Adolescents entering chemical dependency treatment in private managed care: ethnic differences in treatment initiation and retention

Campbell, Cynthia I.; Weisner, Constance; Sterling, Stacy

doi:10.1016/j.jadohealth.2005.05.028

Cited by 52 publications

(60 citation statements)

References 37 publications

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“…A new admission was defined as one that occurred after a service gap of 30 days or more. This is the definition used by the Kaiser Permanente Regional Chemical Dependency Oversight Committee and in other studies (29,30). Use of psychiatric services was also assessed with administrative data and defined as visits to the Kaiser Permanente Department of Psychiatry or to the CDRP psychiatrist.…”

Section: Methodsmentioning

confidence: 99%

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Substance Use, Symptom, and Employment Outcomes of Persons With a Workplace Mandate for Chemical Dependency Treatment

Weisner

Lu²,

Hinman³

et al. 2009

Psychiatric Services

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Objective-This study examined the role of workplace mandates to chemical dependency treatment in treatment adherence, alcohol and drug abstinence, severity of employment problems, and severity of psychiatric problems.Methods-The sample included 448 employed members of a private, nonprofit U.S. managed care health plan who entered chemical dependency treatment with a workplace mandate (N=75) or without one (N=373); 405 of these individuals were followed up at one year (N=70 and N=335, respectively), and 362 participated in a five-year follow up (N=60 and N=302, respectively). Propensity scores predicting receipt of a workplace mandate were calculated. Logistic regression and ordinary leastsquares regression were used to predict length of stay in chemical dependency treatment, alcohol and drug abstinence, and psychiatric and employment problem severity at one and five years.Results-Overall, participants with a workplace mandate had one-and five-year outcomes similar to those without such a mandate. Having a workplace mandate also predicted longer treatment stays and improvement in employment problems. When other factors related to outcomes were controlledThe authors report no competing interests. for, having a workplace mandate predicted abstinence at one year, with length of stay as a mediating variable. NIH Public AccessConclusions-Workplace mandates can be an effective mechanism for improving work performance and other outcomes. Study participants who had a workplace mandate were more likely than those who did not have a workplace mandate to be abstinent at follow-up, and they did as well in treatment, both short and long term. Pressure from the workplace likely gets people to treatment earlier and provides incentives for treatment adherence.Treatment mandates are a major predictor of entry into chemical dependency treatment (1)(2)(3)(4)(5). In the public sector, individuals are often pressured to enter treatment by criminal justice or welfare agencies; in private programs the pressure is often from employers (1,3). Most research in this area has examined legal mandates, with treatment retention and rearrest as outcomes. Results are mixed, but outcomes are often similar to those of voluntary clients (5-12).Employee substance use problems are a major policy issue for employers, insurers, and health plans, as they affect large numbers of workers and impose a substantial financial burden on employers. Treatment mandates originate from employee assistance programs, unions, or employers (3,4,13). Few recent studies have examined how workplace mandates affect treatment outcomes, but earlier studies found that employees who were mandated to enter treatment and those who sought treatment voluntarily had comparable outcomes (14,15).Problem severity and motivation are robust factors affecting chemical dependency treatment outcome, possibly overriding effects of a mandate. Substance use and psychiatric disorders commonly co-occur among individuals in treatment (16-18), and these complex patients typically do less ...

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Section: Methodsmentioning

confidence: 99%

“…Respondents were given five choices to describe the intensity of the pressure they felt, ranging from no pressure to very strong pressure. (29,30). Use of psychiatric services was also assessed with administrative data and defined as visits to the Kaiser Permanente Department of Psychiatry or to the CDRP psychiatrist.…”

mentioning

confidence: 99%

Substance Use, Symptom, and Employment Outcomes of Persons With a Workplace Mandate for Chemical Dependency Treatment

Weisner

Lu²,

Hinman³

et al. 2009

Psychiatric Services

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“…The third hypothesis is that Blacks' low rates of substance abuse treatment utilization account for their greater suffering from the consequences of drinking. A recent study of adolescent substance abuse treatment among insured adolescents revealed that Black adolescents are just as likely to initiate treatment as Whites but they spend less time in treatment (Campbell, Weisner, & Sterling, 2006). Among the adult uninsured and insured populations, Blacks are also less likely to receive substance abuse treatment and services than other groups (Daley, 2005;Wu & Ringwalt, 2005).…”

Section: Alcohol-related Problemsmentioning

confidence: 99%

Windows of Opportunity: Fundamental Concepts for Understanding Alcohol-Related Disparities Experienced by Young Blacks in the United States

2006

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This paper presents a theoretical framework for conceptualizing alcohol-related disparities experienced by young Blacks in the United States. The framework highlights areas of risk and opportunity as they relate to the development of alcohol use and alcohol-related problems. In this paper, life course development theory serves as a guide for identifying a critical period in the development of alcohol-related disparities and it serves to guide the identification of opportunities to prevent or attenuate this health outcome. We also highlight concepts from ecosocial theory, resilience theory, and prevention science that advance our understanding of risk and protective factors for the social problems that young Blacks experience related to alcohol use. We conclude with suggestions for designing studies that range from etiology to preventive interventions. We also recommend methodologies that allow for more nuanced understandings of the etiology and prevention of alcohol use and alcohol-related problems experienced by young Blacks than have been available to date.

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“…Adolescents frequently deny they have any substance abuse problems, even lying about whether they use at all or not (Muck, et al, 2001;Pabon, 2005;Campbell, Weisner, & Sterling, 2006).…”

Section: Substance Abusing Hispanic Youthsmentioning

confidence: 99%

“…Greater "family involvement" (which usually means "parents' involvement") has been found to be associated with higher treatment engagement and increased treatment retention (Campbell, Weisner, & Sterling, 2006;Liddle, 2004). Although caution should be used when interpreting their findings, some researchers speculate that family functioning may be one of the mechanisms through which the intervention affects adolescents' substance abuse and associated problem behaviors .…”

Section: Parental Involvementmentioning

confidence: 99%

Hispanic Adolescents With Severe Substance Abuse Issues: Parental Involvement, Acculturation-Related Factors and Attachment

Lundblad¹

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The sample for this study consisted of 94 adolescent-mother pairs. The adolescent sample was 65% male, and 35% female, with a mean age of 15 years. More than half of the adolescents were born in the United States (60%) and had resided in the U.S. for an average of 12 years; 80% of the caregivers (primarily mothers) were foreign-born and lived in the U.S. for an average of 21 years.Correlation and hierarchical regression were used to answer the research questions. The findings indicate that the hypothesized model and corresponding anticipated effect of the relationship between parental school and peer involvement on vii adolescents' frequency of alcohol, marijuana and cocaine use was not supported by the data. Parental "acculturation-related" variables did not explain any of the variance in adolescent substance use frequency in this sample. Mediation and moderation models were not supported either. However, some interesting relationships were found:

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Adolescents entering chemical dependency treatment in private managed care: ethnic differences in treatment initiation and retention

Cited by 52 publications

References 37 publications

Substance Use, Symptom, and Employment Outcomes of Persons With a Workplace Mandate for Chemical Dependency Treatment

Substance Use, Symptom, and Employment Outcomes of Persons With a Workplace Mandate for Chemical Dependency Treatment

Windows of Opportunity: Fundamental Concepts for Understanding Alcohol-Related Disparities Experienced by Young Blacks in the United States

Hispanic Adolescents With Severe Substance Abuse Issues: Parental Involvement, Acculturation-Related Factors and Attachment

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