Supplemental social services improve outcomes in public addiction treatment

McLellan, A. Thomas; Hagan, Teresa Ann; Levine, Marvin J.; Gould, Frank; Meyers, Kathleen; Bencivengo, Mark; Durell, Jack

doi:10.1046/j.1360-0443.1998.931014895.x

Cited by 194 publications

(142 citation statements)

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“…BZD users in methadone maintenance may benefit from more intensive psychosocial interventions as alternatives, supplements, or prerequisites to CM targeted at other drug use. Such interventions could include individualized case management (McLellan et al, 1998;McLellan et al, 1999) and need-service matching (Friedmann et al, 2004;McLellan et al, 1997). The utility of these findings is increased by the fact that they were based on self-reported BZD use collected using the ASI, an assessment tool widely used in both community and research treatment programs.…”

Section: Discussionmentioning

confidence: 99%

Self-report of illicit benzodiazepine use on the Addiction Severity Index predicts treatment outcome

Ghitza

Epstein

Preston

2008

Drug and Alcohol Dependence

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The relationship between pretreatment illicit benzodiazepine use (days of use in the last 30) assessed on the Addiction Severity Index (ASI) and treatment outcome was investigated by retrospective analysis of data from two controlled clinical trials in 361 methadone maintained cocaine/opiate users randomly assigned to 12-week voucher-or prize-based contingency management (CM) or control interventions. Based on screening ASI, participants were identified as nonusers (BZD-N; 0 days of use) or users (BZD-U; >0 days of use). Outcome measures were: urine drug screens (thrice weekly); quality of life and self-reported HIV-risk behaviors (every 2 weeks); and current DSM-IV diagnosis of cocaine and heroin dependence (study exit). In the CM group, BZD-U had significantly worse outcomes on in-treatment cocaine use, quality-of-life scores, needle-sharing behaviors, and current heroin dependence diagnoses at study exit compared to BZD-N. In the control group, BZD-U had significantly higher in-treatment cocaine use but did not differ from BZD-N on psychosocial measures. Thus, in a sample of non-dependent BZD users, self-reported illicit BZD use on the ASI, even at low levels, predicted worse outcome on cocaine use and blunted response to CM.

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Section: Discussionmentioning

confidence: 99%

Self-report of illicit benzodiazepine use on the Addiction Severity Index predicts treatment outcome

Ghitza

Epstein

Preston

2008

Drug and Alcohol Dependence

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“…Because a range of 'secondary' problems, such as physical or mental illness, unemployment, and homelessness, contribute to the progression of addictive disorders, substance abuse treatment programs may also make available comprehensive or 'wrap-around' services to address 'secondary' problems (Institute of Medicine, 1990;Moos & Finney, 1995). These problems may cause distress and trigger relapse even among persons who successfully reduce their substance use (Friedmann, Saitz, & Samet, 1998;McLellan & Weisner, 1996), and delivery of comprehensive services to address these issues has been shown to improve functioning, treatment retention, and outcomes (McLellan, Arndt, Metzger, Woody, & O'Brien, 1993;McLellan, Grisson, et al, 1993;McLellan & Weisner, 1996;McLellan et al, 1998). Despite their importance to quality substance abuse treatment (Leshner, 1999;Leukefeld, Pickens, & Schuster, 1992), the availability of comprehensive services declined from 1980to 1990(D'Aunno & Vaughn, 1995Etheridge, Craddock, Dunteman, & Hubbard, 1995;McLellan & Weisner, 1996;Widman, Platt, Lidz, Mathis, & Metzger, 1997).…”

Section: Introductionmentioning

confidence: 99%

Trends in comprehensive service availability in outpatient drug abuse treatment

Friedmann

Lemon

Durkin

et al. 2003

Journal of Substance Abuse Treatment

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Comprehensive medical and psychosocial services are essential to quality addiction treatment, but their availability declined in the 1980s. To determine whether this downward trend in the availability of comprehensive services continued in the 1990s, we analyzed data from a national panel study of outpatient substance abuse treatment units in 1990, 1995, and 2000. Response rates were greater than 85%. Regarding the availability of comprehensive services, including physical examinations, routine medical care, mental health services, financial counseling and employment counseling, administrators reported whether any substance abuse treatment client received the service in the past year. With the exception of physical examinations, whose reported availability increased from 1990 to 1995, and financial counseling, whose reported availability decreased during the same time, the reported availability of comprehensive services changed little during the 1990s. These findings highlight the continuing need to monitor access to comprehensive services and other quality markers in addiction treatment over time.

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“…Historically, it is a hard task to explain to the general population that alcoholism is a disease (10) .…”

Section: Discussionmentioning

confidence: 99%

Alcohol effects on family relations: a case study

Reinaldo

Pillon

2008

Rev. Latino-Am. Enfermagem

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Problems related to alcohol abuse have been associated to different factors, regardless of the causes attributed to this phenomenon. Alcohol consumption and dependence is considered a public health problem and deserve attention because of the social, work, family, physical, legal and violence-related risks it represents.This study aimed to identify the effects of alcoholism on family relations and, by means of case management, to encourage the recovery of these relationships. The results show that the problems caused by alcohol abuse impose profound suffering to family members, which contributes to high levels of interpersonal conflict, domestic violence, parental inadequacy, child abuse and negligence, financial and legal difficulties, in addition to clinical problems associated to it. DESCRIPTORS: alcoholism; family practice; patient care planning; psychiatric nursing REPERCUSSIONES DEL ALCOHOLISMO EN LAS RELACIONES FAMILIARES: ESTUDIO DE CASO ACERCA DEL TEMALos problemas relacionados al uso de alcohol han sido asociados a diversos factores, independiente de las causas atribuidas al fenómeno en cuestión. Cuando consideramos que el consumo y la dependencia de alcohol incrementan el riesgo para problemas sociales, de trabajo, familiares, físicos, legales y con violencia, podemos afirmar que merece atención y se configura como un problema de salud pública. La finalidad del estudio fue identificar las repercusiones del alcoholismo en las relaciones familiares y, por medio de la gestión de casos, incentivar el rescate de esas relaciones. Se trata de un estudio de caso. Los resultados demuestran que los trastornos que resultan del uso de alcohol penalizan enormemente los miembros de la familia, contribuyendo para altos niveles de conflicto interpersonal, violencia doméstica, inadecuación parental, abuso y negligencia infantil, dificultades financieras y legales y problemas clínicos relacionados al uso del alcohol.DESCRIPTORES: alcoholismo; medicina familiar y comunitaria; planificación de atención al paciente; enfermería psiquiátrica REPERCUSSÕES DO ALCOOLISMO NAS RELAÇÕES FAMILIARES: ESTUDO DE CASOOs problemas relacionados ao uso do álcool têm sido associados a diversos fatores, independente das causas atribuídas ao fenômeno em questão.

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Supplemental social services improve outcomes in public addiction treatment

Abstract: Adding social services to public sector programs substantially improved the outcomes of addiction treatment. Changes in "real world" systems require time to implement; early evaluations may fail to capture the full impact of those changes.

Cited by 194 publications

References 0 publications

Self-report of illicit benzodiazepine use on the Addiction Severity Index predicts treatment outcome

Self-report of illicit benzodiazepine use on the Addiction Severity Index predicts treatment outcome

Trends in comprehensive service availability in outpatient drug abuse treatment

Alcohol effects on family relations: a case study

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