). No difference between the treatment groups was evident at 6-month follow-up. At each assessment time point, sex with a casual partner versus a regular partner, and being in methadone maintenance versus psychosocial outpatient treatment, were associated with engaging in SUI. Conclusions Overall a motivational and skills training HIV prevention intervention designed for men was associated with greater reduction in SUI than standard HIV education at the 3-month follow-up. PMID:20078464

  14. Activity based costing of probation with and without substance abuse treatment: a case study.

    Science.gov (United States)

    Alemi, Farrokh; Taxman, Faye; Doyon, Victoria; Thanner, Meridith; Baghi, Heibatollah

    2004-06-01

    Since many offenders have drug problems, investigators have proposed that drug testing and treatment should be an integral part of probation. In 1994, the Office of National Drug Control Policy (ONDCP) funded a demonstration project designed to integrate drug treatment with traditional supervision services. As part of this demonstration a new procedure called 'seamless' probation was set up in which treatment providers were co-located with probation officers and probation officers coordinated offenders' participation in treatment. This study examines the cost of providing substance abuse treatment coordination through probation agencies. We used Activity Based Costing (ABC) to examine the cost of probation with and without treatment coordination in one probation agency. Agency budget was analyzed and allocated to various programs. A questionnaire was developed to assess probation officer's activities. The cost of coordinating treatment for one offender was calculated by dividing the total cost of the program by units of various activities done by the probation officers. Preliminary test of reliability of the instrument showed that it was accurately portraying the probation officers time allocation. Probation officers spent 6.9% of their time in seamless supervision and 83.3% time in traditional supervision (83.83%). The seamless probation officers had more group meetings and more phone contact with their offenders than traditional probation officers. The average cost per offender per day was 12 dollars for seamless probation and 7 dollars for traditional probation. This study is limited because it focuses on one agency at one point in time. Results may not be relevant to other agencies or to the same agency as it makes its operation more efficient. This study provides a method of allocating budget cost to per client costs using survey of probation officer's activities -- a tool developed in this study. Comparison of seamless and traditional supervision activities

  15. Demographic and clinical profile of substance abusing women seeking treatment at a de-addiction center in north India

    Directory of Open Access Journals (Sweden)

    Naresh Nebhinani

    2013-01-01

    Full Text Available Background: In the recent decades increasing number of women have been seeking deaddiction services. Despite that the report data is very limited from India. Objectives: The present research aimed to study the demographic and clinical profile of women seeking deaddiction treatment at a tertiary care center in North India. Materials and Methods: Retrospective structured chart review of 100 women substance abusers seeking treatment at a deaddiction center between September 1978 and December 2011. Results: A typical case was of 36.3 years age, married (65%, urban (61%, nuclear family (59% based housewife (56%, with good to fair social support (69%. The commonest substance of abuse was tobacco (60%, followed by opioids (27%, alcohol (15%, and benzodiazepines (13%. The common reasons for initiation of substance use were to alleviate frustration or stress (49% and curiosity (37%. Family history of drug dependence (43%, comorbidity (25%, and impairments in health (74%, family (57%, and social domains (56% were common. Only a third of the sample paid one or more follow visit, and of those 58% were abstinent at the last follow-up. Significant predictors identified were being non-Hindu and higher educational years for abstinent status at follow-up. Conclusion: The common substances of abuse were tobacco, opioids, and alcohol and benzodiazepines; and family history of drug abuse and comorbidity were common. The follow-up and outcome were generally poor. This profile gives us some clues to address a hidden health problem of the community.

  16. Lie-admissible invariant treatment of irreversibility for matter and antimatter at the classical and operator levels

    International Nuclear Information System (INIS)

    Santilli, R.M.

    2006-01-01

    It was generally believed throughout the 20th century that irreversibility is a purely classical event without operator counterpart. however, a classical irreversible system cannot be consistently decomposed into a finite number of reversible quantum particles (and. vive versa), thus establishing that the origin of irreversibility is basically unknown at the dawn of the 21-st century. To resolve this problem. we adopt the historical analytical representation of irreversibility by Lagrange and Hamilton, that with external terms in their analytic equations; we show that, when properly written, the brackets of the time evolution characterize covering Lie-admissible algebras; we prove that the formalism has fully consistent operator counterpart given by the Lie-admissible branch of hadronic mechanics; we identify mathematical and physical inconsistencies when irreversible formulations are treated with the conventional mathematics used for reversible systems; we show that when the dynamical equations are treated with a novel irreversible mathematics, Lie-admissible formulations are fully consistent because invariant at both the classical and operator levels; and we complete our analysis with a number of explicit applications to irreversible processes in classical mechanics, particle physics and thermodynamics. The case of closed-isolated systems verifying conventional total conservation laws, yet possessing an irreversible structure, is treated via the simpler Lie-isotopic branch of hadronic mechanics. The analysis is conducted for both matter and antimatter at the classical and operator levels to prevent insidious inconsistencies occurring for the sole study of matter or, separately, antimatter

  17. Abuse of prescription drugs.

    OpenAIRE

    Wilford, B B

    1990-01-01

    An estimated 3% of the United States population deliberately misuse or abuse psychoactive medications, with severe consequences. According to the National Institute on Drug Abuse, more than half of patients who sought treatment or died of drug-related medical problems in 1989 were abusing prescription drugs. Physicians who contribute to this problem have been described by the American Medical Association as dishonest--willfully misprescribing for purposes of abuse, usually for profit; disable...

  18. Sleep and aggression in substance-abusing adolescents: results from an integrative behavioral sleep-treatment pilot program.

    Science.gov (United States)

    Haynes, Patricia L; Bootzin, Richard R; Smith, Leisha; Cousins, Jennifer; Cameron, Michael; Stevens, Sally

    2006-04-01

    To examine whether change in total sleep time during an integrative, behavioral sleep intervention is associated with aggression. Specifically, we tested whether adolescents who reported experiencing aggressive thoughts or actions after treatment had worse treatment trajectories (e.g., less total sleep time across treatment) than adolescents with no aggressive thoughts or actions after treatment. Nonpharmacologic open trial with 9 weeks of weekly assessment. University of Arizona Sleep Research Laboratory Twenty-three adolescents recently treated for substance abuse in outpatient community centers. Six-week integrative, behavioral sleep intervention. Weekly sleep-summary indexes were calculated from daily sleep diaries and entered as dependent variables in a series of growth-curve analyses. Statistically significant Session x Post-treatment Aggressive Ideation interactions emerged when predicting changes in total sleep time, gamma13 = 9.76 (SE = 4.12), p aggressive ideation and the frequency of substance use, as assessed at baseline. A similar pattern of results was seen for self-reported aggressive actions occurring during conflicts. These pilot data suggest that inadequate sleep in substance-abusing adolescents may contribute to the experiencing of aggressive thoughts and actions. Limitations include a small sample size and a restricted assessment of aggression. Nonetheless, these findings lend preliminary support to the breadth of therapeutic effectiveness of an integrative, behavioral sleep-therapy program for adolescents with a history of substance abuse and related behaviors.

  19. Prevalence of Primary Methamphetamine-Related Cases and Treatment-Centre Preparedness among Youth Outpatient Substance Abuse Treatment Centres in British Columbia, Canada

    Science.gov (United States)

    Callaghan, Russell C.; Rush, Brian; Tavares, Joey; Taylor, Lawren; Victor, J. Charles

    2009-01-01

    Adolescent methamphetamine use is a prominent concern for Canadian media and government. Few empirical studies, however, have established the scope of adolescent methamphetamine use or associated outpatient substance abuse treatment utilization. The current study aimed to answer the following questions: (1) What was the overall proportion of…

  20. Current and future funding sources for specialty mental health and substance abuse treatment providers.

    Science.gov (United States)

    Levit, Katharine R; Stranges, Elizabeth; Coffey, Rosanna M; Kassed, Cheryl; Mark, Tami L; Buck, Jeffrey A; Vandivort-Warren, Rita

    2013-06-01

    Goals were to describe funding for specialty behavioral health providers in 1986 and 2005 and examine how the recession, parity law, and Affordable Care Act (ACA) may affect future funding. Numerous public data sets and actuarial methods were used to estimate spending for services from specialty behavioral health providers (general hospital specialty units; specialty hospitals; psychiatrists; other behavioral health professionals; and specialty mental health and substance abuse treatment centers). Between 1986 and 2005, hospitals-which had received the largest share of behavioral health spending-declined in importance, and spending shares trended away from specialty hospitals that were largely funded by state and local governments. Hospitals' share of funding from private insurance decreased from 25% in 1986 to 12% in 2005, and the Medicaid share increased from 11% to 23%. Office-based specialty providers continued to be largely dependent on private insurance and out-of-pocket payments, with psychiatrists receiving increased Medicaid funding. Specialty centers received increased funding shares from Medicaid (from 11% to 29%), and shares from other state and local government sources fell (from 64% to 46%). With ACA's full implementation, spending on behavioral health will likely increase under private insurance and Medicaid. Parity in private plans will also push a larger share of payments for office-based professionals from out-of-pocket payments to private insurance. As ACA provides insurance for formerly uninsured individuals, funding by state behavioral health authorities of center-based treatment will likely refocus on recovery and support services. Federal Medicaid rules will increase in importance as more people needing behavioral health treatment become covered.

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

    Science.gov (United States)

    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

  2. Relationship power and sexual risk among women in community-based substance abuse treatment.

    Science.gov (United States)

    Campbell, Aimee N C; Tross, Susan; Dworkin, Shari L; Hu, Mei-Chen; Manuel, Jennifer; Pavlicova, Martina; Nunes, Edward V

    2009-11-01

    Relationship power has been highlighted as a major factor influencing women's safer sex practices. Little research, however, has specifically examined relationship power in drug-involved women, a population with increased risk for HIV transmission. Using baseline data from a National Institute on Drug Abuse Clinical Trials Network multisite trial of a women's HIV prevention intervention in community-based drug treatment programs, this paper examined the association between sexual relationship power and unprotected vaginal or anal sex. The Sexual Relationship Power Scale, a measure of relationship control and decision-making dominance, was used to assess the association between power and unprotected sex in relationships with primary male partners. It was hypothesized that increased relationship power would be associated with decreased unprotected sexual occasions, after controlling for relevant empirical and theoretical covariates. Findings show a more complex picture of the association between power and sexual risk in this population, with a main effect in the hypothesized direction for decision-making dominance but not for relationship control. Possible explanations for these findings are discussed, and future research directions for examining power constructs and developing interventions targeting relationship power among drug-involved women are suggested.

  3. Organizational consequences of staff turnover in outpatient substance abuse treatment programs.

    Science.gov (United States)

    Knight, Danica K; Becan, Jennifer E; Flynn, Patrick M

    2012-03-01

    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 measured work environment demands (stress and inadequate staffing), and 3 measured supportive work relationships (communication, cohesion, and 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, decreases perceptions of support, and underscores the need to reduce stress and minimize subsequent turnover among clinical staff. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Nonimmigrant Admissions - Annual Report

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  5. Pregnant substance-abusing women in involuntary treatment: Attachment experiences with the unborn child

    Directory of Open Access Journals (Sweden)

    Myra Siv Merete

    2016-07-01

    Full Text Available BACKGROUND – Use of coercion against pregnant women who misuse substances was legalised in Norway in 1996. The background for the law was that substance abuse during pregnancy represents a significant health problem for the child.

  6. Muscarinic Acetylcholine Receptor Subtypes as Potential Drug Targets for the Treatment of Schizophrenia, Drug Abuse and Parkinson's Disease

    DEFF Research Database (Denmark)

    Dencker, Ditte; Thomsen, Morgane; Wörtwein, Gitta

    2011-01-01

    's disease and drug abuse. Dopaminergic systems are regulated by cholinergic, especially muscarinic, input. Not surprisingly, increasing evidence implicates muscarinic acetylcholine receptor-mediated pathways as potential targets for the treatment of these disorders classically viewed as "dopamine based...... site. Such agents may lead to the development of novel classes of drugs useful for the treatment of psychosis, drug abuse and Parkinson's disease. The present review highlights recent studies carried out using muscarinic receptor knock-out mice and new subtype-selective allosteric ligands to assess...... the roles of M(1), M(4), and M(5) receptors in various central processes that are under strong dopaminergic control. The outcome of these studies opens new perspectives for the use of novel muscarinic drugs for several severe disorders of the CNS....

  7. Childhood Sexual Abuse

    Directory of Open Access Journals (Sweden)

    Evrim Aktepe

    2009-08-01

    behavioral and psychological results by itself, early trauma may also lead to biological effects. Especially traumas during neuron plasticity phase may lead hypersensitivity of neuroendocrine stress response. Early life stresses are shown to lead changes in corticotrophin releasing factor system in preclinical and clinical phase studies. In the treatment of sexual abuse, emotional process related with trauma should be focused on. This process may be conducted with play therapy. Development of higher level defense mechanism, increasing ego capacity, orientation to social activity and personal activity according to skills is aimed. For the elimination of guiltiness related with stigmatization, the child should be told that it is not herhis fault to incorporate into sexual interaction and the culprit is abuser. It is fairly important for medical staff, school and family to have sufficient information about sexual abuse for prevention and early recognition.

  8. Substance Abuse, Relapse, and Treatment Program Evaluation in Malaysia: Perspective of Rehab Patients and Staff Using the Mixed Method Approach

    Science.gov (United States)

    Chie, Qiu Ting; Tam, Cai Lian; Bonn, Gregory; Dang, Hoang Minh; Khairuddin, Rozainee

    2016-01-01

    This study examined reasons for substance abuse and evaluated the effectiveness of substance treatment programs in Malaysia through interviews with rehab patients and staff. Substance rehab patients (aged 18–69 years; n = 30) and staff (ages 30–72 years; n = 10) participated in semi-structured interviews covering a range of topics, including family and peer relationships, substance use and treatment history, factors for substance use and relapse, motivation for entering treatment, work experience, job satisfaction, treatment evaluation, and patient satisfaction. Most patients did not demonstrate the substance progression trend and had normal family relationships. Most patients reported having peers from normal family backgrounds as well. Various environmental and personal factors was cited as contributing to substance abuse and relapse. There was no significant difference between patient and staff program evaluation scores although the mean score for patients was lower. A holistic treatment approach with a combination of cognitive–behavioral, medical, social, and spiritual components was favored by patients. Suggestions for improving existing programs include better tailoring treatment to individual needs, and providing more post-treatment group support. PMID:27303313

  9. Limitation of life-sustaining treatment in patients with prolonged admission to the ICU. Current situation in Spain as seen from the EPIPUSE Study.

    Science.gov (United States)

    Hernández-Tejedor, A; Martín Delgado, M C; Cabré Pericas, L; Algora Weber, A

    2015-10-01

    Limitation of life-sustaining treatment (LLST) is a recommended practice in certain circumstances. Limitation practices are varied, and their application differs from one center to another. The present study evaluates the current situation of LLST practices in patients with prolonged admission to the ICU who suffer worsening of their condition. A prospective, observational cohort study was carried out. Seventy-five Spanish ICUs. A total of 589 patients suffering 777 complications or adverse events with organ function impairment after day 7 of admission, during a three-month recruitment period. The timing of limitation, the subject proposing LLST, the degree of agreement within the team, the influence of LLST upon the doctor-patient-family relationship, and the way in which LLST is implemented. LLST was proposed in 34.3% of the patients presenting prolonged admission to the ICU with severe complications. The incidence was higher in patients with moderate to severe lung disease, cancer, immunosuppressive treatment or dependence for basic activities of daily living. LLST was finally implemented in 97% of the cases in which it was proposed. The decision within the medical team was unanimous in 87.9% of the cases. The doctor-patient-family relationship usually does not change or even improves in this situation. LLST in ICUs is usually carried out under unanimous decision of the medical team, is performed more frequently in patients with severe comorbidity, and usually does not have a negative impact upon the relationship with the patients and their families. Copyright © 2013 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  10. Patterns of drug abuse among drug users with regular and irregular attendance for treatment as detected by comprehensive UHPLC-HR-TOF-MS.

    Science.gov (United States)

    Sundström, Mira; Pelander, Anna; Simojoki, Kaarlo; Ojanperä, Ilkka

    2016-01-01

    The most severe consequences of drug abuse include infectious diseases, overdoses, and drug-related deaths. As the range of toxicologically relevant compounds is continually changing due to the emergence of new psychoactive substances (NPS), laboratories are encountering analytical challenges. Current immunoassays are insufficient for determining the whole range of the drugs abused, and a broad-spectrum screening method is therefore needed. Here, the patterns of drug abuse in two groups of drug users were studied from urine samples using a comprehensive screening method based on high-resolution time-of-flight mass spectrometry. The two groups comprised drug abusers undergoing opioid maintenance treatment (OMT) or drug withdrawal therapy and routinely visiting a rehabilitation clinic, and drug abusers with irregular attendance at a harm reduction unit (HRU) and suspected of potential NPS abuse. Polydrug abuse was observed in both groups, but was more pronounced among the HRU subjects with a mean number of concurrent drugs per sample of 3.9, whereas among the regularly treated subjects the corresponding number was 2.1. NPS and pregabalin were more frequent among HRU subjects, and their abuse was always related to drug co-use. The most common drug combination for an HRU subject included amphetamine, cannabis, buprenorphine, benzodiazepine, and alpha-pyrrolidinovalerophenone. A typical set of drugs for treated subjects was buprenorphine, benzodiazepine, and occasionally amphetamine. Abuse of several concurrent drugs poses a higher risk of drug intoxication and a threat of premature termination of OMT. Since the subjects attending treatment used fewer concurrent drugs, this treatment could be valuable in reducing polydrug abuse. Copyright © 2015 John Wiley & Sons, Ltd.

  11. Effects of lower-cost incentives on stimulant abstinence in methadone maintenance treatment: a National Drug Abuse Treatment Clinical Trials Network study.

    Science.gov (United States)

    Peirce, Jessica M; Petry, Nancy M; Stitzer, Maxine L; Blaine, Jack; Kellogg, Scott; Satterfield, Frank; Schwartz, Marion; Krasnansky, Joe; Pencer, Eileen; Silva-Vazquez, Lolita; Kirby, Kimberly C; Royer-Malvestuto, Charlotte; Roll, John M; Cohen, Allan; Copersino, Marc L; Kolodner, Ken; Li, Rui

    2006-02-01

    Contingency management interventions that provide tangible incentives based on objective indicators of drug abstinence have improved treatment outcomes of substance abusers, but have not been widely implemented in community drug abuse treatment settings. To compare outcomes achieved when a lower-cost prize-based contingency management treatment is added to usual care in community methadone hydrochloride maintenance treatment settings. Random assignment to usual care with (n = 198) or without (n = 190) abstinence incentives during a 12-week trial. Six community-based methadone maintenance drug abuse treatment clinics in locations across the United States. Three hundred eighty-eight stimulant-abusing patients enrolled in methadone maintenance programs for at least 1 month and no more than 3 years. Participants submitting stimulant- and alcohol-negative samples earned draws for a chance to win prizes; the number of draws earned increased with continuous abstinence time. Total number of stimulant- and alcohol-negative samples provided, percentage of stimulant- and alcohol-negative samples provided, longest duration of abstinence, retention, and counseling attendance. Submission of stimulant- and alcohol-negative samples was twice as likely for incentive as for usual care group participants (odds ratio, 1.98; 95% confidence interval, 1.42-2.77). Achieving 4 or more, 8 or more, and 12 weeks of continuous abstinence was approximately 3, 9, and 11 times more likely, respectively, for incentive vs usual care participants. Groups did not differ on study retention or counseling attendance. The average cost of prizes was 120 dollars per participant. An abstinence incentive approach that paid 120 dollars in prizes per participant effectively increased stimulant abstinence in community-based methadone maintenance treatment clinics.

  12. Antibiotic prescribing on admission to patients with pneumonia and prior outpatient antibiotic treatment: a cohort study on clinical outcome

    NARCIS (Netherlands)

    van de Garde, Ewoudt M. W.; Natsch, Stephanie; Prins, Jan M.; van der Linden, Paul D.

    2015-01-01

    Objective: Most pneumonia treatment guidelines recommend that prior outpatient antibiotic treatment should be considered when planning inpatient antibiotic regimen. Our purpose was to study in patients admitted for community-acquired pneumonia the mode of continuing antibiotic treatment at the

  13. Antibiotic prescribing on admission to patients with pneumonia and prior outpatient antibiotic treatment : A cohort study on clinical outcome

    NARCIS (Netherlands)

    Van De Garde, Ewoudt M W; Natsch, Stephanie; Prins, Jan M.; Van Der Linden, Paul D.

    2015-01-01

    Objective: Most pneumonia treatment guidelines recommend that prior outpatient antibiotic treatment should be considered when planning inpatient antibiotic regimen. Our purpose was to study in patients admitted for community-acquired pneumonia the mode of continuing antibiotic treatment at the

  14. Novel approaches for the treatment of psychostimulant and opioid abuse - focus on opioid receptor-based therapies.

    Science.gov (United States)

    Bailey, Chris P; Husbands, Stephen M

    2014-11-01

    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. First, there are three 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 three stimuli. Second, 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. 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 two categories: 'memory-based' and 'receptor-based' and the authors discuss the key targets here within. 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' medication targets, research suggests that a 'non-selective' approach to targeting opioid receptors will be the most effective.

  15. Federal Strategy for Prevention of Drug Abuse and Drug Trafficking, 1982. Prepared for the President Pursuant to the Drug Abuse Office and Treatment Act of 1972.

    Science.gov (United States)

    Office of Policy Development, Washington, DC.

