Outcome evaluation findings of a Hawaiian culture-based adolescent substance abuse treatment program.

As part of efforts to identify effective culturally appropriate treatment for Hawaiian and Asian and Pacific Islander adolescents with substance abuse and co-occurring disorders, this evaluation research sought to assess the efficacy of the I Mua Mau Ohana program. This long-term residential program combined culturally based experiential learning/therapy, education, spirituality, counseling, and family involvement. Participants were interviewed at intake and followed up at 3, 6, and 12 months using the Government Performance and Results Act (GPRA) Tool and the Global Appraisal of Individual Needs (GAIN) instruments. Results showed long-term improvement in substance use and related problems, decreased criminal justice involvement, and improved mental health and social functioning, while showing positive trends in education and employment. However, unexpected findings were revealed in family functioning. Although promising, further research is needed to substantiate the program's effectiveness and possibility of being considered an "evidence-based program." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sensation Seeking Scales and consumer satisfaction with a substance abuse treatment program

Satisfaction of 119 addicts with an addiction treatment program was measured by an 11 item satisfaction scale. The scale's internal consistency was acceptable (Cronbach's alpha = .75). The total satisfaction score was weakly but significantly correlated with Zuckerman's Sensation Seeking scales: Those with higher scores on the Boredom Susceptibility scale (i.e., those easily bored) reported less satisfaction, whereas those with higher scores on Thrill and Adventure Seeking scale (i.e., risk, adventure, and thrill seekers) reported higher levels of treatment satisfaction. Older patients were more satisfied with the feedback they received from their psychological tests and also with staff's respect for their rights.     

Risk factors for adolescent substance abuse and dependence: Data from a national sample.

A national household probability sample of 4,023 adolescents aged 12 to 17 years was interviewed by telephone about substance use, victimization experiences, familial substance use, and posttraumatic reactions to identify risk factors for Diagnostic and Statistical Manual of Mental Disorders- (4th ed.; American Psychiatric Association, 1994) defined substance abuse/dependence. Age and ethnicity data were available for 3,907 participants. Major findings were (a) adolescents who had been physically assaulted, who had been sexually assaulted, who had witnessed violence, or who had family members with alcohol or drug use problems had increased risk for current substance abuse/dependence; (b) posttraumatic stress disorder independently increased risk of marijuana and hard drug abuse/dependence; and (c) when effects of other variables were controlled, African Americans, but not Hispanics or Native Americans, were at approximately 1/3 the risk of substance abuse/dependence as Caucasians. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Incentive program decreases no-shows in nontreatment substance abuse research.

This study examined the use of a low-cost incentive program to decrease the rate of unanticipated no-shows in a nontreatment study of the genetics of substance dependence. Low-cost retail items (such as calling cards or gift certificates) were offered contingent on attendance at the first scheduled research appointment. Although the intervention did not result in an increase in the rate of attendance at appointments, it reduced the likelihood of unanticipated no-shows by almost 50%. This reduction was accompanied by a significant increase in advance cancellations. Despite limitations due to the study's A-B design, this research demonstrates that it may be possible to use modest incentives to increase the efficiency of research enrollment and increase service provision for substance abusers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multimodal treatment package for substance abuse treatment programs.

Describes a multimodal treatment design for a short-term, residential, hospital-based program for drug abusers. Each patient is expected to attend all program services with the intent that one or several will provide the corrective emotional experience facilitating change. Services included medical care, individual counseling/psychotherapy, group counseling, health education seminars, milieu/recreational therapy, Narcotics Anonymous meetings, linkage with aftercare components, and ancillary services (vocational rehabilitation, court liaison, and 90-day follow-up). Psychology interns and students are utilized. Results of internal follow-up show that 40% of Ss admitted over 3 yrs stated they were drug-free at 90 days and 1.5 yrs. (3 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent substance abuse treatment outcome: The role of substance abuse problem severity, psychosocial, and treatment factors.

A structural equation model incorporating substance abuse problem severity, psychosocial risk and protection, and treatment variables examined adolescent drug abuse treatment outcome pathways across 6- and 12-month follow-up points. Findings on resiliency factors and an empirical method adapted from previous research were used to select and assign 10 psychosocial factors to either a multiple protective factor index or a risk factor index. Gender, substance abuse problem severity, treatment modality, treatment length, and aftercare participation were also examined as outcome predictors. The findings suggest that treatment intensity decisions may be better informed by pretreatment psychosocial risk level rather than by substance abuse problem severity. The present study also suggests that drug-abusing adolescents who receive sufficiently long treatment, participate in aftercare, and possess at least 1 individual or interpersonal protective factor during their recovery process have the best chance to maintain gains made during treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using demographic data in a primary prevention substance abuse program for teenagers and parents.

