The Relationship Between Client Characteristics and Wraparound Services in Substance Use Disorder Treatment Centers

Abstract

ABSTRACT. Objective: The National Institute on Drug Abuse (NIDA) recommends a comprehensive treatment program for individuals with substance use disorder (SUD) in order to treat needs they often have in addition to their SUD. Specifi cally, NIDA suggests providing services related to the following issues: medical care, mental health care, HIV/ AIDS, child care, educational, vocational, family counseling, housing, transportation, fi nancial, and legal. By providing a comprehensive model that combines core and wraparound services, treatment centers can deliver a higher quality of treatment. In this article, we assessed the relationship between client characteristics and the availability of wraparound services in SUD treatment centers. Method: We combined two nationally representative samples of treatment centers and used a negative binomial regression and a series of logistic regressions to analyze the relationship between client characteristics and wraparound services. Results: On average, centers offered fewer than half of the wraparound services endorsed by NIDA. Our results indicated that client characteristics were signifi cantly related to the provision of wraparound services. Most notably, the proportion of adolescent clients was positively related to educational services, the proportion of female clients was positively related to child care, but the proportion of clients referred from the criminal justice system was negatively associated with the provision of multiple wraparound services. Conclusions: Our fi ndings have important implications for SUD clients and suggest that, although centers are somewhat responsive to their clients' ancillary needs, most centers do not offer the majority of wraparound services. (J. Stud. Alcohol Drugs, 77, 160-169, 2016)

Substance Use Treatment Utilization Among Women With and Without Human Immunodeficiency Virus

“…These factors should be considered as part of comprehensive, wraparound services in SU treatment programs, especially for women. The National Institute on Drug Abuse recommends wraparound services, which are comprehensive services that address co-occurring needs of individuals with SUD, including medical/HIV care, mental health, child care, housing, transportation, financial, and legal issues [ 19 ]. Studies have shown that wraparound services improve access to healthcare and social services, address social determinants of health, and improve child welfare [ 19 , 20 ].…”

Testing a Socioecological Model of Relapse and Recovery from Alcohol Problems

“…84 Despite evidence of effectiveness, [85][86][87] wraparound services, including housing support and other strategies to build recovery capital, are not commonly integrated into drug and alcohol treatment. 88 These services may help the most complex and chronic patients recover from their alcohol and other drug problems.…”

What Happens After Treatment? Long-Term Effects of Continued Substance Use, Psychiatric Problems and Help-Seeking on Social Status of Alcohol-Dependent Individuals

“…Implicit in these models is a need for ancillary support services during the protracted treatment and recovery process from addiction. Wraparound services, including educational, vocational and housing support, are effective (Institute of Medicine, 1990;McLellan et al, 1998;Milby et al, 1996) and recommended, but still are not yet commonly integrated into drug and alcohol treatment (Paino et al, 2016). Employment and housing support services may have profound benefits for the social integration and social status of people with AUD, and the impacts may be particularly important for people with co-morbid drug or psychiatric problems.…”

“…These problems may be particularly long-lasting and resistant to change: an analysis of the Combining Medications and Behavioral Interventions (COMBINE) Study documented long-term (up to 52 weeks) improvements in mental health and quality of life but the proportion of days paid for working did not show similar improvement in the year after completing treatment (LoCastro et al, 2009). Unfortunately, many treatment agencies do not effectively incorporate these essential support services in their programs (Paino et al, 2016;Polcin, 2016) and those programs which do address ancillary issues such as homelessness often only provide temporary support (Kertesz et al, 2009). An additional limitation of the existing literature is that many studies do not assess secondary treatment outcomes such as social status over a long time period.…”