    This document describes the Federal response to drug abuse and drug trafficking. The actions of President Reagan, in Executive Order 12368, establishing an official advisor on drug abuse policy matters, and the priorities, issues, and objectives (international cooperation, drug law enforcement, education and prevention, detoxification and…

  16. Opioid Addiction and Abuse in Primary Care Practice: A Comparison of Methadone and Buprenorphine as Treatment Options

    Science.gov (United States)

    Bonhomme, Jean; Shim, Ruth S.; Gooden, Richard; Tyus, Dawn; Rust, George

    2014-01-01

    Opioid abuse and addiction have increased in frequency in the United States over the past 20 years. In 2009, an estimated 5.3 million persons used opioid medications nonmedically within the past month, 200 000 used heroin, and approximately 9.6% of African Americans used an illicit drug. Racial and ethnic minorities experience disparities in availability and access to mental health care, including substance use disorders. Primary care practitioners are often called upon to differentiate between appropriate, medically indicated opioid use in pain management vs inappropriate abuse or addiction. Racial and ethnic minority populations tend to favor primary care treatment settings over specialty mental health settings. Recent therapeutic advances allow patients requiring specialized treatment for opioid abuse and addiction to be managed in primary care settings. The Drug Addiction Treatment Act of 2000 enables qualified physicians with readily available short-term training to treat opioid-dependent patients with buprenorphine in an office-based setting, potentially making primary care physicians active partners in the diagnosis and treatment of opioid use disorders. Methadone and buprenorphine are effective opioid replacement agents for maintenance and/or detoxification of opioid-addicted individuals. However, restrictive federal regulations and stigmatization of opioid addiction and treatment have limited the availability of methadone. The opioid partial agonist-antagonist buprenorphine/naloxone combination has proven an effective alternative. This article reviews the literature on differences between buprenorphine and methadone regarding availability, efficacy, safety, side-effects, and dosing, identifying resources for enhancing the effectiveness of medication-assisted recovery through coordination with behavioral/psychological counseling, embedded in the context of recovery-oriented systems of care. PMID:23092049

  17. A family-oriented treatment program for youths with ketamine abuse and their caregivers: a pilot study in Taiwan

    Directory of Open Access Journals (Sweden)

    Wang LJ

    2015-07-01

    Full Text Available Liang-Jen Wang,1 Shing-Fang Lu,1 Wen-Jiun Chou,1 Mian-Yoon Chong,2 Yao-Hsing Wang,1 Yu-Lian Hsieh,1 Yi-Hsuan Lee,1 Ching Chen2 1Department of Child and Adolescent Psychiatry, 2Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan Objective: The abuse of ketamine by youths has grown into a serious public health issue. However, a reliable and efficient treatment has still not been found for youths who abuse ketamine. This pilot study investigated the effects of a family-oriented treatment program for ketamine-using youths and their caregivers.Methods: To carry out this study, 42 youths with ketamine use (mean age 16.6±1.1 years who were referred to take part in a 10-week treatment program based on motivational enhancement principles were selected, as were their principal caregivers (mean age 46.4±7.1 years, who were similarly referred to take part in a 10-week training program for parenting skills. The study had the youths complete the Chinese Craving Beliefs Questionnaire, the Adolescents’ Behavior problem Scale, and the Family APGAR both immediately before and after the program. Likewise, the youths’ caregivers completed the Family APGAR, the 12-item version of the Chinese Health Questionnaire, and the Parenting Stress Index.Results: Of the 42 youth–caregiver pairs that took part in this study, 37 (88% completed the 10-week program and both sets of assessments. After the treatment, the participating youths’ substance cravings declined (t=3.88, P<0.001, while family function, as perceived by the participating caregivers, significantly increased (t=2.22, P=0.033. The improvement in caregivers’ perceptions of family function were positively related to the improvement of the caregivers’ health status (r=-0.36, P=0.022.Conclusion: According to its results, this pilot study submits that family-oriented treatment programs may be considered a potentially effective

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

    Directory of Open Access Journals (Sweden)

    Eoin McElroy

    2016-04-01

    Full Text Available 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.

  19. Reducing the rate and duration of Re- ADMISsions among patients with unipolar disorder and bipolar disorder using smartphone-based monitoring and treatment - the RADMIS trials

    DEFF Research Database (Denmark)

    Faurholt-Jepsen, Maria; Frost, Mads; Martiny, Klaus

    2017-01-01

    Background: Unipolar and bipolar disorder combined account for nearly half of all morbidity and mortality due to mental and substance use disorders, and burden society with the highest health care costs of all psychiatric and neurological disorders. Among these, costs due to psychiatric...... trials aim to investigate whether using a smartphone-based monitoring and treatment system, including an integrated clinical feedback loop, reduces the rate and duration of re-admissions more than standard treatment in unipolar disorder and bipolar disorder. Methods: The RADMIS trials use a randomized...... controlled, single-blind, parallel-group design. Patients with unipolar disorder and patients with bipolar disorder are invited to participate in each trial when discharged from psychiatric hospitals in The Capital Region of Denmark following an affective episode and randomized to either (1...

  20. On the Comparison of Cognitive Function in Substance Abusers and Addicts under Methadone Treatment with Normal Individuals

    Directory of Open Access Journals (Sweden)

    reza mohammadzadeghan

    2015-09-01

    Full Text Available Objective: This study was an attempt to compare cognitive functioning in substance abusers and addicts under methadone treatment with normal individuals. Method: The current study was a causal-comparative one. The statistical population of this research consisted of all male substance abusers who had referred to addiction treatment centers of Khoy city in 2013. The total of 40 addicts under methadone treatment, 40 active drug users, and 40 non-addicts were selected as the participants of this study via convenience sampling method. Wisconsin Card Sorting Test and Wechsler Memory Scale were administered to the three groups for data collection purposes. Results: The results showed that the substance abusers’ scores in Wisconsin card sorting test and Wechsler memory scale were significantly different from those of addicts under methadone treatment and normal individuals. In the same way, there was a significant difference between addicts under methadone treatment and normal individuals in terms of cognitive function however, there was no significant difference between these two groups in terms of perseveration error. Conclusion: It can be concluded that chronic use of psychoactive substances causes damage to multiple brain regions such as prefrontal cortex and hippocampus and, thereby, it leads to cognitive malfunctioning in these areas.

  1. Antibiotic treatment interruption of suspected lower respiratory tract infections based on a single procalcitonin measurement at hospital admission--a randomized trial

    DEFF Research Database (Denmark)

    Kristoffersen, K B; Søgaard, O S; Wejse, C

    2009-01-01

    Recent studies have suggested that procalcitonin (PCT) is a safe marker for the discrimination between bacterial and viral infection, and that PCT-guided treatment may lead to substantial reductions in antibiotic use. The present objective was to evaluate the effect of a single PCT measurement...... to either PCT-guided treatment or standard treatment. Antibiotic treatment duration in the PCT group was based on the serum PCT value at admission. The cut-off point for recommending antibiotic treatment was PCT > or =0.25 microg/L. Physicians could overrule treatment guidelines. The mean duration...... of hospital stay was 5.9 days in the PCT group vs. 6.7 days in the control group (p 0.22). The mean duration of antibiotic treatment during hospitalization in the PCT group was 5.1 days on average, as compared to 6.8 days in the control group (p 0.007). In a subgroup analysis of chronic obstructive pulmonary...

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

    Science.gov (United States)

    Ogle, Richard L; Baer, John S

    2003-11-01

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

  3. The Effect of Matrix Method on Anxiety and Attitude Toward Methamphetamine and Crack Abuse in Males Referring to Addiction Treatment Centers in Tonkabon, Iran

    Directory of Open Access Journals (Sweden)

    Hemmati Sabet

    2015-11-01

    Full Text Available Background Drug abuse is a major problem in the communities and has many harmful effects on human body. Objectives The current study aimed to compare the efficacy of matrix method on anxiety and attitude of male crack abusers referred to addiction treatment centers in Tonkabon, Iran, in 2014. Patients and Methods The current semi -experimental study included 1,000 males referred to addiction treatment centers in Tonkabon with crack abuse history in 2014. Based on Morgan sample volume formula, 278 males with anxiety and higher attitude to drug abuse were randomly selected from 1,000 males referred to addiction treatment centers in Tonkabon. Then, 30 subjects were reselected out of them and equally assigned into two groups of experimental and control, 15 subjects in each group. The experimental group received 24 sessions of 30 - 60 minutes matrix treatment method in group, but the control group received no training. At the end of training period the post-test was carried out. The research findings confirmed the efficacy of matrix method on anxiety and attitude to crack abuse among those referring to the addition treatment center. Results The single covariance analysis of ANCOVA indicated that the value of Eta about 72% of variance of anxiety variable and about 76% of variance of drug abuse variable are taken in to account for variable of group. The intervention was effective in reducing anxiety and attitude to crack in males. Evaluating the adjusted mean showed the effectiveness of matrix method on anxiety and attitude to crack abuse in males. Conclusions The research result showed that matrix method affected the reduction of methamphetamine and attitude to crack abuse in males referred to the addition treatment center.

  4. Electronic-cigarette use by individuals in treatment for substance abuse: A survey of 24 treatment centers in the United States

    OpenAIRE

    Gubner, Noah R.; Andrews, K. Blakely; Mohammad-Zadeh, Ana; Lisha, Nadra E.; Guydish, Joseph

    2016-01-01

    Prevalence and reasons for using electronic cigarettes (e-cigarettes) was examined among patients enrolled in 24 substance abuse treatment centers in the United States (N=1,113). Prevalence of e-cigarette use was assessed for the full sample. Bivariate analyses and multivariate logistic regression were used to identify characteristics associated with e-cigarette use among current cigarette smokers (the majority of e-cigarette users). Overall 55.5% of the sample reported lifetime use of e-ciga...

  5. Substance Abuse Treatment, Anticipated Maternal Roles, and Reentry Success of Drug-Involved Women Prisoners

    Science.gov (United States)

    Robbins, Cynthia A.; Martin, Steven S.; Surratt, Hilary L.

    2009-01-01

    This article reports analyses of recidivism and relapse experiences of substance-abusing women inmates as they reenter the community. Outcomes are compared for women who completed a work-release therapeutic community program, women who entered but did not complete the program, and those who did not receive work-release therapeutic community…

  6. The Interactive Effects of Antisocial Personality Disorder and Court-Mandated Status on Substance Abuse Treatment Dropout

    Science.gov (United States)

    Daughters, Stacey B.; Stipelman, Brooke A.; Sargeant, Marsha N.; Schuster, Randi; Bornovalova, Marina A.; Lejuez, C.W.

    2013-01-01

    The present study sought to examine the interactive effects of court-mandated (CM) treatment and antisocial personality disorder (ASPD) on treatment dropout among 236 inner-city male substance users receiving residential substance abuse treatment through a pretrial release to treatment program. Of the 236 participants, 39.4% (n = 93) met criteria for ASPD and 72.5 % (n = 171) were mandated to treatment by the court system. Results indicated a significant interaction between ASPD and CM status, such that ASPD patients voluntarily receiving treatment were significantly more likely to drop out of treatment than each of the other groups. Subsequent discrete-time survival analyses to predict days until dropout using Cox proportional hazards regression indicated similar findings, with ASPD patients voluntarily receiving treatment completing fewer days of treatment than each of the other groups. These findings suggest the effectiveness of the court system in retaining ASPD patients, as well as the role of ASPD in predicting treatment dropout for individuals who are voluntarily in treatment. Implications are discussed including the potential value of early implementation of specialized interventions aimed at improving adherence for ASPD patients who are receiving treatment voluntarily. PMID:17869050

  7. Mixed methods inquiry into traditional healers' treatment of mental, neurological and substance abuse disorders in rural South Africa.

    Directory of Open Access Journals (Sweden)

    Carolyn M Audet

    Full Text Available Traditional healers are acceptable and highly accessible health practitioners throughout sub-Saharan Africa. Patients in South Africa often seek concurrent traditional and allopathic treatment leading to medical pluralism.We studied the cause of five traditional illnesses known locally as "Mavabyi ya nhloko" (sickness of the head, by conducting 27 in-depth interviews and 133 surveys with a randomly selected sample of traditional healers living and working in rural, northeastern South Africa. These interviews were carried out to identify treatment practices of mental, neurological, and substance abuse (MNS disorders. Participating healers were primarily female (77%, older in age (median: 58.0 years; interquartile range [IQR]: 50-67, had very little formal education (median: 3.7 years; IQR: 3.2-4.2, and had practiced traditional medicine for many years (median: 17 years; IQR: 9.5-30. Healers reported having the ability to successfully treat: seizure disorders (47%, patients who have lost touch with reality (47%, paralysis on one side of the body (59%, and substance abuse (21%. Female healers reported a lower odds of treating seizure disorders (Odds Ratio (OR:0.47, patients who had lost touch with reality (OR:0.26; p-value<0.05, paralysis of one side of the body (OR:0.36, and substance abuse (OR:0.36 versus males. Each additional year of education received was found to be associated with lower odds, ranging from 0.13-0.27, of treating these symptoms. Each additional patient seen by healers in the past week was associated with roughly 1.10 higher odds of treating seizure disorders, patients who have lost touch with reality, paralysis of one side of the body, and substance abuse. Healers charged a median of 500 South African Rand (~US$35 to treat substance abuse, 1000 Rand (~US$70 for seizure disorders or paralysis of one side of the body, and 1500 Rand (~US$105 for patients who have lost touch with reality.While not all healers elect to treat MNS

  8. Stabilizing Group Treatment for Complex Posttraumatic Stress Disorder Related to Childhood Abuse Based on Psycho-Education and Cognitive Behavioral Therapy: A Pilot Study

    Science.gov (United States)

    Dorrepaal, Ethy; Thomaes, Kathleen; Smit, Johannes H.; van Balkom, Anton J. L. M.; van Dyck, Richard; Veltman, Dick J.; Draijer, Nel

    2010-01-01

    Objective: This study tests a Stabilizing Group Treatment protocol, designed for the management of the long-term sequelae of child abuse, that is, Complex Posttraumatic Stress Disorder (Complex PTSD). Evidence-based treatment for this subgroup of PTSD patients is largely lacking. This stabilizing treatment aims at improving Complex PTSD using…

  9. Drug Abuse in Southeast Asia.

    Science.gov (United States)

    Scorzelli, James F.

    This report examines the incidence of drug abuse and the methods of treatment and prevention of drug abuse used in Southeast Asia. Countries studied include Malaysia, Singapore, Thailand, Indonesia, and the Philippines. Because of Malaysia's intensive effort to eliminate its drug abuse problem, emphasis is placed on this country's treatment and…

  10. Drug Abuse

    Science.gov (United States)

    ... Cocaine Heroin Inhalants Marijuana Prescription drugs, including opioids Drug abuse also plays a role in many major social problems, such as drugged driving, violence, stress, and child abuse. Drug abuse can lead to ...

  11. Temperament and character profiles associated with depression and treatment response in patients with or without comorbid substance abuse.

    Science.gov (United States)

    Paavonen, Vesa; Luoto, Kaisa; Koivukangas, Antti; Lassila, Antero; Leinonen, Esa; Kampman, Olli

    2016-11-30

    There is limited knowledge on the relationship between temperament and character profiles and substance abuse comorbidity in depressed patients. We recruited 127 depressed patients without alcohol use problems (non-AUP) and 89 depressed patients with alcohol use problems (AUP). We assessed all patients using the Temperament and Character Inventory (TCI-R) at baseline and after 6 weeks of treatment. Using univariate general linear models (GLMs), we analyzed differences in TCI-R between AUP and non-AUP. GLMs were also used in analyzing the associations between TCI-R changes and antidepressive treatment responses measured with changes in Montgomery Åsberg Depression Rating Scale score (ΔMADRS). Alcohol use explained independently significant proportions of the variation in Novelty Seeking, Self-Directedness, and Persistence. Reward Dependence score change explained 14.1% of the ΔMADRS in AUP, but was non-significant in non-AUP. Character score changes in Self-Directedness and Self-Transcendence explained together 14.1% of ΔMADRS in non-AUP, whereas they were all non-significant in AUP. AUP compared with non-AUP patients had lower Self-Directedness and Persistence and higher Novelty Seeking scores. Detected changes in Reward Dependence and lower Self-Directedness in AUP patients could be reflective of different biological mechanisms associated with depressive symptomatology in alcohol abuse. Changes in character are associated with acute treatment response in non-AUP. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. The impact of managed care on substance abuse treatment: a report of the American Society of Addiction Medicine.

    Science.gov (United States)

    Galanter, M; Keller, D S; Dermatis, H; Egelko, S

    2000-01-01

    This report examines the impact of managed care (MC) and related developments on substance abuse treatment, and evaluates how it has been associated with a decline in the availability of proper treatment for many addicted patients. A trend toward carve-out and for-profit MC organizations is associated with lower financial incentives for intensive treatment than in earlier staff-model and not-for-profit MC organizations. The value of substance abuse insurance coverage has declined by 75% between 1988 and 1998 for employees of mid-to large-size companies, compared with only an 11.5% decline for general health insurance. The shift towards MC has also been associated with a drastic reduction in frequency and duration of inpatient hospitalization, and there is no clear evidence that this reduction has been offset by a corresponding increase in outpatient support. In a survey of physicians treating addiction, the majority felt that MC had a negative impact on detoxification and rehabilitation, and on their ethical practice of addiction medicine.

  13. The relevance of psychodynamic psychotherapy to understanding therapist-patient sexual abuse and treatment of survivors.

    Science.gov (United States)

    Yahav, Rivka; Oz, Sheri

    2006-01-01

    Regardless of the therapy modality, research continues to point to the therapeutic relationship as a major salient factor in clinical success or failure. When a patient is sexually abused by his or her therapist, this therapeutic relationship is cynically exploited in a way that does not properly serve the essential needs of the patient. When this patient then seeks reparative therapy, the subsequent therapist needs to pay close attention to issues of the relationship which were breached by the previous clinician. In this article, two case studies showing very different dynamics will be presented in order to demonstrate: (1) relevant factors related to transference, countertransference, projective identification, and the analytic third pertaining to the former, abusive therapy; and (2) needs versus wishes, and issues related to boundaries and self-disclosure in the corrective therapy.

  14. Motivating Treatment Seeking and Behavior Change by Untreated Military Personnel Abusing Alcohol or Drugs

    Science.gov (United States)

    2015-10-01

    alleviating problems related to alcohol and substance abuse, intimate partner violence, problem gambling , body image and eating disorders, and aggressive... alcohol over the past month. Typi- cal drinking was assessed by asking participants the average number of drinks consumed during a typical occasion in...Lewis,M.A., Lee, C.M., Desai, S., . . . Larimer, M. E. (2010). Group identification as a moderator of the relationship between social norms and alcohol

  15. The economic impact of alcohol abuse and alcoholism.

    Science.gov (United States)

    Burke, T R

    1988-01-01

    The economic effects of alcohol abuse are as damaging to the nation as the health effects, affecting the family, the community, and persons of all ages. Underaged drinking is interfering with children's development, affecting the nation's ability to respond to economic challenge in the future. The college aged may be the most difficult to educate about alcohol abuse because of drinking patterns established at an early age and susceptibility to advertising inducements. Health care costs for families with an alcoholic member are twice those for families without one, and up to half of all emergency room admissions are alcohol related. Fetal alcohol syndrome is one of the top three known causes of birth defects, and is totally preventable. Alcohol abuse and alcoholism are estimated to have cost the nation $117 billion in 1983, while nonalcoholic drug abuse that year cost $60 billion. Costs of alcohol abuse are expected to be $136 billion a year by 1990, mostly from lost productivity and employment. Between 6 and 7 million workers are alcoholic, with an undetermined loss of productivity, profits, and competitiveness of American business. Alcohol abuse contributes to the high health care costs of the elderly beneficiaries of Federal health financing programs. Heavily affected minorities include blacks, Hispanics, and Native Americans. Society tends to treat the medical and social consequences of alcohol abuse, rather than its causes. Although our experience with the consequences of alcohol abuse is greater than that for any other drug, public concern for its prevention and treatment is less than for other major illnesses or abuse of other drugs. Alcohol abuse is a problem being given high priority within the Department in an effort to create a national agenda on the issue and to try to impart a greater sense of urgency about the problems. Ways are being explored to integrate alcoholism activities into more Departmental programs. Employee assistance programs for alcohol

  16. Patterns of admission to acute psychiatric in-patient facilities: a national survey in Italy.

    Science.gov (United States)

    Preti, A; Rucci, P; Santone, G; Picardi, A; Miglio, R; Bracco, R; Norcio, B; de Girolamo, G

    2009-03-01

    A proper understanding of patterns of care represents a crucial step in improving clinical decision making and enhancing service provision. Only a few studies, however, have explored global patterns of psychiatric admissions nationwide, and none have been undertaken in Italy. Sociodemographic, clinical and treatment-related information was collected for 1577 patients admitted to 130 public and 36 private in-patient facilities in Italy during an index period in the year 2004. All patients were also rated using the 24-item Brief Psychiatric Rating Scale (BPRS) and the Personal and Social Performance (PSP) rating scales. Non-affective psychoses (36%) were the most common diagnoses and accounted to a large extent for compulsory admissions. Private facilities were more likely to admit patients with organic mental disorders and substance abuse/dependence and less likely to admit patients with non-affective psychoses. Overall, 77.8% of patients had been receiving treatment by a mental health professional in the month prior to admission. In 54% of cases, the admission was solicited by patients' family members. The main factors preceding admission were impairment in work or social functioning, social withdrawal, and conflict with family members. Agitation, delusions and/or hallucinations, and the presence of multiple problems were associated with compulsory admissions, whereas depressive and anxiety symptoms were associated with voluntary admissions. In a mixed, public-private psychiatric care system, like the Italian one, public and private facilities admit patients with widely different clinical characteristics and needs. Family support represents an important resource for most patients, and interventions specifically addressed to relieving family burden are warranted.

  17. Provider-agency fit in substance abuse treatment organizations: implications for learning climate, morale, and evidence-based practice implementation.

    Science.gov (United States)

    Ramsey, Alex T; van den Berk-Clark, Carissa

    2015-05-12

    Substance abuse agencies have been slow to adopt and implement evidence-based practices (EBPs), due in part to poor provider morale and organizational climates that are not conducive to successful learning and integration of these practices. Person-organization fit theory suggests that alignment, or fit, between provider- and agency-level characteristics regarding the implementation of EBPs may influence provider morale and organizational learning climate and, thus, implementation success. The current study hypothesized that discrepancies, or lack of fit, between provider- and agency-level contextual factors would negatively predict provider morale and organizational learning climate, outcomes shown to be associated with successful EBP implementation. Direct service providers (n = 120) from four substance abuse treatment agencies responded to a survey involving provider morale, organizational learning climate, agency expectations for EBP use, agency resources for EBP use, and provider attitudes towards EBP use. Difference scores between combinations of provider- and agency-level factors were computed to model provider-agency fit. Quadratic regression analyses were conducted to more adequately and comprehensively model the level of the dependent variables across the entire "fit continuum". Discrepancies, or misfit, between agency expectations and provider attitudes and between agency resources and provider attitudes were associated with poorer provider morale and weaker organizational learning climate. For all hypotheses, the curvilinear model of provider-agency discrepancies significantly predicted provider morale and organizational learning climate, indicating that both directions of misfit (provider factors more favorable than agency factors, and vice-versa) were detrimental to morale and climate. However, outcomes were most negative when providers viewed EBPs favorably, but perceived that agency expectations and resources were less supportive of EBP use. The

  18. Impact of anti-tumour necrosis factor alpha treatment on admissions to hospital and days of sick leave in patients with ankylosing spondylitis.

    Science.gov (United States)

    Listing, J; Brandt, J; Rudwaleit, M; Zink, A; Sieper, J; Braun, J

    2004-12-01

    To analyse the impact of infliximab treatment on the number of hospital inpatient days and days of sick leave in patients with active ankylosing spondylitis (AS). The data of a 2 year open extension study of a 12 week, double blind, randomised, placebo controlled trial, in which all patients with AS were treated with 5 mg/kg infliximab, were used to investigate the effect of anti-TNF treatment on admissions to hospital and days of sick leave. All patients were interviewed at baseline and at regular intervals during the study to collect this information by questionnaires. Patients who completed 2 years of treatment (n = 49) and those who did not (n = 20) were analysed separately. Sick leave analysis was restricted to currently employed patients (n = 38). During the 12 months before the screening visit, 20/49 (41%) completers had been admitted to hospital. After 1 and 2 years of treatment this percentage was reduced to 5/49 (10%; ppatients with active AS reduces some important costs of AS, but additional studies with detailed cost calculations are needed.