Collected demographic data by 2 questionnaire surveys from 402 high school students (aged 16–19 yrs) and 266 parents to plan a low-cost, community-based adolescent substance abuse program. Information about teens' drug use, attitudes, alternative activities, and preferred helping resources was compared to parents' knowledge of and attitudes toward their children's drug use. Two programs were planned. The teen program emphasized peer support, drug education before age 16 yrs, the school's drug milieu, sex differences in drug attitudes and use, and the role of religious institutions in prevention. Since parents were almost totally unaware of their children's drug use, the parent program focused on drug information and development of communication skills with teens. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Enhancing substance abuse treatment engagement in incarcerated adolescents.

The purpose of this study was to determine whether motivational interviewing (MI), compared with an attention control condition (relaxation training [RT]) enhances substance abuse treatment engagement in incarcerated adolescents. At the start of incarceration, adolescents were randomly assigned to individually administered MI or RT. Subsequently, therapists and adolescents (N = 130) rated degree of adolescent participation in the facility's standard care group-based treatments targeting crime and substance use. All adolescents received the facility standard care treatment after their individual MI or RT session. MI statistically significantly mitigated negative substance abuse treatment engagement. Other indicators of treatment engagement were in the expected direction; however, effect sizes were small and nonsignificant. These findings are significant, given concerns regarding the deleterious effects of treating delinquent adolescents in groups and the potential for adolescents to reinforce each other's negative behavior, which in turn may lead to escalated substance use and other delinquent behaviors after release. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relapse prevention strategies in outpatient substance abuse treatment.

Reviews the use of relapse prevention (RP) strategies in the treatment of substance abuse disorders. The work of G. A. Marlatt and J. R. Gordon (1980, 1985) provided the cognitive-behavioral base of RP models and numerous techniques. Specific protocols for the treatment of alcoholism, cocaine abuse, marijuana abuse, and heroin addiction are described. This body of knowledge has given the drug-free outpatient treatment of substance abuse a clear focus and direction. The techniques used in the RP include 7 groups of strategies: psychoeducation, identification of high-risk situations for relapse, development of coping skills, development of new-life behaviors, increased self-efficacy, dealing with relapse and avoiding the abstinence violation effect, and drug and alcohol monitoring. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training for substance abuse treatment among psychologists in a rural state.

Is treating substance abuse generally a part of psychological practice? Do psychologists feel prepared to deliver substance abuse treatment? Licensed psychologists in Idaho were surveyed about their training and provision of substance abuse services. Of 144 respondents (66% return rate), nearly all (89%) had contact with substance abusers, yet most rated their graduate training as inadequate preparation for practice. Rural psychologists reported seeing the highest percentage of substance abusers. Many psychologists limited their treatment to self-help group referral. Continuing education offers the most immediate solution and might be related to certification efforts. Predoctoral training of generalist psychologists, especially in rural areas, is advocated with an emphasis on integrated behavioral health care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cost-effectiveness of inpatient substance abuse treatment

OBJECTIVE: To identify the characteristics of cost-effective inpatient substance abuse treatment programs. DATA SOURCES/STUDY SETTING: A survey of program directors and cost and discharge data for study of 38,863 patients treated in 98 Veterans Affairs treatment programs. STUDY DESIGN: We used random-effects regression to find the effect of program and patient characteristics on cost and readmission rates. A treatment was defined as successful if the patient was not readmitted for psychiatric or substance abuse care within six months. PRINCIPAL FINDINGS: Treatment was more expensive when the program was smaller, or had a longer intended length of stay (LOS) or a higher ratio of staff to patients. Readmission was less likely when the program was smaller or had longer intended LOS; the staff to patient ratio had no significant effect. The average treatment cost $3,754 with a 75.0% chance of being effective, a cost-effectiveness ratio of $5,007 per treatment success. A 28-day treatment program was $860 more costly and 3.3% more effective than a 21-day program, an incremental cost-effectiveness of $26,450 per treatment success. Patient characteristics did not affect readmission rates in the same way they affected costs. Patients with a history of prior treatment were more likely to be readmitted but their subsequent stays were less costly. CONCLUSIONS: A 21-day limit on intended LOS would increase the cost-effectiveness of treatment programs. Consolidation of small programs would reduce cost, but would also reduce access to treatment. Reduction of the staff to patient ratio would increase the cost-effectiveness of the most intensively staffed programs.     

Comorbidity of schizophrenia and substance abuse: Implications for treatment.

The problem of substance abuse disorders in schizophrenia patients is reviewed, including the prevalence of comorbid disorders, assessment, hypothesized mechanisms underlying abuse, and the clinical effects of abuse on the course of illness and cognitive functioning. The principles of treatment for dual-diagnosis schizophrenia patients are outlined, and the limitations of existing interventions are noted. Gaps in current knowledge about the impact of substance abuse on schizophrenia and its treatment are identified, and suggestions are made regarding promising avenues of research in this area. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Administration of substance abuse treatment: Local and national developments.

