Improving Alcoholism Treatment Across the Spectrum of Services

Abstract

This article represents the proceedings of a symposium at the 2000 RSA Meeting in Denver, Colorado. The chair was Michael E. Hilton. The presentations were (1) The effects of brief advice and motivational enhancement on alcohol use and related variables in primary care, by Stephen A. Maisto, Joseph Conigliaro, Melissa McNiel, Kevin Kraemer, Mary E. Kelley, and Rosemarie Conigliaro; (2) Enhanced linkage of alcohol dependent persons to primary medical care: A randomized controlled trial of a multidisciplinary health evaluation in a detoxification unit, by Jeffrey H. Samet, Mary Jo Larson, Jacqueline Savetsky, Michael Winter, Lisa M. Sullivan, and Richard Saitz; (3) Cost-effectiveness of day hospital versus traditional alcohol and drug outpatient treatment in a health maintenance organization: Randomized and self-selected samples, by Constance Weisner, Jennifer Mertens, Sujaya Parthasarathy, Charles Moore, Enid Hunkeler, Teh-Wei Hu, and Joe Selby; and (4) Case monitoring for alcoholics: One year clinical and health cost effects, by Robert L. Stout, William Zywiak, Amy Rubin, William Zwick, Mary Jo Larson, and Don Shepard.

A conceptual model to facilitate transitions from primary care to specialty substance use disorder care: a review of the literature

“…Research demonstrates that telephone monitoring to support engagement and access to care is feasible (patients assigned to receive calls do so) (Hilton et al , 2001; Hubbard et al , 2007) and facilitates entry into and attendance of SUD continuing care (Hubbard et al , 2007; Zanjani et al , 2008) and 12-step mutual-help groups, (McKay et al , 2004) among SUD patients completing intensive treatment. Telephone monitoring can also improve SUD outcomes for up to two years among SUD patients, and more 12-step mutual-help group participation helps to explain positive associations between telephone monitoring and better outcomes (Hilton et al , 2001; McKay et al , 2004; Mensinger et al , 2007).…”

Randomized controlled trial of telephone monitoring with psychiatry inpatients with co-occurring substance use and mental health disorders

“…These telephone call “doses” are comparable to those in other trials of telephone interventions with mental health patients (Cook et al, 2008; Seal et al, 2012). However, studies focused on patients with substance use disorders (Hilton et al, 2001; McKay et al, 2004, 2005, 2010b) conducted telephone monitoring over a much longer period than used in our or others’ (Seal et al, 2012; Rosen et al, 2013, 2017) research. For example, McKay et al’s (2010b) telephone monitoring consisted of tapering telephone contacts for 18 months.…”

“…In a randomized trial of patients with alcohol use disorders, at one-year post-intervention, the frequency of heavy drinking was twice as high among controls (24%) than among telephone-monitored patients (12%) who received telephone calls on a tapering schedule. Telephone-monitored patients had 73% fewer emergency room visits and 58% fewer substance-related hospitalizations during the year (Hilton et al, 2001). …”

Psychological Distress and Return to Substance Use Two Years Following Treatment

“…A ''watchful waiting'' approach has been suggested for the long-term management of substance abuse problems (Hilton et al, 2001;McKay et al, 1999;Stout et al, 1999). Thus, psychological distress occurring in the posttreatment period may be more important to assess (in terms of determining likelihood of resumed substance use) than psychiatric symptoms at treatment entry.…”