  19. Neurobiology of hedonic tone: the relationship between treatment-resistant depression, attention-deficit hyperactivity disorder, and substance abuse

    Directory of Open Access Journals (Sweden)

    Sternat T

    2016-08-01

    Full Text Available Tia Sternat,1,2 Martin A Katzman1–4 1START Clinic for Mood and Anxiety Disorders, 2Department of Psychology, Adler Graduate Professional School, Toronto, 3Division of Clinical Sciences, The Northern Ontario School of Medicine, 4Department of Psychology, Lakehead University, Thunder Bay, ON, Canada Abstract: Anhedonia, defined as the state of reduced ability to experience feelings of pleasure, is one of the hallmarks of depression. Hedonic tone is the trait underlying one’s characteristic ability to feel pleasure. Low hedonic tone represents a reduced capacity to experience pleasure, thus increasing the likelihood of experiencing anhedonia. Low hedonic tone has been associated with several psychopathologies, including major depressive disorder (MDD, substance use, and attention-deficit hyperactivity disorder (ADHD. The main neural pathway that modulates emotional affect comprises the limbic–cortical–striatal–pallidal–thalamic circuits. The activity of various components of the limbic–cortical–striatal–pallidal–thalamic pathway is correlated with hedonic tone in healthy individuals and is altered in MDD. Dysfunction of these circuits has also been implicated in the relative ineffectiveness of selective serotonin reuptake inhibitors used to treat anxiety and depression in patients with low hedonic tone. Mood disorders such as MDD, ADHD, and substance abuse share low hedonic tone as well as altered activation of brain regions involved in reward processing and monoamine signaling as their features. Given the common features of these disorders, it is not surprising that they have high levels of comorbidities. The purpose of this article is to review the neurobiology of hedonic tone as it pertains to depression, ADHD, and the potential for substance abuse. We propose that, since low hedonic tone is a shared feature of MDD, ADHD, and substance abuse, evaluation of hedonic tone may become a diagnostic feature used to predict subtypes

  20. Triggers of Substance Abuse Slip and Relapse During Outpatient Treatment in Methadone/Buprenorphine Maintenance Therapy Clinics: A Predictive Model with Emphasis on Treatment-Related Factors

    Directory of Open Access Journals (Sweden)

    Saeid Komasi

    2017-07-01

    Full Text Available Background Most addicts relapse in the first year of treatment especially in the first 3 - 6 months, which is the most vulnerable period. Objectives The present study aimed to assess the predictors of substance abuse slip and relapse among addicts in the first 6 months of treatment with an emphasis on treatment related factors. Methods The data of this cross-sectional study collected through assessment of 148 patients who were referred to the Methadone/Buprenorphine maintenance therapy clinics of Kermanshah city during April to September of 2015. Demographic, history, treatment checklist, comorbidity index, and medical records were used for collecting data. Data was analyzed through chi-square, t-test, and Binary logistic regression analysis. Results The mean age of total participants was 42.4 ± 11.3 years and 98% of them were male. 27% and 35.1% of the patients, respectively, had a slip and relapse during the first 6 months of treatment. After adjustment for all demographic data, it was indicated that self-employment (P = 0.037, more treatment costs (P = 0.049, previous treatment history (P = 0.027, not satisfied dose of medication (P = 0.012, and lack of medical therapy history under physicians supervision (P = 0.046 can increase the possibility of a slip significantly. Conclusions Despite the fact that prevention of re-abuse and relapse of disease includes multi-factorial approach, it seems that the treatment-related factors are as the most major factors in relapse and slip during the first 6 months of treatment. Health practitioners’ special attention to treatment related factors in addiction, especially previous treatment history as the most important predictor of relapse, are probably effective in the control and decrease of a slip and relapse.

  1. Behavior of pharmaceuticals and drugs of abuse in a drinking water treatment plant (DWTP) using combined conventional and ultrafiltration and reverse osmosis (UF/RO) treatments.

    Science.gov (United States)

    Boleda, M A Rosa; Galceran, M A Teresa; Ventura, Francesc

    2011-06-01

    The behavior along the potabilization process of 29 pharmaceuticals and 12 drugs of abuse identified from a total of 81 compounds at the intake of a drinking water treatment plant (DWTP) has been studied. The DWTP has a common treatment consisting of dioxychlorination, coagulation/flocculation and sand filtration and then water is splitted in two parallel treatment lines: conventional (ozonation and carbon filtration) and advanced (ultrafiltration and reverse osmosis) to be further blended, chlorinated and distributed. Full removals were reached for most of the compounds. Iopromide (up to 17.2 ng/L), nicotine (13.7 ng/L), benzoylecgonine (1.9 ng/L), cotinine (3.6 ng/L), acetaminophen (15.6 ng/L), erythromycin (2.0 ng/L) and caffeine (6.0 ng/L) with elimination efficiencies ≥ 94%, were the sole compounds found in the treated water. The advanced treatment process showed a slightly better efficiency than the conventional treatment to eliminate pharmaceuticals and drugs of abuse. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. Understanding factors associated with early therapeutic alliance in PTSD treatment: adherence, childhood sexual abuse history, and social support.

    Science.gov (United States)

    Keller, Stephanie M; Zoellner, Lori A; Feeny, Norah C

    2010-12-01

    Therapeutic alliance has been associated with better treatment engagement, better adherence, and less dropout across various treatments and disorders. In treatment of posttraumatic stress disorder (PTSD), it may be particularly important to establish a strong early alliance to facilitate treatment adherence. However, factors such as childhood sexual abuse (CSA) history and poor social support may impede the development of early alliance in those receiving PTSD treatment. We sought to examine treatment adherence, CSA history, and social support as factors associated with early alliance in individuals with chronic PTSD who were receiving either prolonged exposure therapy (PE) or sertraline. At pretreatment, participants (76.6% female; 64.9% Caucasian; mean age = 37.1 years, SD = 11.3) completed measures of trauma history, general support (Inventory of Socially Supportive Behaviors), and trauma-related social support (Social Reactions Questionnaire). Over the course of 10 weeks of PE or sertraline, they completed early therapeutic alliance (Working Alliance Inventory) and treatment adherence measures. Early alliance was associated with PE adherence (r = .32, p history was not predictive of a lower early alliance. Given the associations with adherence, clinicians may find it useful to routinely assess alliance early in treatment. Positive trauma support, not CSA history, may be particularly important in the development of a strong early therapeutic alliance. (c) 2010 APA, all rights reserved.

  3. Issues in consultation for treatments with distressed activated abuser/protector self-states in dissociative identity disorder.

    Science.gov (United States)

    Chefetz, Richard A

    2017-01-01

    The identified "problem self-state" in a dissociative disorder consultation is like the identified patient in a family therapy; the one who is identified may have an assigned role to be blamed which serves the function of deflecting the activities of painful self-states in other family members. In consultation, the "family" includes the therapist in addition to the patient. When the state identified as a problem self-state is an abuser/protector self-state, complications often involve the profound nature of transference-countertransference enactments between patient and therapist, the delusion of separateness, chronic and acute threats of suicide, negative therapeutic reactions, and the evocation of intense negativity. They also involve affect phobia in both patient and therapist, and the emergence of intense shame in the clinical dyad amongst additional potential burdens in these complicated treatments. The task of the consultant is to protect both patient and therapist from an untoward outcome while relieving the painful burdens entailed by the treatment. The typical core dynamic of the abuser/protector state is as a repository for shame/humiliation welded to anger/rage. This dynamic, and others, must be understood in order to resolve these impasses and create useful movement toward growth in both patient and therapist.

  4. Impact of antiviral treatment and hospital admission delay on risk of death associated with 2009 A/H1N1 pandemic influenza in Mexico

    Directory of Open Access Journals (Sweden)

    Chowell Gerardo

    2012-04-01

    Mexican Social Security system, April-December 2009. We considered a spectrum of disease severity encompassing outpatient visits, hospitalizations, and deaths, and recorded demographic and geographic information on individual patients. We assessed the impact of neuraminidase inhibitor treatment and hospital admission delay (≤ > 2 days after disease onset on the risk of death by multivariate logistic regression. Results Approximately 50% of all A/H1N1-positive patients received antiviral medication during the Spring and Summer 2009 pandemic waves in Mexico while only 9% of A/H1N1 cases received antiviral medications during the fall wave (P  Conclusions Our findings underscore the potential impact of decreasing admission delays and increasing antiviral use to mitigate the mortality burden of future influenza pandemics.

  5. Admissions for drug-related problems at the Emergency Department of a University Hospital in the Kingdom of Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Mastour S Alghamdy

    2015-01-01

    Full Text Available Background and Aim: Medication Errors can result in drug-related problems (DRPs. Insight into the frequency, type, and severity of DRPs could help reduce their incidence. The aim of the present study was to estimate the prevalence of admissions as a result of DRPs at the Emergency Department (ED of a university hospital in the Kingdom of Saudi Arabia. Materials and Methods: Files of suspected cases of DRPs reporting to ED in the year 2012 were scrutinized. Suspicion arose from the hospital record system based on Diagnosis Code Numbers (ICD-9-CM, Professional 2010 and from triggers, such as some drugs, laboratory tests, and signs and symptoms pointing to DRPs. Results: Of 5574 admissions, 253 (4.5% were DRPs and were categorized as: Overdose toxicity and side effects of drugs 50 (19.8%, drug-interactions 29 (11.5%, accidental and suicidal drug ingestions 26 (10.3%, drug abuse 18 (7.1%, drug allergy 10 (4%, super-infections 8 (3.2%, and noncompliance to treatment 112 (44.3%. About 70% of DRPs were preventable; 67 (26.5% required hospital admission for 7-102 days and 10 (4% died. Conclusions: Noncompliance to treatment, overdose toxicity, drug interactions, and drug abuse are important causes of hospital admissions as a result of DRPs. Awareness of prescribers to the problem and their education would help to prevent them and improve patient care.

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

    Science.gov (United States)

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

    2014-12-01

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

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

    Directory of Open Access Journals (Sweden)

    B Myers

    2017-02-01

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

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

    Science.gov (United States)

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

    2017-01-30

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

  9. Sudden losses and sudden gains during a DBT-PTSD treatment for posttraumatic stress disorder following childhood sexual abuse

    Directory of Open Access Journals (Sweden)

    Antje Krüger

    2014-09-01

    Full Text Available Background: Exposure-based treatment approaches are first-line interventions for patients suffering from posttraumatic stress disorder (PTSD. However, the dissemination of exposure-based treatments for PTSD is challenging, as a large proportion of clinicians report being concerned about symptoms worsening as a result of this type of intervention and are therefore reluctant to offer it to patients with PTSD. However, there is only little empirical evidence to date on the pattern of symptom worsening during exposure-based treatment for PTSD. Objective: The goal of the present study was to explore the frequency of sudden losses and sudden gains in the course of an exposure-based treatment programme for female patients suffering from PTSD related to childhood sexual abuse who also show severe comorbidity. In addition, the relationship between sudden changes and treatment outcome was examined. Methods: Female participants (N=74 were randomised to either a 12-week residential DBT-PTSD programme or a treatment-as-usual wait list. The pattern of symptom change was assessed via weekly assessments using the Posttraumatic Diagnostic Scale (PDS. Sudden changes were computed as suggested by the literature on sudden gains. Results: During treatment, only one participant (3% experienced a sudden loss, whereas 25% of participants experienced sudden gains. In the waiting condition, 8% of the participants experienced sudden losses and 5% experienced sudden gains during the same time period. No symptom worsening was observed in response to exposure sessions. However, sudden gains occurred during exposure and non-exposure treatment weeks. Patients with sudden gains showed better treatment outcome in the post-treatment and follow-up assessments. Conclusions: Exposure-based treatment did not lead to PTSD symptom worsening in the study sample. Results show that sudden gains occur frequently during PTSD treatment and have a prognostic value for treatment outcome.

  10. A Cross-Lagged Panel Study of Dissociation and Posttraumatic Stress in a Treatment-Seeking Sample of Survivors of Childhood Sexual Abuse

    DEFF Research Database (Denmark)

    Murphy, Siobhan; Elklit, Ask; Murphy, Jamie

    2017-01-01

    Objective: The current prospective study assessed the temporal relations between dissociation and posttraumatic stress (PTS) in a sample of treatment-seeking female survivors of childhood sexual abuse. PTS refers to symptoms associated with posttraumatic stress disorder (PTSD) in the absence...... clinical implications that may affect their treatment and trauma recovery....

  11. Expanding the National Drug Abuse Treatment Clinical Trials Network to address the management of substance use disorders in general medical settings

    Directory of Open Access Journals (Sweden)

    Tai B

    2014-07-01

    Full Text Available Betty Tai, Steven Sparenborg, Udi E Ghitza, David Liu Center for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, USA Abstract: The Patient Protection and Affordable Care Act (2010 and the Mental Health Parity and Addiction Equity Act (2008 expand substance use disorder (SUD care services in the USA into general medical settings. Care offered in these settings will engage substance-using patients in an integrated and patient-centered environment that addresses physical and mental health comorbidities and follows a chronic care model. This expansion of SUD services presents a great need for evidence-based practices useful in general medical settings, and reveals several research gaps to be addressed. The National Drug Abuse Treatment Clinical Trials Network of the National Institute on Drug Abuse can serve an important role in this endeavor. High-priority research gaps are highlighted in this commentary. A discussion follows on how the National Drug Abuse Treatment Clinical Trials Network can transform to address changing patterns in SUD care to efficiently generate evidence to guide SUD treatment practice within the context of recent US health care legislation. Keywords: Patient Protection and Affordable Care Act, National Drug Abuse Treatment Clinical Trials Network, substance use disorders, practice-based research network, electronic health records

  12. Pneumonia in rural Malawians under five years old: Treatment outcomes and clinical predictors of death on admission

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    Prosper M. Lutala

    2009-09-01

    Method: The medical records of 466 consecutive patients admitted to the Mchinji District Hospital from January 2004 to January 2006 whose disease met the World Health Organization criteria for pneumonia were reviewed. Data were collected from forms that had been filled out and different treatment outcomes and determinants of death were analysed using logistic regression. Results: Of the 466 patients, 62.7% completed treatment, 15.9% had unknown outcomes, 12.9% died, 8.4% were lost to follow-up, 0.8% failed to improve with treatment, and 0.4% were transferred to other facilities. Independent predictors of death were: age less than 2 years, female sex, history of pneumonia, chest retractions, type of pneumonia, and central cyanosis. Conclusion: A high proportion of deaths and unknown outcomes occurred among participants. Young age, female sex, history of pneumonia, chest retractions and central cyanosis were associated with death. Mortality from pneumonia may be reduced by close monitoring of these risk factors and by improving health education programmes and communicating these findings to parents and health workers. Further investigations of local reasons for high rates of unknown/unreported outcomes are welcomed.

  13. Antisocial personality disorder is associated with receipt of physical disability benefits in substance abuse treatment patients.

    Science.gov (United States)

    Byrne, Shannon A; Cherniack, Martin G; Petry, Nancy M

    2013-09-01

    Opioid dependence is growing at an alarming rate in the United States, and opioid dependent patients have substantial medical, as well as psychiatric, conditions that impact their ability to work. This study evaluated the association between antisocial personality disorder (ASPD) and receipt of physical disability payments in methadone maintenance patients. Using data from 115 drug and alcohol abusing methadone maintained patients participating in two clinical trials, baseline characteristics of individuals receiving (n=22) and those not receiving (n=93) physical disability benefits were compared, and a logistic regression evaluated unique predictors of disability status. Both an ASPD diagnosis and severity of medical problems were significant predictors of disability receipt, ps<.05. After controlling for other variables that differed between groups, patients with ASPD were more than five times likelier to receive physical disability benefits than patients without ASPD (odds ratio=5.66; 95% confidence interval=1.58-20.28). These results demonstrate a role of ASPD in the receipt of disability benefits in substance abusers and suggest the need for greater understanding of the reasons for high rates of physical disability benefits in this population. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  14. Admission and capacity planning for the implementation of one-stop-shop in skin cancer treatment using simulation-based optimization.

    Science.gov (United States)

    Romero, H L; Dellaert, N P; van der Geer, S; Frunt, M; Jansen-Vullers, M H; Krekels, G A M

    2013-03-01

    Hospitals and health care institutions are facing the challenge of improving the quality of their services while reducing their costs. The current study presents the application of operations management practices in a dermatology oncology outpatient clinic specialized in skin cancer treatment. An interesting alternative considered by the clinic is the implementation of a one-stop-shop concept for the treatment of new patients diagnosed with basal cell carcinoma. This alternative proposes a significant improvement in the average waiting time that a patient spends between the diagnosis and treatment. This study is focused on the identification of factors that influence the average throughput time of patients treated in the clinic from the logistic perspective. A two-phase approach was followed to achieve the goals stated in this study. The first phase included an integrated approach for the deterministic analysis of the capacity using a demand-supply model for the hospital processes, while the second phase involved the development of a simulation model to include variability to the activities involved in the process and to evaluate different scenarios. Results showed that by managing three factors: the admission rule, resources allocation and capacity planning in the dermato-oncology unit throughput times for treatments of new patients can be decreased with more than 90 %, even with the same resource level. Finally, a pilot study with 16 patients was also conducted to evaluate the impact of implementing the one stop shop concept from a clinical perspective. Patients turned out to be satisfied with the fast diagnosis and treatment.

  15. Evidence-based treatment for adult women with child abuse-related Complex PTSD: a quantitative review

    Directory of Open Access Journals (Sweden)

    Ethy Dorrepaal

    2014-10-01

    Full Text Available Introduction: Effective first-line treatments for posttraumatic stress disorder (PTSD are well established, but their generalizability to child abuse (CA-related Complex PTSD is largely unknown. Method: A quantitative review of the literature was performed, identifying seven studies, with treatments specifically targeting CA-related PTSD or Complex PTSD, which were meta-analyzed, including variables such as effect size, drop-out, recovery, and improvement rates. Results: Only six studies with one or more cognitive behavior therapy (CBT treatment conditions and one with a present centered therapy condition could be meta-analyzed. Results indicate that CA-related PTSD patients profit with large effect sizes and modest recovery and improvement rates. Treatments which include exposure showed greater effect sizes especially in completers’ analyses, although no differential results were found in recovery and improvement rates. However, results in the subgroup of CA-related Complex PTSD studies were least favorable. Within the Complex PTSD subgroup, no superior effect size was found for exposure, and affect management resulted in more favorable recovery and improvement rates and less drop-out, as compared to exposure, especially in intention-to-treat analyses. Conclusion: Limited evidence suggests that predominantly CBT treatments are effective, but do not suffice to achieve satisfactory end states, especially in Complex PTSD populations. Moreover, we propose that future research should focus on direct comparisons between types of treatment for Complex PTSD patients, thereby increasing generalizability of results.

  16. Predictors of Treatment Completion for Families Referred to Trauma Focused-Cognitive Behavioral Therapy after Child Abuse.

    Science.gov (United States)

    Celano, Marianne; NeMoyer, Amanda; Stagg, Anna; Scott, Nikia

    2018-05-22

    Despite advances in the dissemination of evidence-based therapy for abuse-related traumatic stress, many referred children fail to complete treatment. Using archival data from a sample of children participating in trauma-focused cognitive behavioral therapy (TF-CBT) at a hospital-based child advocacy center, analyses explored the impact of baseline child traumatic stress symptoms, a second (nonprimary) caregiver's treatment attendance, and the number of assessment sessions on treatment completion while controlling for demographic variables. We conducted analyses separately for the total sample (n = 77) and for a subsample of children 6 years of age or older (n = 65) who completed measures of traumatic stress. Families who completed TF-CBT had fewer pretreatment assessment sessions, odds ratio (OR) = 0.41, 95% CI [0.19, 0.88], and greater nonprimary caregiver session attendance, OR = 1.30, 95% CI [1.03, 1.64], than families who did not complete treatment. Child age, race, and insurance status did not predict treatment completion. Among children at least 6 years of age, treatment completion was related to younger child age, OR = 0.76, 95% CI [0.59, 0.98], and fewer diagnostic evaluation sessions, OR = 0.29, 95% CI [0.11, 0.74], but not to baseline traumatic stress symptoms. Findings may suggest benefits of shortening the assessment period and including a second caregiver in TF-CBT. Copyright © 2018 International Society for Traumatic Stress Studies.

  17. Occurrence and environmental implications of the presence of drugs of abuse in wastewater treatment plants of Valencia (Spain)

    Science.gov (United States)

    Picó, Yolanda; Andres-Costa, M. Jesus; Andreu, Vicente

    2014-05-01

    Drugs of abuse are continuously discharged into wastewaters due to human excretion as parent compounds and/or secondary metabolites after consumption or accidental disposal into the toilets. (Boles and Wells,2010). Incomplete removal of these compounds during wastewater treatment results in their release to the environment. Pollution by illicit drug residues at very low concentrations is generalized in populated areas, with potential risks for human health and the environment. The impact of treated wastewater effluent on the quality of receiving waters can be evaluated performing an investigated performing an ecotoxicological risk assessment calculating the risk quotient (RQ) of the drugs of abuse level observed. In addition, back-calculation from the concentration of illicit drug in the influents of wastewater treatment plants (WWTPs) provides an important tool for estimating its local consumption (Daughton 2001). Sampling campaigns were in three years, 2011 (March 9th to 15th), 2012 (April 17th to May 1st) and 2013 (March 6th to 12th) in influents and effluents from 3 Wastewater Treatment Plants (WWTPs), Pinedo I, Pinedo II and Quart-Benàger, that treats most of the wastewater of Valencia City and its surrounding towns. Cocaine (COC), amphetamine (AMP), methamphetamine (MAMP), ecstasy (MDMA) and ketamine (KET), Benzoylecgonine (BE), 6-acethylmorphine (6-MAM), and 11-nor-9-carboxy-delta9-tetrahydrocannabinol (THC-COOH) were analyzed using mass spectrometry techniques such as liquid chromatography triple quadrupole mass spectrometry (LC-QqQ-MS/MS) Illicit drugs were extracted using solid phase extraction (SPE) and determined by liquid chromatography tandem mass spectrometry (LC-MS/MS) in positive ionization with an electrospray ionization source (ESI). The determination of drugs of abuse in the influent of the selected WWTP shows that all compounds were detected in 100% of influents from Pinedo I, Pinedo II and Quart-Benàger in samples analyzed during three years

  18. Sex differences in drug-related stress-system changes: implications for treatment in substance-abusing women.

    Science.gov (United States)

    Fox, Helen C; Sinha, Rajita

    2009-01-01

    Extensive research indicates that chronic substance abuse disrupts stress and reward systems of the brain. Gender variation within these stress-system alterations, including the impact of sex hormones on these changes, may influence sex-specific differences in both the development of, and recovery from, dependency. As such, gender variations in stress-system function may also provide a viable explanation for why women are markedly more vulnerable than men to the negative consequences of drug use. This article therefore initially reviews studies that have examined gender differences in emotional and biophysiological changes to the stress and reward system following the acute administration of drugs, including cocaine, alcohol, and nicotine. The article then reviews studies that have examined gender differences in response to various types of stress in both healthy and drug-abusing populations. Studies examining the impact of sex hormones on these gender-related responses are also reported. The implications of these sex-specific variations in stress and reward system function are discussed in terms of both comorbid psychopathology and treatment outcome.