Discusses increases in attention to and funding of solutions for substance abuse problems. At the federal level, more resources have gone to interdiction and supply reduction rather than to substance abuse treatment or prevention. In San Francisco, substance abuse administrators increased the focus on demand reduction by organizing local resources, creatively seeking financial resources, and gathering community support to reduce problems of drug abuse and HIV. The federal reorganization of substance abuse programs presents a unique opportunity to widen the influence of treatment and prevention approaches. The impact of the Alcohol, Drug, and Mental Health Administration Reorganization Act of 1992 and the organization of the newly created Substance Abuse and Mental Health Services Administration are described. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Overview of substance abuse acupuncture treatment research

The research on the efficacy of acupuncture substance abuse treatment is generally still in an early stage. The methodological weaknesses found in the acupuncture research can be found in most substance abuse research. Sufficient early trial, empirical findings suggest that there are positive treatment effects. Certainly, use of the treatment is popular and widespread. Overall, the research has progressed beyond early clinical trials, and the method has been documented to be safe and potentially useful.     

Handwriting in assessing treatment for substance abuse

Analysis of Mathematics and Language Arts scores for 11,438 fourth- and 8,972 seventh-grade students in compensatory education programs on the performance assessments for the Iowa Test of Basic Skills indicated the students performed poorly, particularly in mathematics.     

Group treatment for substance abuse in schizophrenia

OBJECTIVES: A review of the relevant research suggests a need to develop an appropriate, effective, and replicable treatment to help individuals with schizophrenia and substance abuse problems. This pilot study describes a biweekly group specifically designed to help the individual with both schizophrenia and substance abuse. The components of the group were support, psychoeducation, and skills training. Attention was also paid to the stage of recovery. METHOD: Eighteen subjects attended the group and were assessed pregroup. Thirteen subjects completed a 1-year follow-up, and 5 subjects were assessed between 3 and 6 months. RESULTS: At the follow-up assessment, 8 subjects (44%) were abstinent. CONCLUSIONS: This type of treatment appears to be effective for reducing substance abuse in this population.     

Acceptability and availability of harm-reduction interventions for drug abuse in American substance abuse treatment agencies.

[Correction Notice: An erratum for this article was reported in Vol 18(1) of Psychology of Addictive Behaviors (see record 2007-16711-001). On page 208, the first sentence in the note of Table 4 incorrectly reads as follows: "Numbers in parentheses are ns of respondents who provided an 'other' reason for this specific intervention." The sentence should read as follows: "Numbers in parentheses are ns of respondents whose agencies do not offer this intervention."] This study assessed acceptability, availability, and reasons for nonavailability of interventions designed to prevent drug use related harm by substituting pharmaceuticals for illicit drugs; facilitating detoxification; and reducing the occurrence of HIV transmission, relapse, and opiate overdose. A survey was mailed to a sample of 500 randomly selected American substance abuse treatment agencies. Of 435 potentially eligible respondents, 222 (51%) returned usable data. A subset of interventions--including harm reduction education, cue exposure therapy, needle exchange, substitute opiate prescribing, various detoxification regimes, and complementary therapies--were rated as somewhat or completely acceptable by 50% or more of the respondents. Regardless of their acceptability, listed interventions were generally not available from responding agencies; respondents typically attributed unavailability to lack of resources and inconsistency of an intervention with agency philosophy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Twelve-step and cognitive-behavioral treatment for substance abuse: A comparison of treatment effectiveness.

The comparative effectiveness of 12-step and cognitive-behavioral (C-B) models of substance abuse treatment was examined among 3,018 patients from 15 programs at the US Department of Veterans Affairs Medical Centers. Across program types, participants showed significant improvements in functioning from treatment admission to a 1-year follow-up. Although 12-step patients were somewhat more likely to be abstinent at the 1-year follow-up, 12-step, C-B, and combined 12-Step–C-B treatment programs were equally effective in reducing substance use and improving most other areas of functioning. The finding of equal effectiveness was consistency over several treatment subgroups: Patients attending the "purest" 12-step and C-B treatment programs, and patients who had received the "full dose" of treatment. Also, patients with only substance abuse diagnoses, those with concomitant psychiatric diagnoses, and patients who were mandated to treatment showed similar improvement at the 1-year follow-up, regardless of type of treatment received. These data provide important new evidence supporting the effectiveness of 12-step treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethnocultural factors and substance abuse: Toward culturally sensitive treatment models.

Discusses the role of ethnocultural factors in understanding and treating substance abuse disorders. Research and theory suggest that acculturation experiences, sources of stress, coping mechanisms, social support variations, and beliefs about substance use are key factors associated with differential patterns of substance abuse among some ethnic groups, particularly African Americans, Hispanics, and Native Americans. In recent years, models of substance abuse intervention specifically targeting these ethnic groups have been developed. The author examines the movement toward culturally sensitive psychosocial treatment models. (PsycINFO Database Record (c) 2010 APA, all rights reserved)