Assessment and Treatment of Co-occurring Eating Disorders in Publicly Funded Addiction Treatment Programs

Abstract

Objective Publicly funded addiction treatment programs were surveyed to increase understanding of treatment options for persons with co-occurring eating and substance use disorders. Methods Data were collected between 2002 and 2004 from face-to-face interviews with program directors of a nationally representative sample of 351 addiction treatment programs. Results Half of the programs screen patients for eating disorders; 29% admit all persons with eating disorders, and 48% admit persons with eating disorders of low severity. Few programs attempt to treat eating disorders. Programs that admit and treat patients with eating disorders are more likely to emphasize a medical-psychiatric model of addiction, use psychiatric medications, admit patients with other psychiatric disorders, and have a lower caseload of African-American patients. Conclusions Generally, patients with co-occurring eating and substance use disorders do not appear to receive structured assessment or treatment for eating disorders in addiction treatment programs. These results highlight the need for education of addiction treatment professionals in assessment of eating disorders.

Gender Research in the National Institute on Drug Abuse National Treatment Clinical Trials Network: A Summary of Findings

“…Given the potential clinical relevance of eating disorder symptoms among treatment-seeking women with SUDs, investigators examined data from the National Treatment Center Study (NTCS) [30,31] to enhance understanding of current treatment resources available to patients with co-occurring eating disorders who present for addiction treatment [14,15]. The first analysis focused on a nationally representative sample (n=351) of publicly-funded programs that received more than 50% of their annual operating revenues from federal, state, or local grant sources [14].…”

“…The first analysis focused on a nationally representative sample (n=351) of publicly-funded programs that received more than 50% of their annual operating revenues from federal, state, or local grant sources [14]. Data were collected during on-site visits conducted between January 2005 and August 2006.…”

“…Of these 15 trials, 4 studies were pharmacologic, 8 psychosocial/behavioral, 1 a combination of medication and counseling, and 2 targeted HIV/hepatitis C virus risk behavior [11]. In addition to these 24 trials, CTN investigators conducted 14 ancillary studies, 2 of which were gender-specific [12, 13], 5 cross-study secondary analyses, one of which was a secondary analysis examining gender differences in HIV risk behaviors [10], a national health services survey in collaboration with non-CTN investigators [14, 15], and a critical review of the literature on gender and substance abuse treatment [9]. Four of the 24 randomized clinical trials have been on gender-specific treatment protocols (3 focused on women and 1 on men) [16–19].…”

Substance Abuse in Women

“…At present, no integrated, evidence-based treatments for EDs and substance-use disorders are available. 30 Like many co-occurring psychiatric conditions, individuals presenting to treatment with substance-use disorders and EDs typically receive treatment in programs specializing in substance-use disorders or EDs. They rarely receive services for both disorders.…”

“…A recent national survey of screening and treatment practices at 351 addiction treatment programs revealed that only half (51%) screen for EDs at intake or assessment, and only 29% admit patients who screen positive for EDs. 30 …”