  19. Peadiatric social admission

    OpenAIRE

    Carter Anand, Janet

    2009-01-01

    The phenomenon of paediatric social admission describes the hospitalisation of children for medicallynon- urgent and/or social reasons. Much of the research in this field has been in relation to avoidable admissions which have been identified, studied and condoned based on strict medical criteria. Such research has tended to mask the significance of social factors and the commonplace practice of Paediatric Social Admission. This paper examines decision making from the perspective of the healt...

  20. A Case of Profound Soft Tissue Infection of Lower Limb Contained Maggots after IV Abuse of Iranian

    Directory of Open Access Journals (Sweden)

    Majid Heidary

    2016-07-01

    Full Text Available Background: Infections include soft tissue infections are notable reason for hospital admission among IDUs, owing to unsterile injection techniques and equipment, contamination of drugs with organisms, and poor hygiene. In present case report a patient with profound limb infection is introduced. Case: A 32 years old man was transferred to the emergency department. He was IDU with Iranian for 3 years. Gangrenous deformity of left lower extremity below the knee was seen. Live maggots were moving around the limb freely. The patient underwent before knee amputation (BKA to remove the infected tissues of the limb. Conclusion: In order to evaluate and treat the serious infectious disease problems, drug abuse treatment programs will need to develop appropriate procedures. It is important that physicians, nurses, and other health care providers become better educated about drug abuse. Workers in drug abuse treatment should be well informed about infectious diseases and other complications of drug abuse.

  1. 24 CFR 5.854 - When must I prohibit admission of individuals who have engaged in drug-related criminal activity?

    Science.gov (United States)

    2010-04-01

    ... for Criminal Activity or Alcohol Abuse Denying Admissions § 5.854 When must I prohibit admission of... a pattern of illegal use of a drug may interfere with the health, safety, or right to peaceful...

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

    Science.gov (United States)

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

    2009-06-01

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

  3. Introduction to the Lie-admissible treatment of non-potential interactions in Newtonian, statistical, and particle mechanics

    International Nuclear Information System (INIS)

    Santilli, R.M.

    1982-01-01

    Views on the experimental origin, theoretical formulation, and mathematical structure of nonpotential interactions in Newtonian, statistical, and particle mechanics are presented. The simplest but most dominant consideration of this introduction is the expectation that the charge distribution of hadrons is not perfectly rigid, but admits deformations under suitable impacts with other hadrons. These rather natural deformations then imply: (1) the breaking of the SU(2)-spin symmetry for the interior strong problem, with the understanding that conventional, conserved, total spin quantities are recovered in the exterior treatment; (2) the consequential necessary breaking of the T- and P-symmetries, also for the interior strong problem, owing to the explicit dependence of the discrete operators on spin, with the understanding that the center-of-mass trajectories of closed strong systems recover the T- and P-symmetries; and (3) the origin of irreversibility at the most elemental level of nature, via the nonpotential interactions originating from mutual penetrations and overlappings of hadrons under strong interactions

  4. Indications for admission, treatment and improved outcome of paediatric haematology/oncology patients admitted to a tertiary paediatric ICU.

    LENUS (Irish Health Repository)

    Owens, C

    2012-02-01

    BACKGROUND: Overall survival in paediatric cancer has improved significantly over the past 20 years. Treatment strategies have been intensified, and supportive care has made substantial advances. Historically, paediatric oncology patients admitted to an intensive care unit (ICU) have had extremely poor outcomes. METHODS: We conducted a retrospective cohort study over a 3-year period in a single centre to evaluate the outcomes for this particularly vulnerable group of patients admitted to a paediatric ICU. RESULTS: Fifty-five patients were admitted a total of 66 times to the ICU during the study period. The mortality rate of this group was 23% compared with an overall ICU mortality rate of 5%. 11\\/15 patients who died had an underlying haematological malignancy. Twenty-eight percent of children with organism-identified sepsis died. CONCLUSIONS: While mortality rates for paediatric oncology patients admitted to a ICU have improved, they are still substantial. Those with a haematological malignancy or admitted with sepsis are most at risk.

  5. Response to Individualized Homeopathic Treatment for Depression in Climacteric Women with History of Domestic Violence, Marital Dissatisfaction or Sexual Abuse: Results from the HOMDEP-MENOP Study.

    Science.gov (United States)

    Macías-Cortés, Emma Del Carmen; Llanes-González, Lidia; Aguilar-Faisal, Leopoldo; Asbun-Bojalil, Juan

    2018-06-05

     Although individualized homeopathic treatment is effective for depression in climacteric women, there is a lack of well-designed studies of its efficacy for depression in battered women or in post-traumatic stress disorder. The aim of this study was to assess the association between individualized homeopathic treatment or fluoxetine and response to depression treatment in climacteric women with high levels of domestic violence, sexual abuse or marital dissatisfaction.  One hundred and thirty-three Mexican climacteric women with moderate-to-severe depression enrolled in the HOMDEP-MENOP Study (a randomized, placebo-controlled, double-blind, double-dummy, three-arm trial, with a 6-week follow-up study) were evaluated. Domestic violence, marital dissatisfaction and sexual abuse were assessed at baseline. Response to depression treatment was defined by a decrease of 50% or more from baseline score of Hamilton scale. Association between domestic violence, sexual abuse, and marital dissatisfaction and response to depression treatment was analyzed with bivariate analysis in the three groups. Odds ratio (OR) and 95% confidence interval (CI) were calculated.  Homeopathy versus placebo had a statistically significant association with response to depression treatment after adjusting for sexual abuse (OR [95% CI]: 11.07 [3.22 to 37.96]), domestic violence (OR [95% CI]: 10.30 [3.24 to 32.76]) and marital dissatisfaction (OR [95% CI]: 8.61 [2.85 to 25.99]).  Individualized homeopathic treatment is associated with response to depression treatment in climacteric women with high levels of domestic violence, sexual abuse or marital dissatisfaction. Further studies should be conducted to evaluate its efficacy specifically for post-traumatic stress disorder in battered women. CLINICALTRIALS. NCT01635218,:  URL: http://clinicaltrials.gov/ct2/show/NCT01635218?term=depression+homeopathy&rank=1. The Faculty of Homeopathy.

  6. Predictors of Substance Abuse Assessment and Treatment Completion for Parents Involved with Child Welfare: One State's Experience in Matching across Systems.

    Science.gov (United States)

    Traube, Dorian E; He, Amy S; Zhu, Limei; Scalise, Christine; Richardson, Tyrone

    2015-01-01

    To date, few studies have examined the effect of interagency collaboration on substance abuse assessment ity of Southern California and treatment completion for parents who are involved in child welfare. The purpose of this paper is to: (1) describe a statewide, interagency collaborative program aimed at providing targeted substance abuse assessment and treatment to parents engaged in the child welfare system; (2) document the specialized assessment and treatment outcomes for parents engaged through this collaborative program; and (3) determine factors related to successful treatment completion for parents involved in the child welfare system. This is a retrospective study of an open cohort of 13,829 individuals admitted to the New Jersey Child Protection Substance Abuse Initiative (CPSAI) program from October 1, 2009, through September 30, 2010. Data were drawn from two unique administrative data sources. Multivariate Cox regression models were used to explore factors related to successfil treatment completion for parents involved in the child welfare system. Trend analysis for the total sample in the CPSAI program revealed that, of the 10,909 individuals who received a CPSAI assessment, 59% were referred to treatment. Of those referred to treatment, 40% enrolled in a treatment program. Once enrolled in a treatment program, 55% completed or were in the process of completing substance abuse treatment. These findings suggest that when adequate screening and treatment is available through a streamlined process, many of the ethnic and gender disparities present among other populations of individuals seeking treatment are minimized. Utilizing inherent child welfare case factors appears to be an important motivating element that aids parents during the assessment and treatment process.

  7. Understanding abuse of buprenorphine/naloxone film versus tablet products using data from ASI-MV® substance use disorder treatment centers and RADARS® System Poison Centers.

    Science.gov (United States)

    Butler, Stephen F; Black, Ryan A; Severtson, Stevan Geoffrey; Dart, Richard C; Green, Jody L

    2018-01-01

    The objectives were to examine the abuse prevalence and route-of-administration (ROA) profiles of sublingual buprenorphine/naloxone combination (BNX) film in comparison with the BNX tablet and to identify clinically-relevant subgroups of patients or geographic patterns. Between Q1 2015 through Q3 2015, data were collected from two major surveillance systems: (1) assessment of individuals in substance use disorder (SUD) treatment collected from the National Addictions Vigilance Intervention and Prevention Program (NAVIPPRO®) ASI-MV® system and (2) intentional abuse/misuse exposures in the RADARS® System Poison Center Program. Poisson regression models were tailored to each system's data characteristics by population (all SUD treatment patients, US census) and adjusted for prescription volume. Effects of gender, race, age and US region as well as ROA profile were examined. For the ASI-MV study, 45,695 assessments of unique adults evaluated for substance use problems were collected. The abuse rate unadjusted for prescription volume of BNX tablet formulation was 2.64 cases/100 ASI-MV respondents versus 7.01 cases for the film formulation (RR=0.390, pfilm) (RR=1.25, pfilm abuse (0.0364) were greater than for tablet (0.0161), while prescription-adjusted rates were greater for tablet (0.2114) than for film (0.1703) per 100,000 prescriptions. ASI-MV ROA analyses indicated less abuse of the film by any alternate route, insufflation or injection than the tablet. Poison center data found more injection of tablets than film, although insufflation was not significantly different. On a prescription-adjusted basis, overall abuse of the BNX tablet is greater than that of the sublingual film formulation. For those who continue to abuse BNX, use by alternate ROAs was, in general, lower for the film. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Design paper: The CapOpus trial: a randomized, parallel-group, observer-blinded clinical trial of specialized addiction treatment versus treatment as usual for young patients with cannabis abuse and psychosis

    DEFF Research Database (Denmark)

    Hjorthøj, Carsten; Fohlmann, Allan; Larsen, Anne-Mette

    2008-01-01

    : The major objective for the CapOpus trial is to evaluate the additional effect on cannabis abuse of a specialized addiction treatment program adding group treatment and motivational interviewing to treatment as usual. DESIGN: The trial is designed as a randomized, parallel-group, observer-blinded clinical...

  9. Course of self-reported symptoms of attention deficit and hyperactivity in substance abusers during early treatment

    DEFF Research Database (Denmark)

    Hesse, Morten

    2010-01-01

    Attention deficit and hyperactivity disorder has been associated with poor outcome in studies of substance use disorders. This study aimed to assess the course of self-reported symptoms of both attention deficit and hyperactivity among adults presenting for treatment for substance use disorders....... A sample of 75 substance abusers were assessed after they were admitted to a centralized intake unit, and followed at 3 and 6 months after intake by independent interviewers (follow-up rate 81%). Symptoms of attention deficit and hyperactivity were assessed with the Adult Self-report Scale for ADHD (ASRS......). Both types of symptoms declined significantly during follow-up, but attention symptoms had a high intraclass correlation (0.79), and hyperactivity had a moderate intraclass correlation (0.64). Both baseline attention deficit and hyperactivity symptoms were associated with worse work and social...

  10. Cost-utility analysis of different treatments for post-traumatic stress disorder in sexually abused children

    Directory of Open Access Journals (Sweden)

    Gospodarevskaya Elena

    2012-04-01

    Full Text Available Abstract Background Post-traumatic stress disorder (PTSD is diagnosed in 20% to 53% of sexually abused children and adolescents. Living with PTSD is associated with a loss of health-related quality of life. Based on the best available evidence, the NICE Guideline for PTSD in children and adolescents recommends cognitive behavioural therapy (TF-CBT over non-directive counselling as a more efficacious treatment. Methods A modelled economic evaluation conducted from the Australian mental health care system perspective estimates incremental costs and Quality Adjusted Life Years (QALYs of TF-CBT, TF-CBT combined with selective serotonin reuptake inhibitor (SSRI, and non-directive counselling. The "no treatment" alternative is included as a comparator. The first part of the model consists of a decision tree corresponding to 12 month follow-up outcomes observed in clinical trials. The second part consists of a 30 year Markov model representing the slow process of recovery in non-respondents and the untreated population yielding estimates of long-term quality-adjusted survival and costs. Data from the 2007 Australian Mental Health Survey was used to populate the decision analytic model. Results In the base-case and sensitivity analyses, incremental cost-effectiveness ratios (ICERs for all three active treatment alternatives remained less than A$7,000 per QALY gained. The base-case results indicated that non-directive counselling is dominated by TF-CBT and TF-CBT + SSRI, and that efficiency gain can be achieved by allocating more resources toward these therapies. However, this result was sensitive to variation in the clinical effectiveness parameters with non-directive counselling dominating TF-CBT and TF-CBT + SSRI under certain assumptions. The base-case results also suggest that TF-CBT + SSRI is more cost-effective than TF-CBT. Conclusion Even after accounting for uncertainty in parameter estimates, the results of the modelled economic evaluation

  11. Systematic evaluation of "compliance" to prescribed treatment medications and "abstinence" from psychoactive drug abuse in chemical dependence programs: data from the comprehensive analysis of reported drugs.

    Science.gov (United States)

    Blum, Kenneth; Han, David; Femino, John; Smith, David E; Saunders, Scott; Simpatico, Thomas; Schoenthaler, Stephen J; Oscar-Berman, Marlene; Gold, Mark S

    2014-01-01

    This is the first quantitative analysis of data from urine drug tests for compliance to treatment medications and abstinence from drug abuse across "levels of care" in six eastern states of America. Comprehensive Analysis of Reported Drugs (CARD) data was used in this post-hoc retrospective observational study from 10,570 patients, filtered to include a total of 2,919 patients prescribed at least one treatment medication during 2010 and 2011. The first and last urine samples (5,838 specimens) were analyzed; compliance to treatment medications and abstinence from drugs of abuse supported treatment effectiveness for many. Compared to non-compliant patients, compliant patients were marginally less likely to abuse opioids, cannabinoids, and ethanol during treatment although more likely to abuse benzodiazepines. Almost 17% of the non-abstinent patients used benzodiazepines, 15% used opiates, and 10% used cocaine during treatment. Compliance was significantly higher in residential than in the non-residential treatment facilities. Independent of level of care, 67.2% of the patients (n = 1963; Pabuse detected in either the first or last urine samples (abstinence). Moreover, in 2010, 16.9% of the patients (n = 57) were abstinent at first but not at last urine (deteriorating abstinence), the percentage dropped to 13.3% (n = 174) in 2011; this improvement over years was statistically significant. A longitudinal analysis for abstinence and compliance was studied in a randomized subset from 2011, (n = 511) representing 17.5% of the total cohort. A statistically significant upward trend (p = 2.353×10-8) of abstinence rates as well as a similar but stronger trend for compliance ((p = 2.200×10-16) was found. Being cognizant of the trend toward drug urine testing being linked to medical necessity eliminating abusive screening, the interpretation of these valuable results require further intensive investigation.

  12. EFFECT OF JOB SKILLS TRAINING ON EMPLOYMENT AND JOB SEEKING BEHAVIORS IN AN AMERICAN INDIAN SUBSTANCE ABUSE TREATMENT SAMPLE.

    Science.gov (United States)

    Foley, K; Pallas, D; Forcehimes, A A; Houck, J M; Bogenschutz, M P; Keyser-Marcus, L; Svikis, D

    2010-10-26

    Employment difficulties are common among American Indian individuals in substance abuse treatment. To address this problem, the Southwest Node of NIDA's Clinical Trials Network conducted a single-site adaptation of its national Job Seekers Workshop study in an American Indian treatment program, Na'Nizhoozhi Center (NCI). 102 (80% men, 100% American Indian) participants who were in residential treatment and currently unemployed were randomized to (1) a three session, manualized program (Job seekers workshop: JSW) or (2) a 40-minute Job Interviewing Video: JIV). Outcomes were assessed at 3-month follow up: 1) number of days to a new taxed job or enrollment in a job-training program, and 2) total hours working or enrolled in a job-training program. No significant differences were found between the two groups for time to a new taxed job or enrollment in a job-training program. There were no significant differences between groups in substance use frequency at 3-month follow-up. These results do not support the use of the costly and time-consuming JSW intervention in this population and setting. Despite of the lack of a demonstrable treatment effect, this study established the feasibility of including a rural American Indian site in a rigorous CTN trial through a community-based participatory research approach.

  13. Substance abuse associated with elder abuse in the United States.

    Science.gov (United States)

    Jogerst, Gerald J; Daly, Jeanette M; Galloway, Lara J; Zheng, Shimin; Xu, Yinghui

    2012-01-01

    Substance abuse by either victim or perpetrator has long been associated with violence and abuse. Sparse research is available regarding elder abuse and its association with substance abuse. The objective of this study was to evaluate the association of state-reported domestic elder abuse with regional levels of substance abuse. Census demographic and elder abuse data were sorted into substate regions to align with the substance use treatment-planning regions for 2269 US counties. From the 2269 US counties there were 229 substate regions in which there were 213,444 investigations of abuse. For the other Ns (reports and substantiations) there were fewer counties and regions. See first sentence of data analyses and first sentence of results. Elder abuse report rates ranged from .03 to .41% (80 regions), investigation rates .001 to .34% (229 regions), and substantiation rates 0 to .22% (184 regions). Elder abuse investigations and substantiations were associated with various forms of substance abuse. Higher investigation rates were significantly associated with a higher rate of any illicit drug use in the past month, a lower median household income, lower proportion of the population graduated high school, and higher population of Hispanics. Higher substantiation rates were significantly associated with higher rate of illicit drug use in the past month and higher population of Hispanics. It may be worthwhile for administrators of violence programs to pay particular attention to substance abuse among their clients and in their community's environment, especially if older persons are involved. Measures of documented elder abuse at the county level are minimal. To be able to associate substance abuse with elder abuse is a significant finding, realizing that the substance abuse can be by the victim or the perpetrator of elder abuse.

  14. [What Psychiatrists Should Know about the Medical Documentation They Issue: Admission for Medical Care and Protection, Medical Treatment for Persons with Disabilities, Mental Health Disability Certification, etc].

    Science.gov (United States)

    Yamasaki, Masao

    2015-01-01

    Psychiatrists issue a wide variety of documentation, among which are torms such as Registration of Admission for Medical Care and Protection, Periodic Report of Condition, Certification of Medical Treatment for Persons with Disabilities, and Mental Health Disability Certification, which are required under laws such as the Act on Mental Health and Welfare for the Mentally Disabled. These documents are important in that they are related to protecting the human rights of people with mental disorders, as well as securing appropriate medical and welfare services for them. However, in the course of reviewing and evaluating documentation at our Mental Health and Welfare Center, we encounter forms which are incomplete, or which contain inappropriate content. In order to protect the human rights of people with mental disorders, and to ensure the provision of appropriate medical and welfare services for them, I call on psychiatrists to issue carefully written and appropriate documentation. In this talk I will focus primarily on what psychiatrists should know when filling in forms in the course of their day-to-day clinical work.

  15. Child sexual abuse, links to later sexual exploitation/high-risk sexual behavior, and prevention/treatment programs.

    Science.gov (United States)

    Lalor, Kevin; McElvaney, Rosaleen

    2010-10-01

    This paper reviews the literature on the nature and incidence of child sexual abuse, explores the link between child sexual abuse and later sexual exploitation, and reviews the literature on prevention strategies and effective interventions in child sexual abuse services. Our understanding of the international epidemiology of child sexual abuse is considerably greater than it was just 10 years ago, and studies from around the world are examined. Childhood sexual abuse can involve a wide number of psychological sequelae, including low self-esteem, anxiety, and depression. Numerous studies have noted that child sexual abuse victims are vulnerable to later sexual revictimization, as well as the link between child sexual abuse and later engagement in high-risk sexual behaviour. Survivors of child sexual abuse are more likely to have multiple sex partners, become pregnant as teenagers, and experience sexual assault as adults. Various models which attempt to account for this inter-relationship are presented; most invoke mediating variables such as low self-esteem, drug/alcohol use, PTSD and distorted sexual development. Prevention strategies for child sexual abuse are examined including media campaigns, school-based prevention programmes, and therapy with abusers. The results of a number of meta-analyses are examined. However, researchers have identified significant methodological limitations in the extant research literature that impede the making of recommendations for implementing existing therapeutic programmes unreservedly.

  16. An Admissions Officer's Credentials

    Science.gov (United States)

    Chronicle of Higher Education, 2007

    2007-01-01

    Marilee Jones has resigned as a dean of admissions at the Massachusetts Institute of Technology after admitting that she had misrepresented her academic degrees when first applying to work at the university in 1979. As one of the nation's most prominent admissions officers--and a leader in the movement to make the application process less…

  17. A Stunning Admission

    Science.gov (United States)

    Hu, Helen

    2012-01-01

    Few people set out to become admissions counselors, say people in the profession. But the field is requiring skills that are more demanding and varied than ever. And at a time when universities are looking especially hard at the bottom line, people in admissions need to constantly learn new things and make themselves indispensable. Counselors…

  18. Advice on Admissions Transparency

    Science.gov (United States)

    Australian Government Tertiary Education Quality and Standards Agency, 2018

    2018-01-01

    Admissions transparency means that prospective domestic undergraduate students can easily find good quality admissions information that allows them to compare courses and providers and make informed study choices. In October 2016 the Higher Education Standards Panel (HESP) made recommendations to achieve greater transparency in higher education…

  19. Inhalant Abuse

    Science.gov (United States)

    ... is when you pour the product into a bag, hold it over your mouth and nose, and inhale. How is inhalant abuse diagnosed? If you think your child is abusing inhalants, talk to them. Be honest and open. Tell them ...

  20. Abusive Relationships

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Abusive Relationships KidsHealth / For Teens / Abusive Relationships Print en español Relaciones de maltrato Healthy Relationships = Respect & Trust Healthy relationships involve respect, trust, and ...

  1. An Integrated, Multidimensional Treatment Model for Individuals Living with HIV, Mental Illness, and Substance Abuse

    Science.gov (United States)

    Bouis, Stephanie; Reif, Susan; Whetten, Kathryn; Scovil, Janet; Murray, Andrea; Swartz, Marvin

    2007-01-01

    The challenge of providing effective treatment services for the growing population of HIV-positive individuals who are also dually diagnosed with substance use and mental disorders has only recently been recognized as an important public health concern affecting both HIV treatment and prevention. This article describes a treatment model that was…

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

    Science.gov (United States)

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

    2016-11-01

    Child abuse includes all forms of physical and emotional ill treatment, sexual abuse, neglect, and exploitation that results in actual or potential harm to the child's health, development, or dignity. In Taiwan, the Child Protection Medical Service Demonstration Center (CPMSDC) was established to protect children from abuse and neglect. We further analyzed and compared the trends and clinical characteristics of cases reported by CPMSDC to evaluate the function of CPMSDC in approaching child abuse and neglect in Taiwan. We prospectively recorded children with reported child abuse and neglect in a CPMSDC in a tertiary medical center from 2014 to 2015. Furthermore, we analyzed and compared age, gender, scene, identifying settings, time of visits, injury type, injury severity, hospital admission, hospitalization duration, and outcomes based on the different types of abuse and the different settings in which the abuse or neglect were identified. Of 361 child abuse cases (mean age 4.8 ± 5.36 years), the incidence was highest in 1- to 6-year-old children (n = 198, 54.85%). Physical abuse and neglect were predominant in males, while sexual abuse was predominant in females (P Neglect was most common (n = 279, 75.85%), followed by physical (n = 56, 15.51%) and sexual abuse (n = 26, 7.2%). The most common identifying setting was the emergency department (n = 320, 88.64%), with neglect being most commonly reported. Head, neck, and facial injuries were more common in physically abused children than in neglected and sexual abused children (P neglect (P abuse, and to increase the rate of registry. Cases of physical abuse had a higher Injury Severity Score, longer duration of hospitalization, and more injuries of head, face, and neck compared with other types of abuse. The reported rate of neglect was highly elevated after the CPMSDC established during the study period. Recognition of neglect is not easy, but the consequent injury, especially

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

    Science.gov (United States)

    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. Effect of Educational Program to Encourage Safe Sexual Behaviors Among Addicted Men Refered to Substance Abuse Treatment Centers in Hamadan, Western Iran: Applying the Theory of Planned Behavior

    Directory of Open Access Journals (Sweden)

    Babak Moeini

    2014-06-01

    Full Text Available Introduction: Unsafe sexual behaviors as important risky behaviors can expose individuals and society to dangerous infectious disease such as AIDS and viral hepatitis. Considering the high prevalence of unsafe sexual behaviors, this study aimed to determine the effect of educational programs to encourage safe sexual behaviors among substance abusers referred to substance abuse treatment centers in Hamadan, Western Iran by applying the theory of planned behavior. Materials & Methods: This quasi-experimental study was performed on 104 men substance abusers (52 participants in each of the control and intervention groups referred to substance abuse treatment centers in Hamadan. Data collection tool was a questionnaire containing demographic information and the theory of planned behavior constructs. Before the educational program, questionnaires were completed by both groups. After the pretest in both groups, participants in the intervention group participated in four educational sessions designed based on the theory of planned behavior. Two months after the end of program, posttest was performed. Data was analyzed using independent T-test, chi-square, fisher exact test, McNemar’s test and multiple linear regressions using SPSS-16. Results: After educational intervention, the mean scores of the theory constructs (attitude toward behavior, subjective norms, behavioral control, behavioral intention and behaviors, in the intervention group increased significantly (P<0.05, despite the fact, changes were not significant in the control group. Conclusion: Implementation of educational courses to encourage safe sexual behaviors based on the theory of planned behavior can be beneficial for substance abusers referred to substance abuse treatment centers.

  5. Abuse of prescription drugs.

    Science.gov (United States)

    Wilford, B B

    1990-01-01

    An estimated 3% of the United States population deliberately misuse or abuse psychoactive medications, with severe consequences. According to the National Institute on Drug Abuse, more than half of patients who sought treatment or died of drug-related medical problems in 1989 were abusing prescription drugs. Physicians who contribute to this problem have been described by the American Medical Association as dishonest--willfully misprescribing for purposes of abuse, usually for profit; disabled by personal problems with drugs or alcohol; dated in their knowledge of current pharmacology or therapeutics; or deceived by various patient-initiated fraudulent approaches. Even physicians who do not meet any of these descriptions must guard against contributing to prescription drug abuse through injudicious prescribing, inadequate safeguarding of prescription forms or drug supplies, or acquiescing to the demands or ruses used to obtain drugs for other than medical purposes. PMID:2349801

  6. A systems perspective on research and treatment with abused and neglected children.

    Science.gov (United States)

    Clyman, R B

    2000-01-01

    To discuss two systems-level changes in the organization and financing of mental health and child welfare services that will increasingly affect abused and neglected children: the implementation of managed care processes and the incorporation of accountability mechanisms in the management of mental health and child welfare services, particularly the use of systematic outcomes assessments. A central goal of the paper is to identify critical research questions which will help us to understand the impact of these changes on maltreated children. These two systems-level changes are described, and ways they may affect maltreated children are addressed. Both managed care and the growing focus on managing services by monitoring outcomes may positively or negatively affect maltreated children. Both of these trends are affecting the mental health and child welfare systems. It is likely that they will affect maltreated children's access to and the quality, cost, and outcomes of mental health and child welfare services. Systematic research on the impact of these large-scale changes can increase the likelihood that these changes will benefit maltreated children. A number of critical areas are identified for future research.

  7. Adolescent Abuse.

    Science.gov (United States)

    Foreman, Susan; Seligman, Linda

    1983-01-01

    Discusses legal and developmental aspects of adolescent abuse, as distinguished from child abuse. The role of the school counselor in identifying and counseling abused adolescents and their families is discussed and several forms of intervention and support services are described. (JAC)

  8. Elder abuse

    OpenAIRE

    1999-01-01

    Elder abuse takes many forms and occurs in a variety of settings; it is both under-recognised and under-reported. Despite a lack of statutory guidelines or legislation, effective management is possible. More could be done to recognise abuse, and healthcare workers need to be vigilant, paying attention to both the circumstances in which abuse occurs and its warning signs.

  9. [Cost differences in the treatment of severe sepsis between survivors and non-survivors on the first day of intensive care admission].

    Science.gov (United States)

    Csomós, Akos; Szentkereszty, Zoltán; Fülesdi, Béla

    2007-09-30

    Patients admitted to intensive care unit with severe sepsis have high mortality and use significant resources. Determination of variable cost differences on day 1 between survivors and non-survivors of severe sepsis in Hungary. A sample of 6 intensive care units (ICU) included 70 patients who were admitted with severe sepsis to their ICU. Retrospective data collection of resource consumption for 24 hours following ICU admission using medical and nursing records. 59 different resource uses were collected separately for radiology, biochemistry and disposables. Blood products and drugs/fluids were collected individually. The authors identified the price of each resource for the cost calculation. The ICU mortality of severe sepsis in our sample was found to be 64%, the average length of stay for survivors was 19.9 (SD +/- 11.4) and for non-survivors was 13.0 (SD +/- 8.5). Mean ICU variable cost on day 1 of severe sepsis was HUF 60 957 (247 Euro), more for non-survivors (HUF 70 835 vs. 40 108, p = 0.020). The use of blood products is higher in non-survivors ( p = 0.047) and so is the use of drugs/fluids ( p = 0.003). The use of more colloids ( p = 0.016) and more expensive antibiotics ( p = 0.021) was responsible for the higher drugs/fluids spending in non-survivors. The mortality of severe sepsis is high and the cost of sepsis treatment is low in Hungary compared to international data. Non-survivors cost almost twice as much even on day 1, this warrants the need for early diagnosis and adequate treatment.

  10. Motivation and readiness for drug treatment: differences by modality and special populations.

    Science.gov (United States)

    Melnick, Gerald; Hawke, Josephine; De Leon, George

    2014-01-01

    The purpose of this research is to expand our knowledge of motivational factors among admissions to various substance abuse treatment modalities and among those entering special programs. Differences in motivation are reported in a convenience sample of more than 6,000 admissions to 38 programs. Results from multilevel analyses show (a) an ordered increase in motivation by settings from referral to outpatient, to methadone maintenance, and to the highest levels in residential programs and (b) significantly lower motivation among admissions to programs for special populations. Results are discussed in relation to the demand characteristics of treatment and non-recovery reasons for entering treatment.

  11. Maternal substance use and integrated treatment programs for women with substance abuse issues and their children: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Milligan Karen

    2010-09-01

    Full Text Available Abstract Background The rate of women with substance abuse issues is increasing. Women present with a unique constellation of risk factors and presenting needs, which may include specific needs in their role as mothers. Numerous integrated programs (those with substance use treatment and pregnancy, parenting, or child services have been developed to specifically meet the needs of pregnant and parenting women with substance abuse issues. This synthesis and meta-analysis reviews research in this important and growing area of treatment. Methods We searched PsycINFO, MedLine, PubMed, Web of Science, EMBASE, Proquest Dissertations, Sociological Abstracts, and CINAHL and compiled a database of 21 studies (2 randomized trials, 9 quasi-experimental studies, 10 cohort studies of integrated programs published between 1990 and 2007 with outcome data on maternal substance use. Data were summarized and where possible, meta-analyses were performed, using standardized mean differences (d effect size estimates. Results In the two studies comparing integrated programs to no treatment, effect sizes for urine toxicology and percent using substances significantly favored integrated programs and ranged from 0.18 to 1.41. Studies examining changes in maternal substance use from beginning to end of treatment were statistically significant and medium sized. More specifically, in the five studies measuring severity of drug and alcohol use, the average effect sizes were 0.64 and 0.40, respectively. In the four cohort studies of days of use, the average effect size was 0.52. Of studies comparing integrated to non-integrated programs, four studies assessed urine toxicology and two assessed self-reported abstinence. Overall effect sizes for each measure were not statistically significant (d = -0.09 and 0.22, respectively. Conclusions Findings suggest that integrated programs are effective in reducing maternal substance use. However, integrated programs were not

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

    DEFF Research Database (Denmark)

    Hesse, Morten; Stefánsson, Ragnar

    2008-01-01

    -III. Baserate scores indicated a prevalence of 95% of personality disorders. A logistic regression analysis correctly identified 95% of the sample, and showed that antisocial personality disorder traits were characteristic of the prison sample, and masochistic personality disorder traits were characteristic......Abstract  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...... of the inpatient sample. The findings indicate that treatment models used in prison settings should be adjusted to meet the needs of antisocial patients....

  13. Child abuse

    International Nuclear Information System (INIS)

    Dorst, J.P.; Johns Hopkins Medical Institutions, Baltimore, MD

    1982-01-01

    Child abuse is common in most, if not all, Western nations; it probably occurs worldwide. It may be a major factor in the increase in violence throughout much of the world. Radiologists who treat children should think of the possibilitys of abuse whenever they diagnose a fracture, intracranial bleed, ar visceral injury, especially when the history is not compatible with their findings. Metaphyseal 'corner' fractures in infants usually are caused by abuse. Less than 20% of abused children, however, present injuries that can be recognized by radiologic techniques. Consequently normal roentgenograms, nuclear medicine scans, ultrasound studies, and computed tomograms do not exclude child abuse. (orig.)

  14. Child abuse

    Energy Technology Data Exchange (ETDEWEB)

    Dorst, J.P.

    1982-08-01

    Child abuse is common in most, if not all, Western nations; it probably occurs worldwide. It may be a major factor in the increase in violence throughout much of the world. Radiologists who treat children should think of the possibilitys of abuse whenever they diagnose a fracture, intracranial bleeding or visceral injury, especially when the history is not compatible with their findings. Metaphyseal 'corner' fractures in infants usually are caused by abuse. Less than 20% of abused children, however, present injuries that can be recognized by radiologic techniques. Consequently normal roentgenograms, nuclear medicine scans, ultrasound studies, and computed tomograms do not exclude child abuse.

  15. A Unified Electronic Tool for CPR and Emergency Treatment Escalation Plans Improves Communication and Early Collaborative Decision Making for Acute Hospital Admissions.

    Science.gov (United States)

    Johnson, Mae; Whyte, Martin; Loveridge, Robert; Yorke, Richard; Naleem, Shairana

    2017-01-01

    The National Confidential Enquiry into Patient Outcomes and Death (NCEPOD) report 'Time to Intervene' (2012) stated that in a substantial number of cases, resuscitation is attempted when it was thought a 'do not attempt cardiopulmonary resuscitation' (DNACPR) decision should have been in place. Early decisions about CPR status and advance planning about limits of care now form part of national recommendations by the UK Resuscitation Council (2016). Treatment escalation plans (TEP) document what level of treatment intervention would be appropriate if a patient were to become acutely unwell and were not previously formally in place at King's College Hospital. A unifying paper based form was successfully piloted in the Acute Medical Unit, introducing the TEP and bringing together decision making around both treatment escalation and CPR status. Subsequently an electronic order-set for CPR status and treatment escalation was launched in April 2015 which led to a highly visible CPR and escalation status banner on the main screen at the top of the patient's electronic record. Ultimately due to further iterations in the electronic process by December 2016, all escalation decisions for acutely admitted patients now have high quality supporting, explanatory documentation with 100% having TEPs in place. There is now widespread multidisciplinary engagement in the process of defining limits of care for acutely admitted medical patients within the first 14 hours of admission and a strategy for rolling this process out across all the divisions of the hospital through our Deteriorating Patient Group (DPG). The collaborative design with acute medical, palliative and intensive care teams and the high visibility provided by the electronic process in the Electronic Patient Record (EPR) has enhanced communication with these teams, patients, nursing staff and the multidisciplinary team by ensuring clarity through a universally understood process about escalation and CPR. Clarity and

  16. Electronic-cigarette use by individuals in treatment for substance abuse: A survey of 24 treatment centers in the United States.

    Science.gov (United States)

    Gubner, Noah R; Andrews, K Blakely; Mohammad-Zadeh, Ana; Lisha, Nadra E; Guydish, Joseph

    2016-12-01

    Prevalence and reasons for using electronic cigarettes (e-cigarettes) was examined among patients enrolled in 24 substance abuse treatment centers in the United States (N=1113). Prevalence of e-cigarette use was assessed for the full sample. Bivariate analyses and multivariate logistic regression were used to identify characteristics associated with e-cigarette use among current cigarette smokers (the majority of e-cigarette users). Overall 55.5% of the sample reported lifetime use of e-cigarettes, and 30.5% reported using e-cigarettes in the past 30days (current users). The main reasons for using e-cigarettes were (a) at times/places when smoking was prohibited (53.5%), and (b) as a way to quit/reduce cigarette smoking (50.3%). Daily vs non-daily e-cigarette users were more likely to use e-cigarettes both as a way to reduce health risks, and as a way to quit/reduce cigarette smoking. A majority of e-cigarette users (87.1%) reported dual use of e-cigarettes and tobacco cigarettes during the past month. Among current cigarette smokers, those that also used e-cigarettes smoked more cigarettes per day, were more likely to have made a past year cigarette quit attempt, and to have tried nicotine replacement therapy compared to cigarette only smokers. There was a high rate of dual e-cigarette and cigarette use by persons enrolled in addiction treatment. E-cigarette users may be heavier cigarette smokers trying to quit or reduce their cigarette smoking. However, e-cigarettes were also used at times when individuals could not smoke cigarettes. Substance abuse treatment centers developing tobacco policies need to consider these potentially conflicting reasons for using e-cigarettes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Symptom Prevalence of ADHD in a Community Residential Substance Abuse Treatment Program

    Science.gov (United States)

    McAweeney, Mary; Rogers, Nikki L.; Huddleston, Carole; Moore, Dennis; Gentile, Julie P.

    2010-01-01

    Objective: ADHD is a common comorbid condition with substance use disorder. This study seeks to examine the discrepancy in the prevalence rate between those previously diagnosed with ADHD and those diagnosed while in treatment. It is hypothesized that clients with ADHD would have earlier unsuccessful terminations from treatment than non-ADHD…

  18. History of the treatment of persons with psychological difficulties and the abuse of their civil rights

    Directory of Open Access Journals (Sweden)

    Petrović Nikola M.

    2013-01-01

    Full Text Available Treatment of persons with psychological difficulties varied in different historical periods, but in its essence remained similar until today. It included an inhumane relationship towards these persons, involuntary treatment through torture, and isolation from society as a kind of punishment for their diversity. It was not until the late 19th century that the relationship of society towards these individuals started to improve gradually, but in the 21st century isolation of these individuals still remained the dominant form of acceptable social solution for the “problem”, with a somewhat more humane attitude towards them and less cruel treatment. Serbia has followed the trends of treatment of the persons with psychological difficulties from the rest of Europe for centuries, but is still lagging behind the world in the introduction of new methods of treatment. Indeed the first legal solution to regulate the human rights of these people is currently in the process of implementation. The subject of this paper is the treatment of persons with psychological difficulties and the violation of their civil rights. In a subject specific context the goal of the analysis was the historical review of the treatment towards persons with psychological difficulties by doctors, other practicioners and the community in general, with reference to the current situation regarding their treatment within the psychiatric institutions, as well as the legal regulations and the protection of their civil rights.

  19. The importance of need for cognition and educational experience in enhanced and standard substance abuse treatment.

    Science.gov (United States)

    Czuchry, Michael; Dansereau, Donald F

    2004-06-01

    The current study examined the relationship between need for cognition (i.e., cognitive motivation or "will") and educational experience (i.e., cognitive ability or "skill") to perceived improvements during treatment of probationers receiving residential treatment within the criminal justice system. Probationers were randomly assigned to either receive motivational activities developed by the authors (the "enhanced" condition), or treatment as usual (but with access to general reading materials in lieu of the motivational activities). Need for cognition and educational experience were assessed and used as blocking variables, and ratings of progress were assessed midway and toward the end of treatment. The results indicate that both need for cognition and educational experience are important predictors of improvement during treatment, and that the motivational activities developed by the authors were particularly valuable for clients with lower levels of need for cognition.

  20. Management systems, patient quality improvement, resource availability, and substance abuse treatment quality.

    Science.gov (United States)

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

    2012-06-01

    To examine the relationships among general management systems, patient-focused quality management/continuous process improvement (TQM/CPI) processes, resource availability, and multiple dimensions of substance use disorder (SUD) treatment. Data are from a nationally representative sample of 221 SUD treatment centers through the National Treatment Center Study (NTCS). The design was a cross-sectional field study using latent variable structural equation models. The key variables are management practices, TQM/continuous quality improvement (CQI) practices, resource availability, and treatment center performance. Interviews and questionnaires provided data from treatment center administrative directors and clinical directors in 2007-2008. Patient-focused TQM/CQI practices fully mediated the relationship between internal management practices and performance. The effects of TQM/CQI on performance are significantly larger for treatment centers with higher levels of staff per patient. Internal management practices may create a setting that supports implementation of specific patient-focused practices and protocols inherent to TQM/CQI processes. However, the positive effects of internal management practices on treatment center performance occur through use of specific patient-focused TQM/CPI practices and have more impact when greater amounts of supporting resources are present. © Health Research and Educational Trust.

  1. The Readiness Ruler as a measure of readiness to change poly-drug use in drug abusers

    DEFF Research Database (Denmark)

    Hesse, Morten

    2006-01-01

    Readiness to change is a crucial issue in the treatment of substance use disorders. Experiences with methadone maintenance treatment (MMT) has shown that continuous drug and alcohol use with all its consequences characterize most MMT programs. In a prospective study of drug abusers seeking opiate...... agonist maintenance treatment in the City of Copenhagen, subjects were administered the Addiction Severity Index, and the Readiness Ruler for each of 11 different licit and illicit drugs by research technicians. Data was collected upon admission to the program and at a 18 month follow-up. Subjects who...... indicated they wanted to quit or cut down upon admission, reported less drug use at 18 month follow-up, after controlling for severity of drug problems at intake. Subjects who expressed readiness to change their drug use upon admission decreased their drug use. It is concluded that the Readiness Ruler...

  2. Veterans in substance abuse treatment program self-initiate box gardening as a stress reducing therapeutic modality.

    Science.gov (United States)

    Lehmann, Lauren P; Detweiler, Jonna G; Detweiler, Mark B

    2018-02-01

    To assess the experiences of a veteran initiated horticultural therapy garden during their 28-day inpatient Substance Abuse Residential Rehabilitation Treatment Program (SARRTP). Retrospective study. Veterans Affairs Medical Center (VAMC), Salem, Virginia, USA INTERVENTIONS: Group interviews with veterans from the last SARRTP classes and individual interviews with VAMC greenhouse staff in summer of 2016. Time spent in garden, frequency of garden visits, types of passive and active garden activities, words describing the veterans' emotional reactions to utilizing the garden. In 3 summer months of 2016, 50 percent of the 56 veterans interviewed visited and interacted with the gardens during their free time. Frequency of visits generally varied from 3 times weekly to 1-2 times a day. Amount of time in the garden varied from 10min to 2h. The veterans engaged in active and/or passive gardening activities during their garden visits. The veterans reported feeling "calm", "serene", and "refreshed" during garden visitation and after leaving the garden. Although data was secured only at the end of the 2016 growing season, interviews of the inpatient veterans revealed that they used their own initiative and resources to continue the horticulture therapy program for 2 successive growing years after the original pilot project ended in 2014. These non-interventionist, therapeutic garden projects suggest the role of autonomy and patient initiative in recovery programs for veterans attending VAMC treatment programs and they also suggest the value of horticulture therapy as a meaningful evidence- based therapeutic modality for veterans. Published by Elsevier Ltd.

  3. Hospitalization of abused and neglected children.

    Science.gov (United States)

    Marshall, W N

    1997-03-01

    To describe the use of inpatient hospitalization for abused and neglected children living in a metropolitan area. Retrospective record review of abused and neglected children admitted in 1992 and 1993 to hospitals with 87% of metropolitan area pediatric admissions; comparison of these data with population, crisis nursery, and child protective services data. Thirty-four abused and neglected children were admitted to hospital, representing 0.3% (34/11,066; 95% confidence interval, 0%-1.2%) of pediatric admissions and 0.2% (34/19,950; 95% confidence interval, 0%-0.6%) of child protective services reports. This represents a rate of hospitalization for child abuse of 10 children (95% confidence interval, 0-46) per 100,000 child population per year. Seven hundred fifteen children were admitted to the crisis nursery by child protective services. Of those admitted to the hospital, 12 needed intensive care, 5 of whom died. Only 3 of 34 hospital-admitted children had private health insurance; 19 of 34 were younger than 1 year. Inpatient hospitalization for abuse represented a small fraction of total pediatric admissions and of child protective services reports. Comprehensive medical care for most abused children and medical education about child abuse must occur in outpatient settings.

  4. Overdose prevention in injecting opioid users: The role of substance abuse treatment and training programs

    Directory of Open Access Journals (Sweden)

    Ana Sarasa-Renedo

    2014-03-01

    Conclusions: These findings suggest that preventive programs would benefit from accounting for linguistic and educational limitations and from participation in every treatment episode. Comprehensiveness and broad coverage of such programs could help to maximize their impact.

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

    Science.gov (United States)

    Arfken, Cynthia L; Kubiak, Sheryl Pimlott

    2009-01-01

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

  6. The Association between Foster Care and Substance Abuse Risk Factors and Treatment Outcomes: An Exploratory Secondary Analysis

    Science.gov (United States)

    Blome, Wendy Whiting; Shields, Joseph; Verdieck, Mary Jeanne

    2009-01-01

    The child welfare and substance abuse systems are integrally linked through the children and families they both serve. There is a dearth of knowledge, however, on how children who have experienced foster care fare when they are treated for substance abuse issues as adults. This article presents an exploratory study using the Alcohol and Drug…

  7. Cultural Considerations in the Treatment of Mental Illness among Sexually Abused Children and Adolescents: The Case of Bali, Indonesia

    Science.gov (United States)

    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…

  8. Early Intervention and Maltreated Children: A Current Look at the Child Abuse Prevention and Treatment Act and Part C

    Science.gov (United States)

    Moxley, Kathleen M.; Squires, Jane; Lindstrom, Lauren

    2012-01-01

    Current literature regarding the prevalence of child abuse and neglect, resulting developmental impacts on children, and early intervention services for children and families involved in the child welfare system is summarized. While early intervention eligibility referrals are mandated for this population under the Child Abuse Prevention and…

  9. Differences in Addiction Severity between Social and Probable Pathological Gamblers among Substance Abusers in Treatment in Rio de Janeiro

    Science.gov (United States)

    Mathias, Ana Carolina R.; Vargens, Renata W.; Kessler, Felix H.; Cruz, Marcelo S.

    2009-01-01

    There is a strong association between pathological gambling and substance abuse. The objective of this study is to identify the differences between substance abusers with and without gambling problems. A cross sectional study was conducted interviewing with Addiction Severity Index (ASI) and South Oaks Gambling Screen (SOGS), alcohol and drug…

  10. What characterizes substance abusers who commit suicide attempts? Factors related to Axis I disorders and patterns of substance use disorders. A study of treatment-seeking substance abusers in Norway.

    Science.gov (United States)

    Landheim, A S; Bakken, K; Vaglum, P

    2006-01-01

    The frequency of suicide attempts and clinical characteristics of attempters among poly-substance abusers and alcoholics were examined. A consecutive sample (n = 260) of in- and outpatients from two Norwegian counties were assessed by Composite International Diagnostic Interview (Axis I disorders), Millon's Clinical Multiaxial Inventory (Axis II disorders) and the Norwegian National Client Assessment Form. When analysing the association between suicide attempters and the range of predictor variables, logistic regression analysis was conducted. Almost half (47%) of the sample reported lifetime suicide attempts; significantly more frequently in poly-substance abusers (58%) than alcoholics (38%). A substance use disorder with duration of >or=15 years and an early onset (suicide attempter after controlling for Axis I disorders. In addition, eating disorders, agoraphobia and major depression were strongly and independently associated with being a suicide attempter. Attempts at preventing suicidal behaviour should not ignore the suicide risk among poly-substance abusers. In addition, prevention of suicidal behaviour demands a treatment programme focusing concomitantly on both addictive behaviour and comorbid psychiatric disorders. Copyright 2006 S. Karger AG, Basel.

  11. Undergraduate Admissions | NSU

    Science.gov (United States)

    . Continuing Education Financial Aid Career Development Regional Campuses International Affairs Veterans Admissions Honors College Experiential Education Study Abroad Research Opportunities Career Preparation SharkLink California Disclosure International Affairs Undergraduate Advising Career Development Libraries at

  12. Changes in emotion regulation in adults with and without a history of childhood abuse following posttraumatic stress disorder treatment.

    Science.gov (United States)

    Jerud, Alissa B; Zoellner, Lori A; Pruitt, Larry D; Feeny, Norah C

    2014-08-01

    This study compared changes in emotion regulation and trait affect over the course of PTSD treatment with either prolonged exposure (PE) therapy or sertraline in adults with and without a history of childhood abuse (CA). Two hundred adults with PTSD received 10 weeks of PE or sertraline. Emotion regulation and trait affect were assessed pre- and posttreatment and at 6-month follow-up with the Emotion Regulation Questionnaire (Gross & John, 2003), the Negative Mood Regulation Scale (Catanzaro & Mearns, 1990), and the Positive and Negative Affect Schedule (Watson, Clark, & Tellegen, 1988). Individuals with and without a history of CA did not differ from one another at pretreatment on PTSD severity, emotion regulation, or positive/negative affect. In addition, treatment was effective at improving emotion regulation and trait affect in those with and without a history of CA, and no significant differences in emotion regulation or trait affect emerged posttreatment or at 6-month follow-up between adults with and without a history of CA. Furthermore, noninferiority analyses indicated that the emotion regulation and trait affect outcomes of individuals with a history of CA were no worse than those of individuals without a history of CA. These findings cast doubt on the assumption that CA is associated with worse emotion regulation following PTSD treatment, arguing against assertions that a history of CA itself is a contraindication for traditional PTSD treatment, and that there is a clear necessity for additional interventions designed to target assumed emotion regulation deficits. [Corrected] PsycINFO Database Record (c) 2014 APA, all rights reserved.

  13. Nonimmigrant Admissions: Fiscal Year 2008

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  14. Nonimmigrant Admissions: Fiscal Year 2012

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  15. Nonimmigrant Admissions - Fiscal Year 2013

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  16. Nonimmigrant Admissions: Fiscal Year 2005

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  17. Nonimmigrant Admissions: Fiscal Year 2016

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  18. Nonimmigrant Admissions: Fiscal Year 2010

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  19. Nonimmigrant Admissions: Fiscal Year 2006

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  20. Nonimmigrant Admission: Fiscal Year 2007

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  1. Nonimmigrant Admissions: Fiscal Year 2014

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  2. Nonimmigrant Admissions: Fiscal Year 2009

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  3. Nonimmigrant Admissions: Fiscal Year 2011

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  4. Nonimmigrant Admissions: Fiscal Year 2004

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  5. Nonimmigrant Admissions: Fiscal Year 2015

    Data.gov (United States)

    Department of Homeland Security — Nonimmigrants are foreign nationals granted temporary admission into the United States. The major purposes for which nonimmigrant admission may be authorized include...

  6. Substance abuse and gender differences in first episode psychosis: Impact on hospital readmissions.

    Science.gov (United States)

    Crosas, Josep M; Cobo, Jesus; Ahuir, Maribel; Hernández, Carla; García, Rebeca; Pousa, Esther; Oliva, Joan-Carles; Monreal, José-Antonio; Palao, Diego J

    There have been controversial results in the study of gender differences in first episode psychosis (FEP). Substance abuse is the main existing comorbidity in FEP, and has been associated with worse prognosis and greater symptom severity. To explore gender differences in FEP in relation to drug abuse, and their relationship with hospital readmissions. Descriptive and prospective study (18 months). We included 141 patients (31.2% women), aged 26.1 years on average, mostly diagnosed with schizophreniform disorder (32.6%). A percentage of 58.9 had problematic use of drugs. Gender significant differences were found in age of onset, age at entry to the programme, marital status and cohabitation, and percentage differences were revealed in current drug abuse and frequency of consumption. Gender, duration of untreated psychosis, psychiatric history, age of onset and previous drug use were not predictors of re-entry. Hospital readmission rate was 24.8%, with no gender differences. The most common reasons for admission were abandonment of treatment (66.7%) and drug abuse (44.4%). Drug abuse was higher in the men than in the women as a reason for re-admission. There are gender differences in FEP. Men have an earlier onset of symptoms and have worse functional outcomes. Drug abuse in men is higher and represents a major cause of hospital readmission. Therapeutic interventions to prevent the effects of drug abuse are necessary from the early stages of the illness. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Eating Disorder Symptoms and Alcohol Use Among Adolescents in Substance Abuse Treatment

    Directory of Open Access Journals (Sweden)

    Janelle E. Arias

    2009-11-01

    Full Text Available Objective: To examine the relationship of eating disorder (ED symptoms with the severity of alcohol use among adolescents in treatment for alcohol and other substance use disorders (AOSUDs. Method: A sample consisted of 177 adolescents who participated in outpatient AOSUD treatment programs in Connecticut. Chi square tests, one-way ANOVAs and Pearson’s correlation coefficients were used to describe the prevalence and correlates of any eating disorders, and the related symptoms. Multivariate regression was used to test the associations between ED symptoms and alcohol consumption. Results: 26.4% of the participants had at least one ED symptom, with the highest number of symptoms occurring in females. The number of ED symptoms was associated with increases in the number of times that they became intoxicated in the year before entering treatment, the number of alcohol-related social problems, and the number of alcohol-related physical symptoms after taking into consideration the effects of age and gender. Conclusions: The prevalence of symptoms of EDs is high in adolescents with AOSUDs, with the number of ED symptoms correlating with increased alcohol consumption. Further studies on the course and treatment of adolescents with AOSUDs and symptoms of EDs are warranted.

  8. Treatment of Co-Occurring Substance Abuse and Suicidality among Adolescents: A Randomized Trial

    Science.gov (United States)

    Esposito-Smythers, Christianne; Spirito, Anthony; Kahler, Christopher W.; Hunt, Jeffrey; Monti, Peter

    2011-01-01

    Objective: This study tested a cognitive-behavioral treatment protocol for adolescents with a co-occurring alcohol or other drug use disorder (AOD) and suicidality in a randomized clinical trial. Method: Forty adolescents (M[subscript age] = 15 years; 68% female, 89% White) and their families recruited from an inpatient psychiatric hospital were…

  9. Adopting evidence-based medically assisted treatments in substance abuse treatment organizations: roles of leadership socialization and funding streams.

    Science.gov (United States)

    Blum, Terry C; Davis, Carolyn D; Roman, Paul M

    2014-01-01

    This paper examines the organizational adoption of medically assisted treatments (MAT) for substance use disorders (SUDs) in a representative sample of 555 US for-profit and not-for-profit treatment centers. The study examines organizational adoption of these treatments in an institutionally contested environment that traditionally has valued behavioral treatment, using sociological and resource dependence frameworks. The findings indicate that socialization of leadership, measured by formal clinical education, is related to the adoption of MAT. Funding patterns also affect innovation adoption, with greater adoption associated with higher proportions of earned income from third party fees for services, and less adoption associated with funding from criminal justice sources. These findings may generalize to other social mission-oriented organizations where innovation adoption may be linked to private and public benefit values inherent in the type of socialization of leadership and different patterns of funding support.

  10. Sex differences in treatment-seeking behavior by education and marital status before and after admission to hospital. A register-based cohort study of the Danish population aged 50+

    DEFF Research Database (Denmark)

    Höhn, Andreas; Lindahl-Jacobsen, Rune; Rau, Roland

    to hospital between 1999 and 2008. For this population, we identified all contacts with GPs between 1996 and 2011 to quantify the sex differences in treatment-seeking behavior within the 3-year periods before and after hospitalization, and to estimate the impact of the civil and educational status on the sex...... differentials in treatment-seeking. We found women having consistently more GP contacts across all ages, but a narrowing of the treatment-seeking behavior shortly before and after admission to hospital. We moreover found a gradient of the educational and the marital status, suggesting that groups with higher...

  11. 28 CFR 550.51 - Drug abuse education course.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Drug abuse education course. 550.51... DRUG PROGRAMS Drug Abuse Treatment Program § 550.51 Drug abuse education course. (a) Purpose of the drug abuse education course. All institutions provide a drug abuse education course to: (1) Inform...

  12. Ibogaine Detoxification Transitions Opioid and Cocaine Abusers Between Dependence and Abstinence: Clinical Observations and Treatment Outcomes

    Directory of Open Access Journals (Sweden)

    Deborah C. Mash

    2018-06-01

    Full Text Available Ibogaine may be effective for transitioning opioid and cocaine dependent individuals to sobriety. American and European self-help groups provided public testimonials that ibogaine alleviated drug craving and opioid withdrawal symptoms after only a single dose administration. Preclinical studies in animal models of addiction have provided proof-of-concept evidence in support of these claims. However, the purported therapeutic benefits of ibogaine are based on anecdotal reports from a small series of case reports that used retrospective recruitment procedures. We reviewed clinical results from an open label case series (N = 191 of human volunteers seeking to detoxify from opioids or cocaine with medical monitoring during inpatient treatment. Whole blood was assayed to obtain pharmacokinetic measures to determine the metabolism and clearance of ibogaine. Clinical safety data and adverse events (AEs were studied in male and female subjects. There were no significant adverse events following administration of ibogaine in a dose range that was shown to be effective for blocking opioid withdrawal symptoms in this study. We used multi-dimensional craving questionnaires during inpatient detoxification to test if ibogaine was effective in diminishing heroin and cocaine cravings. Participants also completed standardized questionnaires about their health and mood before and after ibogaine treatment, and at program discharge. One-month follow-up data were reviewed where available to determine if ibogaine’s effects on drug craving would persist outside of an inpatient setting. We report here that ibogaine therapy administered in a safe dose range diminishes opioid withdrawal symptoms and reduces drug cravings. Pharmacological treatments for opioid dependence include detoxification, narcotic antagonists and long-term opioid maintenance therapy. Our results support product development of single oral dose administration of ibogaine for the treatment of opioid

  13. An Approach to Treatment of the Child Sexual Abuser in the Military.

    Science.gov (United States)

    1987-04-20

    orientation is to children. 2. Pedophilic interests begin at aaolescence. 3. No precipitating stress/no subjective distress. 4. Persistent interest and...maturation) issues. Regressed Type i. Primary sexual orientation is to agemates. 2. Pedophilic interests emerge in adulthood. 3. Precioitating stress usually...assessment of otfenoers is sea oi rnrv’ cet *een! the fixated pedophile and the rearessec oeooohile is verv imoortant in an approach to treatment ot the :7ce_

  14. The relationship between child maltreatment and substance abuse treatment outcomes among emerging adults and adolescents.

    Science.gov (United States)

    Garner, Bryan R; Hunter, Brooke D; Smith, Douglas C; Smith, Jane Ellen; Godley, Mark D

    2014-01-01

    Emerging adulthood is the period of greatest risk for problematic substance use. The primary aim of the current study was to examine the relationship between a broad measure of child maltreatment and several key outcomes for a large clinical sample of emerging adults (n = 858) and adolescents (n = 2,697). The secondary aim was to examine the extent to which the relationship between child maltreatment and treatment outcomes differed between emerging adults and adolescents. Multilevel latent growth curve analyses revealed emerging adults and adolescents who experienced child maltreatment reported significantly greater reductions over time on several treatment outcomes (e.g., substance use, substance-related problems, and emotional problems). Overall, analyses did not support differential relationships between child maltreatment and changes over time in these substance use disorder treatment outcomes for emerging adults and adolescents. The one exception was that although emerging adults with child maltreatment did reduce their HIV risk over time, their improvements were not as great as were the improvements in HIV risk reported by adolescents who had experienced child maltreatment. © The Author(s) 2014.

  15. The Comparison of Neuro Behavioral Activity Mechanisms between Substance Abuse Sufferers under Maintenance Treatment and Non-Sufferers

    Directory of Open Access Journals (Sweden)

    H Kazemi

    2014-12-01

    Full Text Available Objective: The current study aimed at comparing preventive behavioral mechanisms behavioral tendencies, and the clash between drug users under maintenance treatmentandnon-users. Method: It was a causal-comparative study. All addicts of Esfahan city who had referred to one of the drug quitting centers constituted the study population. The selected sample consisted of 50drug users under maintenance treatment and 50non-users who were selected by convenience sampling. Gray- Wilson Personality Questionnaire was used for data collection purposes. Findings: The results showed that there was a significant difference between the two groups in terms of BAS and FFS scales while the difference between the two groups in terms of BIS scale was not reported to be significant. As well, there was a significant difference between the two groups in terms of approach, passive avoidance, fight, and silence. Conclusion: Investigating the neural/behavioral foundations within the range of substance abuse disorders indicates a difference between this group and those without the disorder, and it can further our understanding of the neural foundations of these disorders.

  16. Substance abuse in patients admitted voluntarily and involuntarily to acute psychiatric wards: a national cross-sectional study

    Directory of Open Access Journals (Sweden)

    Anne Opsal

    2011-12-01

    Full Text Available Background: Substance abuse and mental disorder comorbidity is high among patients admitted to acute psychiatric wards. The aim of the study was to identify this co-occurrence as a reason for involuntary admission and if specific substance use-related diagnoses were associated with such admissions.Methods: The study was a part of a multicentre, cross-sectional national study carried out during 2005-2006 within a research network of acute mental health services. Seventy-five percent of Norwegian hospitals providing acute in-patient treatment participated. Substance use was measured using the Clinician Rating Scale and the ICD-10 diagnoses F10-19. Diagnostic assessments were performed by the clinicians during hospital stay.Results: Overall, 33.2% (n=1,187 of the total patient population (3,506 were abusing alcohol or drugs prior to admission according to the Clinician Rating Scale. No difference in the overall prevalence of substance abuserelated diagnoses between the two groups was found. Overall, 310 (26% of the admissions, 216 voluntarily and 94 involuntarily admitted patients received a double diagnosis. Frequent comorbid combinations among voluntarily admitted patients were; a combination of alcohol and either mood disorder (40% or multiple mental disorders (29%. Among involuntarily admitted patients, a combination of poly drug use and schizophrenia was most frequent (47%. Substance abusing patients diagnosed with mental and behavioral disorders due to the use of psychoactive stimulant substances had a significantly higher risk of involuntary hospitalization (OR 2.3.Conclusion: Nearly one third of substance abusing patients are involuntarily admitted to mental hospitals, in particular stimulant drug use was associated with involuntarily admissions.

  17. Prize-based contingency management for the treatment of substance abusers: a meta-analysis.

    Science.gov (United States)

    Benishek, Lois A; Dugosh, Karen L; Kirby, Kim C; Matejkowski, Jason; Clements, Nicolle T; Seymour, Brittany L; Festinger, David S

    2014-09-01

    To review randomized controlled trials to assess efficacy of a prize-based contingency management procedure in reducing substance use (where a drug-free breath or urine sample provides a chance of winning a prize). A meta-analysis was conducted on papers published from January 2000 to February 2013 to determine the effect size of studies comparing prize-based contingency management to a treatment-as-usual control condition (k = 19 studies). Parallel analyses evaluated the efficacy of both short- (k = nine studies) and long-term outcomes (k = six studies) of prize-based contingency management. The average end-of-treatment effect size (Cohen's d) was 0.46 [95% confidence interval (CI) = 0.37, 0.54]. This effect size decreased at the short-term (≤3-month) post-intervention follow-up to 0.33 (95% CI = 0.12, 0.54) and at the 6-month follow-up time-point there was no detectable effect [d = -0.09 (95% CI = -0.28, 0.10)]. Adding prize-based contingency management to behavioral support for substance use disorders can increase short-term abstinence, but the effect does not appear to persist to 6 months. © 2014 Society for the Study of Addiction.

  18. Correlates of Performance of Healthcare Workers in Emergency, Triage, Assessment and Treatment plus Admission Care (ETAT+) Course in Rwanda: Context Matters

    Science.gov (United States)

    Hategekimana, Celestin; Shoveller, Jeannie; Tuyisenge, Lisine; Kenyon, Cynthia; Cechetto, David F.; Lynd, Larry D.

    2016-01-01

    Background The Emergency, Triage, Assessment and Treatment plus Admission care (ETAT+) course, a comprehensive advanced pediatric life support course, was introduced in Rwanda in 2010 to facilitate the achievement of the fourth Millennium Development Goal. The impact of the course on improving healthcare workers (HCWs) knowledge and practical skills related to providing emergency care to severely ill newborns and children in Rwanda has not been studied. Objective To evaluate the impact of the ETAT+ course on HCWs knowledge and practical skills, and to identify factors associated with greater improvement in knowledge and skills. Methods We used a one group, pre-post test study using data collected during ETAT+ course implementation from 2010 to 2013. The paired t-test was used to assess the effect of ETAT+ course on knowledge improvement in participating HCWs. Mixed effects linear and logistic regression models were fitted to explore factors associated with HCWs performance in ETAT+ course knowledge and practical skills assessments, while accounting for clustering of HCWs in hospitals. Results 374 HCWs were included in the analysis. On average, knowledge scores improved by 22.8/100 (95% confidence interval (CI) 20.5, 25.1). In adjusted models, bilingual (French & English) participants had a greater improvement in knowledge 7.3 (95% CI 4.3, 10.2) and higher odds of passing the practical skills assessment (adjusted odds ratio (aOR) = 2.60; 95% CI 1.25, 5.40) than those who were solely proficient in French. Participants who attended a course outside of their health facility had higher odds of passing the skills assessment (aOR = 2.11; 95% CI 1.01, 4.44) than those who attended one within their health facility. Conclusions The current study shows a positive impact of ETAT+ course on improving participants’ knowledge and skills related to managing emergency pediatric and neonatal care conditions. The findings regarding key factors influencing ETAT+ course outcomes

  19. Correlates of Performance of Healthcare Workers in Emergency, Triage, Assessment and Treatment plus Admission Care (ETAT+ Course in Rwanda: Context Matters.

    Directory of Open Access Journals (Sweden)

    Celestin Hategekimana

    Full Text Available The Emergency, Triage, Assessment and Treatment plus Admission care (ETAT+ course, a comprehensive advanced pediatric life support course, was introduced in Rwanda in 2010 to facilitate the achievement of the fourth Millennium Development Goal. The impact of the course on improving healthcare workers (HCWs knowledge and practical skills related to providing emergency care to severely ill newborns and children in Rwanda has not been studied.To evaluate the impact of the ETAT+ course on HCWs knowledge and practical skills, and to identify factors associated with greater improvement in knowledge and skills.We used a one group, pre-post test study using data collected during ETAT+ course implementation from 2010 to 2013. The paired t-test was used to assess the effect of ETAT+ course on knowledge improvement in participating HCWs. Mixed effects linear and logistic regression models were fitted to explore factors associated with HCWs performance in ETAT+ course knowledge and practical skills assessments, while accounting for clustering of HCWs in hospitals.374 HCWs were included in the analysis. On average, knowledge scores improved by 22.8/100 (95% confidence interval (CI 20.5, 25.1. In adjusted models, bilingual (French & English participants had a greater improvement in knowledge 7.3 (95% CI 4.3, 10.2 and higher odds of passing the practical skills assessment (adjusted odds ratio (aOR = 2.60; 95% CI 1.25, 5.40 than those who were solely proficient in French. Participants who attended a course outside of their health facility had higher odds of passing the skills assessment (aOR = 2.11; 95% CI 1.01, 4.44 than those who attended one within their health facility.The current study shows a positive impact of ETAT+ course on improving participants' knowledge and skills related to managing emergency pediatric and neonatal care conditions. The findings regarding key factors influencing ETAT+ course outcomes demonstrate the importance of considering key

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

    Science.gov (United States)

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

    2011-11-01

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

  1. Internet addiction disorder and problematic use of Google Glass™ in patient treated at a residential substance abuse treatment program.

    Science.gov (United States)

    Yung, Kathryn; Eickhoff, Erin; Davis, Diane L; Klam, Warren P; Doan, Andrew P

    2015-02-01

    Internet addiction disorder (IAD) is characterized by the problematic use of online video games, computer use, and mobile handheld devices. While not officially a clinical diagnosis according to the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM), individuals with IAD manifest severe emotional, social, and mental dysfunction in multiple areas of daily activities due to their problematic use of technology and the internet. We report a 31year-old man who exhibited problematic use of Google Glass™. The patient has a history of a mood disorder most consistent with a substance induced hypomania overlaying a depressive disorder, anxiety disorder with characteristics of social phobia and obsessive compulsive disorder, and severe alcohol and tobacco use disorders. During his residential treatment program at the Navy's Substance Abuse and Recovery Program (SARP) for alcohol use disorder, it was noted that the patient exhibited significant frustration and irritability related to not being able to use his Google Glass™. The patient exhibited a notable, nearly involuntary movement of the right hand up to his temple area and tapping it with his forefinger. He reported that if he had been prevented from wearing the device while at work, he would become extremely irritable and argumentative. Over the course of his 35-day residential treatment, the patient noted a reduction in irritability, reduction in motor movements to his temple to turn on the device, and improvements in his short-term memory and clarity of thought processes. He continued to intermittently experience dreams as if looking through the device. To our knowledge, this is the first reported case of IAD involving problematic use of Google Glass™. Published by Elsevier Ltd.

  2. Psychiatric comorbidity and additional abuse of drugs in maintenance treatment with L- and D,L-methadone.

    Science.gov (United States)

    Wedekind, Dirk; Jacobs, Stefan; Karg, Iris; Luedecke, Christel; Schneider, Udo; Cimander, Konrad; Baumann, Pierre; Ruether, Eckart; Poser, Wolfgang; Havemann-Reinecke, Ursula

    2010-03-01

    Sixty D,L- or L-methadone treated patients in maintenance therapy were interviewed for additional drug abuse and psychiatric comorbidity; 51.7% of the entire population had a comorbid Axis-I disorder, with a higher prevalence in females (P=0.05). Comorbid patients tended to have higher abuse of benzodiazepines, alcohol, cannabis, and cocaine, but not of heroin. They had received a significantly lower D,L- (Pabuse.

  3. Causes of Hospital Admissions in Domus

    DEFF Research Database (Denmark)

    Skov Benthien, Kirstine; Nordly, Mie; von Heymann-Horan, Annika

    2018-01-01

    CONTEXT: Avoidable hospital admissions are important negative indicators of quality of end-of-life care. Specialized palliative care (SPC) may support patients remaining at home. OBJECTIVES: Therefore, the purpose of this study was to investigate if SPC at home could prevent hospital admissions...... in patients with incurable cancer. METHODS: These are secondary results of Domus: a randomized controlled trial of accelerated transition to SPC with psychological intervention at home (Clinicaltrials.gov: NCT01885637). Participants were patients with incurable cancer and limited antineoplastic treatment...... significantly in overall potentially avoidable admissions. Both groups felt mostly safe about their place of care. CONCLUSION: The intervention did not prevent hospital admissions. Likely, any intervention effects were outweighed by increased identification of problems in the intervention group leading...

  4. A Comparison of the Structural Factors of the Propensity for Abusiveness Scale for Women and Men in a Domestic Violence Treatment Program.

    Science.gov (United States)

    Allen, Christopher T; Swan, Suzanne C; Maas, Carl D; Barber, Sara

    2015-08-01

    Court-mandated domestic violence (DV) treatment programs across the country have seen a marked increase in female clients. These programs use a variety of measurement tools to assess the needs of their clients. Increased numbers of women in treatment for DV reflect a need to address the measurement of intimate partner violence (IPV) for both males and females. Unfortunately, the reliability and validity of many of measures used to assess IPV and related constructs for women remains unknown. The current study focuses on a particular measure, the Propensity for Abusiveness Scale (PAS). The PAS is not a measure of abusive behavior per se; rather, it assesses risk factors for abuse, including affective lability, anger expression, trauma symptoms, and harsh parenting experienced by the respondent. Specifically, the current study compares the factor structure and the measurement properties of the PAS for males and females in a sample of 885 (647 female, 238 male) participants in a DV treatment program. Findings indicate that the PAS demonstrated configural, metric, and scalar invariance between the female and male samples. These results suggest that it is appropriate for researchers and clinicians to make comparisons between women and men based on PAS factor scores. © The Author(s) 2014.

  5. Parenting Efficacy and Support in Mothers With Dual Disorders in a Substance Abuse Treatment Program.

    Science.gov (United States)

    Brown, Suzanne; Hicks, Laurel M; Tracy, Elizabeth M

    2016-01-01

    Approximately 73% of women entering treatment for substance use disorders are mothers of children younger than 18, and the high rate of mental health disorders among mothers with substance use disorders increases their vulnerability to poor parenting practices. Parenting efficacy and social support for parenting have emerged as significant predictors of positive parenting practices among families at risk for child maltreatment. The purpose of the current study was to examine the impact of parenting support and parenting efficacy on the likelihood of out-of-home placement and custody status among the children of mothers with dual substance use and mental health disorders. This study examined the impact of parenting efficacy and assistance with childcare on the likelihood of child out-of-home placement and custody status among 175 mothers with diagnosed dual substance and mental health disorder and in treatment for substance dependence. Logistic regression was utilized to assess the contributions of parenting efficacy and the number of individuals in mothers' social networks who assist with childcare to the likelihood of out-of-home placement and custody loss of children. Parenting efficacy was also examined as a mediator using bootstrapping in PROCESS for SPSS. Greater parenting efficacy was associated with lower likelihood of having at least one child in out-of-home placement (B = -.064, SE = .029, p = .027) and lower likelihood of loss of child custody (B = -.094, SE = .034, p = .006). Greater number of children in the 6 to 18 age range predicted greater likelihood of having at least one child in the custody of someone else (B = .409, SE = .171, p = .017) and in out-of-home placement (B = .651, SE = .167, p child in out-of-home placement (B = .927, SE = .382, p = .015) or to have lost custody of a child (B = -1.31, SE = .456, p = .004). Finally, parenting efficacy mediated the relationship between parenting support and likelihood of out-of-home placement (effect

  6. Hippotherapy as a treatment for socialization after sexual abuse and emotional stress

    Science.gov (United States)

    Guerino, Marcelo R.; Briel, Alysson F.; Araújo, Maria das Graças Rodrigues

    2015-01-01

    [Purpose] Hippotherapy is a therapeutic resource that uses the horse as a kinesiotherapy instrument to elicit motor and cognitive improvements in individuals with special needs. [Subjects and Methods] This research evaluated two women aged 18 and 21 years, who had suffered sexual violence when they were children between the ages of 6 and 7 years old. The subjects did not have mental dysfunction but they were regular students registered at a school of special education. The patients presented severe motor limitation, difficulty with coordination, significant muscular retractions, thoracic and cervical kyphosis, cervical protrusion wich was basically a function of the postures they had adopted when victims of the sexual violence suffered in childhood. The patients performed twenty sessions of 30 minutes of hippotherapy on a horse. The activities were structured to stimulate coordination, proprioception, the vestibular and motor-sensorial systems for the improvement of posture, muscle activity and cognition. [Results] The activities provided during the hippotherapy sessions elicited alterations in postural adjustment resulting in 30% improvement, 80% improvement in coordination in, 50% improvement in corporal balance and in sociability and self-esteem. [Conclusion] Hippotherapy proved to be an effective treatment method for coordination, balance and postural correction, and also improved the patients’ self-esteem that had suffered serious emotional stress. PMID:25931769

  7. Other Drugs of Abuse

    Science.gov (United States)

    ... People Abuse » Other Drugs of Abuse Other Drugs of Abuse Listen There are many other drugs of abuse, ... and Rehab Resources About the National Institute on Drug Abuse (NIDA) | About This Website Tools and Resources | Contact ...

  8. Treatment effects on insular and anterior cingulate cortex activation during classic and emotional Stroop interference in child abuse-related complex post-traumatic stress disorder.

    Science.gov (United States)

    Thomaes, K; Dorrepaal, E; Draijer, N; de Ruiter, M B; Elzinga, B M; van Balkom, A J; Smit, J H; Veltman, D J

    2012-11-01

    Functional neuroimaging studies have shown increased Stroop interference coupled with altered anterior cingulate cortex (ACC) and insula activation in post-traumatic stress disorder (PTSD). These brain areas are associated with error detection and emotional arousal. There is some evidence that treatment can normalize these activation patterns. At baseline, we compared classic and emotional Stroop performance and blood oxygenation level-dependent responses (functional magnetic resonance imaging) of 29 child abuse-related complex PTSD patients with 22 non-trauma-exposed healthy controls. In 16 of these patients, we studied treatment effects of psycho-educational and cognitive behavioural stabilizing group treatment (experimental treatment; EXP) added to treatment as usual (TAU) versus TAU only, and correlations with clinical improvement. At baseline, complex PTSD patients showed a trend for increased left anterior insula and dorsal ACC activation in the classic Stroop task. Only EXP patients showed decreased dorsal ACC and left anterior insula activation after treatment. In the emotional Stroop contrasts, clinical improvement was associated with decreased dorsal ACC activation and decreased left anterior insula activation. We found further evidence that successful treatment in child abuse-related complex PTSD is associated with functional changes in the ACC and insula, which may be due to improved selective attention and lower emotional arousal, indicating greater cognitive control over PTSD symptoms.

  9. Treatment of Anxiety Disorders and Comorbid Alcohol Abuse with Buspirone in a Patient with Antidepressant-Induced Platelet Dysfunction: A Case Report

    Directory of Open Access Journals (Sweden)

    Mir Mazhar

    2013-01-01

    Full Text Available The risk of abnormal bleeding with serotonin reuptake inhibitors has been known, but there is insufficient evidence base to guide pharmacological treatment of anxiety in patients with underlying haematological conditions. The following case report is about a 50-year-old female with generalized anxiety disorder, social phobia, obsessive compulsive disorder, and alcohol abuse where pharmacological treatment of anxiety symptoms has been difficult as it would lead to bruising due to the patient’s underlying qualitative platelet dysfunction. Treatment with venlafaxine, citalopram, escitalopram, and clomipramine resulted in improvement and anxiety symptoms, as well as reduction in alcohol use, but pharmacological treatment has to be discontinued because of bruising and hematomas. In view of an active substance use disorder, benzodiazepines were avoided as a treatment option. The patient’s anxiety symptoms and comorbid alcohol abuse responded well to pharmacological treatment with buspirone which gradually titrated up to a dose of 30 mg BID. Patient was followed for around a six-month period while she was on buspirone before being discharged to family doctor’s care. Buspirone is unlikely to have a significant effect on platelet serotonin transponder and could be an effective alternative for pharmacological treatment of anxiety in patients with a bleeding diathesis.

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

    Science.gov (United States)

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

    2015-05-01

    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). 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. 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, popioid abstinence. Eight percent (n=27/338) used heroin for the first time during follow-up; 10.1% reported first-time injection heroin use. 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. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. A Thermally Stable Form of Bacterial Cocaine Esterase: A Potential Therapeutic Agent for Treatment of Cocaine Abuse

    Energy Technology Data Exchange (ETDEWEB)

    Brim, Remy L.; Nance, Mark R.; Youngstrom, Daniel W.; Narasimhan, Diwahar; Zhan, Chang-Guo; Tesmer, John J.G.; Sunahara, Roger K.; Woods, James H. (Michigan); (Michigan-Med); (Kentucky)

    2010-09-03

    Rhodococcal cocaine esterase (CocE) is an attractive potential treatment for both cocaine overdose and cocaine addiction. CocE directly degrades cocaine into inactive products, whereas traditional small-molecule approaches require blockade of the inhibitory action of cocaine on a diverse array of monoamine transporters and ion channels. The usefulness of wild-type (wt) cocaine esterase is hampered by its inactivation at 37 C. Herein, we characterize the most thermostable form of this enzyme to date, CocE-L169K/G173Q. In vitro kinetic analyses reveal that CocE-L169K/G173Q displays a half-life of 2.9 days at 37 C, which represents a 340-fold improvement over wt and is 15-fold greater than previously reported mutants. Crystallographic analyses of CocE-L169K/G173Q, determined at 1.6-{angstrom} resolution, suggest that stabilization involves enhanced domain-domain interactions involving van der Waals interactions and hydrogen bonding. In vivo rodent studies reveal that intravenous pretreatment with CocE-L169K/G173Q in mice provides protection from cocaine-induced lethality for longer time periods before cocaine administration than wt CocE. Furthermore, intravenous administration (pretreatment) of CocE-L169K/G173Q prevents self-administration of cocaine in a time-dependent manner. Termination of the in vivo effects of CoCE seems to be dependent on, but not proportional to, its clearance from plasma as its half-life is approximately 2.3 h and similar to that of wt CocE (2.2 h). Taken together these data suggest that CocE-L169K/G173Q possesses many of the properties of a biological therapeutic for treating cocaine abuse but requires additional development to improve its serum half-life.

  12. Multiple Gastrointestinal Complications of Crack Cocaine Abuse

    Directory of Open Access Journals (Sweden)

    Neal Carlin

    2014-01-01

    Full Text Available Cocaine and its alkaloid free base “crack-cocaine” have long since been substances of abuse. Drug abuse of cocaine via oral, inhalation, intravenous, and intranasal intake has famously been associated with a number of medical complications. Intestinal ischemia and perforation remain the most common manifestations of cocaine associated gastrointestinal disease and have historically been associated with oral intake of cocaine. Here we find a rare case of two relatively uncommon gastrointestinal complications of hemorrhage and pancreatitis presenting within a single admission in a chronic crack cocaine abuser.

  13. Schizophrenia, substance abuse, and violent crime.

    Science.gov (United States)

    Fazel, Seena; Långström, Niklas; Hjern, Anders; Grann, Martin; Lichtenstein, Paul

    2009-05-20

    Persons with schizophrenia are thought to be at increased risk of committing violent crime 4 to 6 times the level of general population individuals without this disorder. However, risk estimates vary substantially across studies, and considerable uncertainty exists as to what mediates this elevated risk. Despite this uncertainty, current guidelines recommend that violence risk assessment should be conducted for all patients with schizophrenia. To determine the risk of violent crime among patients diagnosed as having schizophrenia and the role of substance abuse in mediating this risk. Longitudinal designs were used to link data from nationwide Swedish registers of hospital admissions and criminal convictions in 1973-2006. Risk of violent crime in patients after diagnosis of schizophrenia (n = 8003) was compared with that among general population controls (n = 80 025). Potential confounders (age, sex, income, and marital and immigrant status) and mediators (substance abuse comorbidity) were measured at baseline. To study familial confounding, we also investigated risk of violence among unaffected siblings (n = 8123) of patients with schizophrenia. Information on treatment was not available. Violent crime (any criminal conviction for homicide, assault, robbery, arson, any sexual offense, illegal threats, or intimidation). In patients with schizophrenia, 1054 (13.2%) had at least 1 violent offense compared with 4276 (5.3%) of general population controls (adjusted odds ratio [OR], 2.0; 95% confidence interval [CI], 1.8-2.2). The risk was mostly confined to patients with substance abuse comorbidity (of whom 27.6% committed an offense), yielding an increased risk of violent crime among such patients (adjusted OR, 4.4; 95% CI, 3.9-5.0), whereas the risk increase was small in schizophrenia patients without substance abuse comorbidity (8.5% of whom had at least 1 violent offense; adjusted OR, 1.2; 95% CI, 1.1-1.4; Pgenetic or early environmental) confounding of the

  14. Spiritual transcendence as a predictor of psychosocial outcome from an outpatient substance abuse program.

    Science.gov (United States)

    Piedmont, Ralph L

    2004-09-01

    Does the Spiritual Transcendence Scale (STS; R. L. Piedmont, 1999) predict psychosocial outcomes from an outpatient substance abuse program? Self-report data on symptoms, personality, and coping resources were obtained for 73 consecutive admissions (57 men and 16 women; ages 19-66 years) at intake and again from the 56 (47 men and 9 women) who completed treatment. Controlling for relevant demographic variables, pretreatment STS scores were significantly related to self-ratings at posttreatment. The STS predicted treatment outcomes over and above the contribution of the five-factor model of personality. Significant partial correlations between pretreatment STS scores and therapist ratings of treatment outcome were also obtained. Spiritual Transcendence, especially the facets of Universality and Connectedness, appears to play a significant role in substance abuse recovery. (c) 2004 APA

  15. The national drug abuse treatment clinical trials network data share project: website design, usage, challenges, and future directions.

    Science.gov (United States)

    Shmueli-Blumberg, Dikla; Hu, Lian; Allen, Colleen; Frasketi, Michael; Wu, Li-Tzy; Vanveldhuisen, Paul

    2013-01-01

    There are many benefits of data sharing, including the promotion of new research from effective use of existing data, replication of findings through re-analysis of pooled data files, meta-analysis using individual patient data, and reinforcement of open scientific inquiry. A randomized controlled trial is considered as the 'gold standard' for establishing treatment effectiveness, but clinical trial research is very costly, and sharing data is an opportunity to expand the investment of the clinical trial beyond its original goals at minimal costs. We describe the goals, developments, and usage of the Data Share website (http://www.ctndatashare.org) for the National Drug Abuse Treatment Clinical Trials Network (CTN) in the United States, including lessons learned, limitations, and major revisions, and considerations for future directions to improve data sharing. Data management and programming procedures were conducted to produce uniform and Health Insurance Portability and Accountability Act (HIPAA)-compliant de-identified research data files from the completed trials of the CTN for archiving, managing, and sharing on the Data Share website. Since its inception in 2006 and through October 2012, nearly 1700 downloads from 27 clinical trials have been accessed from the Data Share website, with the use increasing over the years. Individuals from 31 countries have downloaded data from the website, and there have been at least 13 publications derived from analyzing data through the public Data Share website. Minimal control over data requests and usage has resulted in little information and lack of control regarding how the data from the website are used. Lack of uniformity in data elements collected across CTN trials has limited cross-study analyses. The Data Share website offers researchers easy access to de-identified data files with the goal to promote additional research and identify new findings from completed CTN studies. To maximize the utility of the website

  16. Reducing the rate and duration of Re-ADMISsions among patients with unipolar disorder and bipolar disorder using smartphone-based monitoring and treatment - the RADMIS trials: study protocol for two randomized controlled trials.

    Science.gov (United States)

    Faurholt-Jepsen, Maria; Frost, Mads; Martiny, Klaus; Tuxen, Nanna; Rosenberg, Nicole; Busk, Jonas; Winther, Ole; Bardram, Jakob Eyvind; Kessing, Lars Vedel

    2017-06-15

    Unipolar and bipolar disorder combined account for nearly half of all morbidity and mortality due to mental and substance use disorders, and burden society with the highest health care costs of all psychiatric and neurological disorders. Among these, costs due to psychiatric hospitalization are a major burden. Smartphones comprise an innovative and unique platform for the monitoring and treatment of depression and mania. No prior trial has investigated whether the use of a smartphone-based system can prevent re-admission among patients discharged from hospital. The present RADMIS trials aim to investigate whether using a smartphone-based monitoring and treatment system, including an integrated clinical feedback loop, reduces the rate and duration of re-admissions more than standard treatment in unipolar disorder and bipolar disorder. The RADMIS trials use a randomized controlled, single-blind, parallel-group design. Patients with unipolar disorder and patients with bipolar disorder are invited to participate in each trial when discharged from psychiatric hospitals in The Capital Region of Denmark following an affective episode and randomized to either (1) a smartphone-based monitoring system including (a) an integrated feedback loop between patients and clinicians and (b) context-aware cognitive behavioral therapy (CBT) modules (intervention group) or (2) standard treatment (control group) for a 6-month trial period. The trial started in May 2017. The outcomes are (1) number and duration of re-admissions (primary), (2) severity of depressive and manic (only for patients with bipolar disorder) symptoms; psychosocial functioning; number of affective episodes (secondary), and (3) perceived stress, quality of life, self-rated depressive symptoms, self-rated manic symptoms (only for patients with bipolar disorder), recovery, empowerment, adherence to medication, wellbeing, ruminations, worrying, and satisfaction (tertiary). A total of 400 patients (200 patients with

  17. Drug abuse

    International Nuclear Information System (INIS)

    Simon, T.R.; Seastrunk, J.W.; Malone, G.; Knesevich, M.A.; Hickey, D.C.

    1991-01-01

    This paper reports that this study used SPECT to examine patients who have abused drugs to determine whether SPECT could identify abnormalities and whether these findings have clinical importance. Fifteen patients with a history of substance abuse (eight with cocaine, six with amphetamine, and one with organic solvent) underwent SPECT performed with a triple-headed camera and Tc-99m HMPAO both early for blood flow and later for functional information. These images were then processed into a 3D videotaped display used in group therapy. All 15 patients had multiple areas of decreased tracer uptake peppered throughout the cortex but mainly affecting the parietal lobes, expect for the organic solvent abuser who had a large parietal defect. The videotapes were subjectively described by a therapist as an exceptional tool that countered patient denial of physical damage from substance abuse. Statistical studies of recidivism between groups is under way

  18. Drugs of abuse--opiates.

    OpenAIRE

    Ling, W; Wesson, D R

    1990-01-01

    Treating opiate-dependent patients can be difficult for many physicians because the patients' life-styles, values, and beliefs differ from those of the physicians. Primary care physicians, however, are often involved in the treatment of the medical complications of opiate abuse, and physicians must often manage a patient's opiate dependence until appropriate referral to a drug abuse treatment program can be arranged. Treatment is guided by an understanding of the patient's addictive disease, ...

  19. Spouse Abuse

    OpenAIRE

    Dixon, Louise

    2010-01-01

    The term spouse abuse is commonly used to refer to Aggressive, violent and/or controlling behaviours that take place between two people involved in an intimate Relationship. Spouse abuse is a high frequency crime resulting in victims from all social classes, ethnicities, genders and educational backgrounds. Preventative methods at societal and community levels are required in addition to more traditional intervention approaches in order to adequately address this problem. This entry will prov...

  20. The therapeutic relationship after psychiatric admission.

    LENUS (Irish Health Repository)

    Roche, Eric

    2014-03-01

    The therapeutic relationship is one of the most central and important factors in the treatment of mental health disorders. A better therapeutic relationship is associated with service engagement, medication adherence, and satisfaction with services. This study aimed to compare the demographic and clinical factors associated with the therapeutic relationship in voluntarily and involuntarily admitted psychiatric service users. We found that individuals who had been admitted involuntarily, who had a diagnosis of a psychotic disorder, and who reported higher levels of perceived pressures on admission were more likely to have a poorer therapeutic relationship with their consultant psychiatrist. Greater levels of insight and treatment satisfaction, together with higher levels of procedural justice experienced on admission, were associated with a better therapeutic relationship. We found that the level of perceived coercion on admission was not related to the therapeutic relationship. Targeted interventions to improve the therapeutic relationship, particularly for involuntarily admitted service users, are discussed.

  1. Correlates of improvement in substance abuse among dually diagnosed veterans with post-traumatic stress disorder in specialized intensive VA treatment.

    Science.gov (United States)

    Coker, Kendell L; Stefanovics, Elina; Rosenheck, Robert

    2016-01-01

    Substantial rates of substance use comorbidity have been observed among veterans with Post-Traumatic Stress Disorder (PTSD), highlighting the need to identify patient and program characteristics associated with improved outcomes for substance abuse. Data were drawn from 12,270 dually diagnosed veterans who sought treatment from specialized intensive Veterans Health Administration PTSD programs between 1993 and 2011. The magnitude of the improvement in Addiction Severity Index (ASI) alcohol and drug use composite scores from baseline was moderate, with effect sizes (ES) of -.269 and -.287, respectively. Multivariate analyses revealed that treatment in longer-term programs, being prescribed psychiatric medication, and planned participation in reunions were all associated with slightly improved outcomes. Reductions in substance use measures were associated with robust improvements in PTSD symptoms and violent behavior. These findings suggest not only synergistic treatment effects linking improvement in PTSD symptoms with substance use disorders among dually diagnosed veterans with PTSD, but also to reductions in violent behavior. Furthermore, the findings indicate that proper discharge planning in addition to intensity and duration of treatment for dually diagnosed veterans with severe PTSD may result in better outcomes. Further dissemination of evidence-based substance abuse treatment may benefit this population. (c) 2016 APA, all rights reserved).

  2. Admissibility and hyperbolicity

    CERN Document Server

    Barreira, Luís; Valls, Claudia

    2018-01-01

    This book gives a comprehensive overview of the relationship between admissibility and hyperbolicity. Essential theories and selected developments are discussed with highlights to applications. The dedicated readership includes researchers and graduate students specializing in differential equations and dynamical systems (with emphasis on hyperbolicity) who wish to have a broad view of the topic and working knowledge of its techniques. The book may also be used as a basis for appropriate graduate courses on hyperbolicity; the pointers and references given to further research will be particularly useful. The material is divided into three parts: the core of the theory, recent developments, and applications. The first part pragmatically covers the relation between admissibility and hyperbolicity, starting with the simpler case of exponential contractions. It also considers exponential dichotomies, both for discrete and continuous time, and establishes corresponding results building on the arguments for exponent...

  3. Mathematics Admission Test Remarks

    Directory of Open Access Journals (Sweden)

    Ideon Erge

    2016-12-01

    Full Text Available Since 2014, there have been admission tests in mathematics for applicants to the Estonian University of Life Sciences for Geodesy, Land Management and Real Estate Planning; Civil Engineering; Hydraulic Engineering and Water Pollution Control; Engineering and Technetronics curricula. According to admission criteria, the test must be taken by students who have not passed the specific mathematics course state exam or when the score was less than 20 points. The admission test may also be taken by those who wish to improve their state exam score. In 2016, there were 126 such applicants of whom 63 took the test. In 2015, the numbers were 129 and 89 and in 2014 150 and 47 accordingly. The test was scored on scale of 100. The arithmetic average of the score was 30.6 points in 2016, 29.03 in 2015 and 18.84 in 2014. The test was considered to be passed with 1 point in 2014 and 20 points in 2015 and 2016. We analyzed test results and gave examples of problems which were solved exceptionally well or not at all.

  4. Group Cognitive Behavioral Treatment for Parents and Children At-Risk for Physical Abuse: An Initial Study

    Science.gov (United States)

    Runyon, Melissa K.; Deblinger, Esther; Steer, Robert A.

    2010-01-01

    To compare the relative efficacy of two types of group cognitive-behavioral therapy for treating the traumatized child and at-risk or offending parent in cases of child physical abuse (CPA), 24 parents and their children were treated with Combined Parent-Child Cognitive Behavioral Therapy (CPC-CBT) and 20 parents were treated with Parent-Only CBT.…

  5. Controlling behaviours and technology‐facilitated abuse perpetrated by men receiving substance use treatment in England and Brazil: Prevalence and risk factors

    Science.gov (United States)

    Canfield, Martha; Radcliffe, Polly; D'Oliveira, Ana Flavia Pires Lucas

    2017-01-01

    Abstract Introduction and Aims Controlling behaviours are highly prevalent forms of non‐physical intimate partner violence (IPV). The prevalence of perpetrating controlling behaviours and technology‐facilitated abuse (TFA) was compared by men receiving substance use treatment in England (n = 223) and Brazil (n = 280). Factors associated with perpetrating these behaviours towards their current/most recent partner and their association with other types of IPV were explored. Design and Methods Secondary analysis from two cross‐sectional studies was performed. Data on socio‐demographic characteristics, infidelity, IPV perpetration and victimisation, adverse childhood experiences (ACE), attitudes towards gender relations and roles, substance use, depressive symptoms and anger expression were collected. Results Sixty‐four percent (143/223) and 33% (73/223) of participants in England and 65% (184/280) and 20% (57/280) in Brazil reported controlling behaviours and TFA, respectively, during their current/most recent relationship. Excluding IPV victimisation from the multivariate models; perpetrating controlling behaviours was associated with a higher number of ACE, higher anger expression (England) and severe physical IPV perpetration (Brazil), and perpetrating TFA was associated with younger age. Including both IPV victimisation and perpetration in the multivariate models; perpetrating controlling behaviour was associated with experiencing a higher number of ACE, higher anger expression (England), emotional IPV victimisation (England) and experiencing controlling behaviour from a partner (England). The perpetration of TFA was associated with younger age and experiencing TFA from a partner. Conclusions Technological progress provides opportunities for perpetrators to control and abuse their partners. Controlling behaviours and TFA should be addressed to reduce IPV perpetration by males in substance use treatment. [Gilchrist G, Canfield M,Radcliffe P, d

  6. Maternal and Neonatal Complications of Substance Abuse in Iranian Pregnant Women

    Directory of Open Access Journals (Sweden)

    Maryam Hosseinnezhad-Yazdi

    2012-06-01

    Full Text Available There is an increased prevalence of maternal substance abuse during pregnancy in younger women in all socioeconomic classes and races. Our aim was to determine the prevalence and correlates of self-reported substance abuse among pregnant women and obstetric complications or neonatal outcomes in Iran. This retrospective cohort study is covering a five year period on medical records of pregnant women attending the maternity unit of four major hospitals (Mahdieh, Taleghani, Imam Hossein and Akbarabadi Hospitals. Women who reported using opium, heroin, crack, cannabis or methamphetamine were compared with women with no reported history of drug abuse for obstetric complications and prenatal morbidity and neonatal mortality. From 100,620 deliveries substance abuse was recorded for 519 women giving a prevalence of 0.5%. Opium was the most prevalent substance abused followed by crack (a mix of heroin and amphetamines. The exposed group had significantly more obstetric complications including preterm low birth weight and postpartum hemorrhage than the non-exposed group. The exposed group had significantly worse prenatal outcomes including more admissions to intensive care unit and higher infant mortality than the non-exposed group. None of the women in the exposed group was on methadone treatment at time of delivery. Risks of maternal and neonatal complications were increased in substance using pregnant women, especially preterm birth and low birth weight. We recommend a multidisciplinary team to provide methadone maintenance therapy for substance using pregnant women and urinary screen of all pregnant women presenting to hospital.

  7. Role of the laboratory in the evaluation of suspected drug abuse.

    Science.gov (United States)

    Gold, M S; Dackis, C A

    1986-01-01

    Despite the high incidence of substance abuse, it remains a common cause of misdiagnosis. In patients who have abused or who are currently abusing drugs, symptoms of a psychiatric illness may be mimicked by either the drug's presence or absence. The laboratory can aid in making a differential diagnosis and eliminating drugs from active consideration as a cause of psychosis, depression, mania, and personality changes. Treatment planning and prevention of serious medical consequences often rest on the accuracy of the admission drug screen. Testing is widely used to assess improvement in substance abuse in both inpatient and outpatient settings. In occupational settings, testing has been used as an early indicator that a problem exists and as a successful prevention tool. The appropriate use of analytic technology in drug abuse testing requires an understanding of available test methodologies. These include drug screens by thin-layer chromatography, comprehensive testing using enzyme immunoassay, and computer-assisted gas chromatography-mass spectrometry (GC-MS). Testing for specific drugs considered likely causes or precipitants of "psychiatric" complaints is available with enzyme assays, radioimmunoassay, or definitive forensic-quality testing using GC-MS.

  8. Self-Esteem and Oral Condition of Institutionalized Abused Children in Japan.

    Science.gov (United States)

    Sano-Asahito, T; Suzuki, A; Matsuyama, J; Mitomi, T; Kinoshita-Kawano, S; Hayashi-Sakai, S; Asahito, T

    2015-01-01

    Abused children have been reported to have low self-esteem. The aim of this study was to investigate the effects of dental intervention on self-esteem, oral condition, and concern for oral health in abused children admitted to a child protection service facility. We examined the oral condition of 65 children (34 boys, 31 girls; aged 2-15 years), instructed them in tooth-brushing. Self-esteem was examined using Pope's five-scale test for children. Before discharge, the children completed questionnaires on concern about their oral health. The findings revealed the reasons for admission were child abuse and neglect (n=45), domestic violence against the mother (n= 20), special needs (n=11), delinquency (n=7), school refusal (n=2), and other reasons (n=3). Thirty-five of the 65 residents (54%) needed treatment for caries. Of these, 24 (69%) were abused children and 11 (31%) were admitted due to other reasons. Mean self-esteem score differed significantly between the resident children (n=43) and an outpatient control group (n=102) (59.16±14.54 vs 73.92±16.81, respectively; pchildren had low self-esteem, after dental intervention, positive answers regarding oral health were obtained. The findings suggest that dental interventions might be effective for helping to improve the self-esteem of abused children.

  9. Design paper: The CapOpus trial: A randomized, parallel-group, observer-blinded clinical trial of specialized addiction treatment versus treatment as usual for young patients with cannabis abuse and psychosis

    Directory of Open Access Journals (Sweden)

    Gluud Christian

    2008-07-01

    Full Text Available Abstract Background A number of studies indicate a link between cannabis-use and psychosis as well as more severe psychosis in those with existing psychotic disorders. There is currently insufficient evidence to decide the optimal way to treat cannabis abuse among patients with psychosis. Objectives The major objective for the CapOpus trial is to evaluate the additional effect on cannabis abuse of a specialized addiction treatment program adding group treatment and motivational interviewing to treatment as usual. Design The trial is designed as a randomized, parallel-group, observer-blinded clinical trial. Patients are primarily recruited through early-psychosis detection teams, community mental health centers, and assertive community treatment teams. Patients are randomized to one of two treatment arms, both lasting six months: 1 specialized addiction treatment plus treatment as usual or 2 treatment as usual. The specialized addiction treatment is manualized and consists of both individual and group-based motivational interviewing and cognitive behavioral therapy, and incorporates both the family and the case manager of the patient. The primary outcome measure will be changes in amount of cannabis consumption over time. Other outcome measures will be psychosis symptoms, cognitive functioning, quality of life, social functioning, and cost-benefit analyses. Trial registration ClinicalTrials.gov NCT00484302.

  10. Sex Under the Influence of Drugs or Alcohol: Common for Men in Substance Abuse Treatment and Associated with High Risk Sexual Behavior

    Science.gov (United States)

    Calsyn, Donald A.; Cousins, Sarah J.; Hatch-Maillette, Mary A.; Forcehimes, Alyssa; Mandler, Raul; Doyle, Suzanne R.; Woody, George

    2010-01-01

    Sex under the influence of drugs or alcohol is associated with high risk sexual behavior. Heterosexual men (n=505) in substance abuse treatment completed a computer administered interview assessing sexual risk behaviors. Most men (73.3%) endorsed sex under the influence in the prior 90 days, and 39.1% endorsed sex under the influence during their most recent sexual event. Sex under the influence at the most recent event was more likely to involve anal intercourse, sex with a casual partner, and less condom use. Patients might benefit from interventions targeting sexual behavior and substance use as mutual triggers. PMID:20163383

  11. Structure preserving transformations for Newtonian Lie-admissible equations

    International Nuclear Information System (INIS)

    Cantrijn, F.

    1979-01-01

    Recently, a new formulation of non-conservative mechanics has been presented in terms of Hamilton-admissible equations which constitute a generalization of the conventional Hamilton equations. The algebraic structure entering the Hamilton-admissible description of a non-conservative system is that of a Lie-admissible algebra. The corresponding geometrical treatment is related to the existence of a so-called symplectic-admissible form. The transformation theory for Hamilton-admissible systems is currently investigated. The purpose of this paper is to describe one aspect of this theory by identifying the class of transformations which preserve the structure of Hamilton-admissible equations. Necessary and sufficient conditions are established for a transformation to be structure preserving. Some particular cases are discussed and an example is worked out

  12. Leaving an Abusive Relationship

    Science.gov (United States)

    ... Elder abuse Emotional and verbal abuse Financial abuse Harassment Human trafficking Physical abuse Sexual coercion Stalking Violence ... A teacher, counselor, or principal at your child’s school. An adult at your child’s school can help ...

  13. Predictors of PTSD Treatment Response Trajectories in a Sample of Childhood Sexual Abuse Survivors: The Roles of Social Support, Coping, and PTSD Symptom Clusters.

    Science.gov (United States)

    Fletcher, Shelley; Elklit, Ask; Shevlin, Mark; Armour, Cherie

    2017-11-01

    This study aimed to (a) identify posttraumatic stress disorder (PTSD) trajectories in a sample of Danish treatment-seeking childhood sexual abuse (CSA) survivors and (b) examine the roles of social support, coping style, and individual PTSD symptom clusters (avoidance, reexperiencing, and hyperarousal) as predictors of the identified trajectories. We utilized a convenience sample of 439 CSA survivors attending personalized psychotherapy treatment in Denmark. Four assessments were conducted on a six monthly basis over a period of 18 months. We used latent class growth analysis (LCGA) to test solutions with one to six classes. Following this, a logistic regression was conducted to examine predictors of the identified trajectories. Results revealed four distinct trajectories which were labeled high PTSD gradual response, high PTSD treatment resistant, moderate PTSD rapid response, and moderate PTSD gradual response. Emotional and detached coping and more severe pretreatment avoidance and reexperiencing symptoms were associated with more severe and treatment resistant PTSD. High social support and a longer length of time since the abuse were associated with less severe PTSD which improved over time. The findings suggested that treatment response of PTSD in CSA survivors is characterized by distinct patterns with varying levels and rates of PTSD symptom improvement. Results revealed that social support is protective and that emotional and detached coping and high pretreatment levels of avoidance and reexperiencing symptoms are risk factors in relation to PTSD severity and course. These factors could potentially identify patients who are at risk of not responding to treatment. Furthermore, these factors could be specifically addressed to increase positive outcomes for treatment-seeking CSA survivors.

  14. [Physicians and nurses subjected to disciplinary actions because of substance abuse. Ten years of experience with supervision in Copenhagen].

    Science.gov (United States)

    Hansen, Elisabet Tornberg; Fouchard, Jan R; Hoffmeyer, Jane H; Rosdahl, Nils

    2002-11-18

    Medical Health Officers supervise medical staff on behalf of the Danish National Board of Health. The Board can impose disciplinary action on registered providers of health care. This retrospective investigation was based on case reports from 1 January 1989 to 31 December 1995 on medical staff under individual supervision because of alcohol or drug abuse, with a 3-year follow-up to 31 December 1998 in Greater Copenhagen (about 1.25 million inhabitants). Altogether 173 health personnel were identified. Of these, 47 physicians and 91 nurses had disciplinary actions imposed on them because of abuse. In well over a third the abuse had lasted less than two years, whereas in a third it had lasted more than five years before admission to individual supervision. Half of both physicians and nurses had undergone psychiatric treatment before that time. Frequent disciplinary actions imposed were examination of urine passed without prior warning and controlled treatment of alcohol abuse. Difficulties in adhering to these conditions were found in one third to half of the cases. The Medical Health Officers notified the National Board of Health of breaches in 64%, often several times for each person. At the end of the follow-up period, 49% were still working. There was a statistically significant excess mortality in the group. Of the 26 dead, four had committed suicide and in a further 12 cases poisoning or abuse was a contributory cause of death. Earlier detection, a tightening of sanctions, and improved treatment are recommended.

  15. Concurrent Treatment of Substance Abuse, Child Neglect, Bipolar Disorder, Post-Traumatic Stress Disorder, and Domestic Violence: A Case Examination Involving Family Behavior Therapy

    Science.gov (United States)

    Donohue, Brad C.; Romero, Valerie; Herdzik, Karen; Lapota, Holly; Al, Ruwida Abdel; Allen, Daniel N.; Azrin, Nathan H.; Van Hasselt, Vincent B.

    2012-01-01

    High rates of co-occurrence between substance abuse and child neglect have been well documented and especially difficult to treat. As a first step in developing a comprehensive evidence-based treatment for use in this population, the present case examination underscores Family Behavior Therapy (FBT) in the treatment of a mother who evidenced Substance Dependence, child neglect, Post-Traumatic Stress Disorder, Bipolar I Disorder, and domestic violence. Utilizing psychometrically validated self-report inventories and objective urinalysis, treatment was found to result in the cessation of substance use, lower risk of child maltreatment, improved parenting attitudes and practices, and reduced instances of violence in the home. The importance of utilizing validity scales in the assessment of referrals from child welfare settings is discussed, and future directions are reported in light of the results. PMID:23457426

  16. Implementation of integrated therapies for comorbid post-traumatic stress disorder and substance use disorders in community substance abuse treatment programs.

    Science.gov (United States)

    Killeen, Therese K; Back, Sudie E; Brady, Kathleen T

    2015-05-01

    The high prevalence of trauma and post-traumatic stress disorder (PTSD) in individuals with substance use disorders (SUDs) presents a number of treatment challenges for community treatment providers and programs in the USA. Although several evidence-based, integrated therapies for the treatment of comorbid PTSD/SUD have been developed, rates of utilisation of such practices remain low in community treatment programs. The goal of this article was to review the extant literature on common barriers that prevent adoption and implementation of integrated treatments for PTSD/SUD among substance abuse community treatment programs. Organisational, provider-level and patient-level factors that drive practice decisions were discussed, including organisational philosophy of care policies, funding and resources, as well as provider and patient knowledge and attitudes related to implementation of new integrated treatments for comorbid PTSD and SUD. Understanding and addressing these community treatment challenges may facilitate use of evidence-based integrated treatments for comorbid PTSD and SUD. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  17. New drugs of abuse.

    Science.gov (United States)

    Rech, Megan A; Donahey, Elisabeth; Cappiello Dziedzic, Jacqueline M; Oh, Laura; Greenhalgh, Elizabeth

    2015-02-01

    Drug abuse is a common problem and growing concern in the United States, and over the past decade, novel or atypical drugs have emerged and have become increasingly popular. Recognition and treatment of new drugs of abuse pose many challenges for health care providers due to lack of quantitative reporting and routine surveillance, and the difficulty of detection in routine blood and urine analyses. Furthermore, street manufacturers are able to rapidly adapt and develop new synthetic isolates of older drugs as soon as law enforcement agencies render them illegal. In this article, we describe the clinical and adverse effects and purported pharmacology of several new classes of drugs of abuse including synthetic cannabinoids, synthetic cathinones, salvia, desomorphine, and kratom. Because many of these substances can have severe or life-threatening adverse effects, knowledge of general toxicology is key in recognizing acute intoxication and overdose; however, typical toxidromes (e.g., cholinergic, sympathomimetic, opioid, etc.) are not precipitated by many of these agents. Medical management of patients who abuse or overdose on these drugs largely consists of supportive care, although naloxone may be used as an antidote for desomorphine overdose. Symptoms of aggression and psychosis may be treated with sedation (benzodiazepines, propofol) and antipsychotics (haloperidol or atypical agents such as quetiapine or ziprasidone). Other facets of management to consider include treatment for withdrawal or addiction, nutrition support, and potential for transmission of infectious diseases. © 2014 Pharmacotherapy Publications, Inc.

  18. Subjective effects, misuse, and adverse effects of osmotic-release methylphenidate treatment in adolescent substance abusers with attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Winhusen, Theresa M; Lewis, Daniel F; Riggs, Paula D; Davies, Robert D; Adler, Lenard A; Sonne, Susan; Somoza, Eugene C

    2011-10-01

    Psychostimulants are effective treatments for attention-deficit/hyperactivity disorder (ADHD) but may be associated with euphoric effects, misuse/diversion, and adverse effects. These risks are perceived by some clinicians to be greater in substance-abusing adolescents relative to non-substance-abusing adults. The present study evaluates the subjective effects, misuse/diversion, and adverse effects associated with the use of osmotic-release oral system methylphenidate (OROS-MPH), relative to placebo, for treating ADHD in adolescents with a substance use disorder (SUD) as a function of substance use severity and compared these risks with those associated with the treatment of ADHD in adults without a non-nicotine SUD. Datasets from two randomized placebo-controlled trials of OROS-MPH for treating ADHD, one conducted with 303 adolescents (13-18) with at least one non-nicotine SUD and one with 255 adult smokers (18-55), were analyzed. Outcome measures included the Massachusetts General Hospital Liking Scale, self-reported medication compliance, pill counts, and adverse events (AEs). Euphoric effects and misuse/diversion of OROS-MPH were not significantly affected by substance use severity. The euphoric effects of OROS-MPH did not significantly differ between the adolescent and adult samples. Adults rated OROS-MPH as more effective in treating ADHD, whereas adolescents reported feeling more depressed when taking OROS-MPH. The adolescents lost more pills relative to the adults regardless of treatment condition, which suggests the importance of careful medication monitoring. Higher baseline use of alcohol and cannabis was associated with an increased risk of experiencing a treatment-related AE in OROS-MPH, but baseline use did not increase the risk of serious AEs or of any particular category of AE and the adolescents did not experience more treatment-related AEs relative to the adults. With good monitoring, and in the context of substance abuse treatment, OROS-MPH can

  19. Nonflexible Lie-admissible algebras

    International Nuclear Information System (INIS)

    Myung, H.C.

    1978-01-01

    We discuss the structure of Lie-admissible algebras which are defined by nonflexible identities. These algebras largely arise from the antiflexible algebras, 2-varieties and associator dependent algebras. The nonflexible Lie-admissible algebras in our discussion are in essence byproducts of the study of nonassociative algebras defined by identities of degree 3. The main purpose is to discuss the classification of simple Lie-admissible algebras of nonflexible type

  20. Child abuse, a case report

    Directory of Open Access Journals (Sweden)

    Andri M.T. Lubis

    2004-03-01

    Full Text Available Child abuse is a pervasive social and medical problem that remains a major cause of disability and death among children. The annual incidence of abuse is estimated to be 15 to 42 cases per 1,000 children and appears to be increasing. Fractures are the second most common presentation of physical abuse after skin lesions, and approximately one third of abused children will eventually be seen by an orthopedic surgeon. We report a 7-month-old boy who was suspected to be abused. Our diagnosis was based on findings of multiple fractures, delay in seeking medical treatment and discrepancy between the history of illness and the clinical findings. He sustained multiple fractures in variety of healing, namely fractures on left supracondylar humeri, left radius and ulna, right radius and ulna, both femora, right tibia, and left tibia and fibula. Radiological examination was an important modality in revealing the possibility of abuse on this child. He had received medical treatment, protection, consultation team for the parents and an underway police investigation. (Med J Indones 2004; 13: 59-65 Keywords: child, abuse