The Relationship Between Substance Abuse Performance Measures and Mutual-Help Group Participation after Treatment

The authors examined the relationship between treatment quality, using during-treatment process measures, and mutual-help group (e.g., Alcoholics Anonymous) attendance after outpatient substance use disorder (SUD) treatment for 739 clients in the Alcohol and Drug Services Study. Logistic regression models estimated any and regular mutual-help attendance after treatment. Clients referred to mutual-help groups were significantly more likely to attend any mutual help after treatment. Results were mixed for facility offered mutual-help groups; treatment engagement and retention were not significant. These findings offer treatment providers further evidence of the importance of referring clients to post-treatment mutual-help groups, an effective, low-cost option.     

Retention in Substance Abuse Treatment

The authors investigated the association between psychiatric symptom severity and subsequent treatment retention among substance abusers. The Symptom Check List-90-R was administered, after admission to an addiction treatment facility, to 308 male and 106 female clients with moderate-to-severe substance abuse problems. Mean scores on nine symptom and three summary scales were computed. Controlling for other sociodemographic and treatment variables, somatization was significantly associated with dropout from specialized outpatient and inpatient treatment programs. This study, however, suggests that psychopathologic symptom severity at admission has only limited utility in predicting subsequent treatment retention among substance abusers with overall moderate levels of psychological distress.     

The Relationship Between Anxiety Levels and Outcome of Cocaine Abuse Treatment

Although a number of studies have examined the comorbidity of anxiety disorders and substance use disorders, much less is known about the impact of anxiety symptoms on substance use and on substance abuse treatment outcome. In the current study, we examined how self-reported anxiety levels, as measured by the Spielberger State-Trait Anxiety Inventory, were related to cocaine use variables and patterns following substance abuse treatment. There were 108 patients in substance abuse treatment who met DSM-III-R diagnostic criteria for cocaine abuse or dependence who completed an assessment battery at pretreatment, posttreatment, and 3-month follow-up. State anxiety scores significantly declined from pre- to posttreatment and remained stable into the 3-month follow-up period regardless of relapse status. Trait anxiety was correlated positively with negative consequences due to cocaine use and negatively correlated with days in treatment. State and trait anxiety both were correlated positively with the Alcohol Composite Index of the Addiction Severity Index (ASI). These findings suggest that elevated anxiety scores at pretreatment subside with time, do not require clinical management of associated anxiety symptoms, and may be a temporary by-product of experiencing negative consequences due to recent cocaine use.     

Aggression,Impulsivity, Personality Traits,and Childhood Trauma of Prisoners with Substance Abuse and Addiction

Introduction: The aim of our study is then to analyze psychological and judicial features of a subgroup of inmates with substance abuse. Methods: Prisoners with substance abuse (n = 312) were compared to prisoners without substance abuse (n = 591). Recruited inmates completed a semistructured interview for collection of sociodemographic and judicial data and a battery of psychometric tests for assessement of aggression, impulsivity, depression, personality traits, hostility, resilience, and childhood trauma. Results: Substance abusers had on average multiple incarcerations (78.8%), more juvenile convictions (60.2%), more violent behaviors during detention (29.8%), and a history of one or more suicide attempts (20.8%). They also had higher scores on subscales for childhood trauma, higher scores for psychoticism and neuroticism, higher impulsivity levels, worse resilience, increased hostility, and prevalent suicidal ideation. Conclusion: Prisoners with substance abuse constitute a subgroup with increased judiciary and psychiatric issues, possibly due to early life history and psychological characteristics, such as high impulsivity and aggressiveness, poor resilience, and higher suicidal risk.     

The Relationship between Substance Abuse Performance Measures and Mutual Help Group Participation after Treatment

We examined the relationship between treatment quality, using during-treatment process measures, and mutual help group (e.g., Alcoholics Anonymous) attendance after outpatient substance use disorder (SUD) treatment for 739 clients in the Alcohol and Drug Services Study. Logistic regression models estimated any and regular mutual help attendance after treatment. Clients referred to mutual help groups were significantly more likely to attend any mutual help after treatment. Results were mixed for facility offered mutual help groups; treatment engagement and retention were not significant. These findings offer treatment providers further evidence of the importance of referring clients to post-treatment mutual help groups, an effective, low-cost option.     

The Link Between Substance Abuse and Posttraumatic Stress Disorder in Women

Research has documented a high incidence of comorbid posttraumatic stress disorder (PTSD) and substance abuse. Women substance abusers, in particular, show high rates of this dual diagnosis (30% to 59%), most commonly deriving from a history of repetitive childhood physical and/or sexual assault. Rates for men are two to three times lower and typically stem from combat or crime trauma. Patients with both disorders are characterized by high severity on a multitude of psychological and treatment variables and use of the most severe drugs (cocaine and opioids). Treatment research on women is limited but suggests the possibility of retaining patients and achieving positive outcomes.     

The Relationship between Antidepressant Use and Smoking Cessation in Pregnant Women in Treatment for Substance Abuse

Background: Bupropion's efficacy for smoking cessation in pregnant women is unknown. Objectives: To determine if substance-dependent women prescribed bupropion smoked fewer cigarettes/day than those prescribed citalopram/escitalopram or no antidepressant medication. Methods: Comparison of smoking in bupropion (n = 11), citalopram/escitalopram (n = 17), and no antidepressant (n = 28) groups. Results and Conclusions: Trend for greater decrease in smoking for the bupropion vs. citalopram/escitalopram group [?6.4 vs. ?.4 cigarettes/day (p = .276)], although the bupropion decrease was similar to that seen in the no antidepressant group [?5.3 cigarettes/day]. Scientific Significance: Data support continued study of bupropion in depressed pregnant substance-dependent smokers.     

Substance Abuse Treatment Readmission Patterns of Asian Americans: Comparisons with Other Ethnic Groups

Background and significance: According to New York statewide substance abuse treatment and discharge data, Asians are a small minority who differ significantly from other racial–ethnic groups on income, primary language, treatment setting, substance abuse, referral source, and discharge status. Objectives: The present study further compares alcohol and substance abuse service utilization patterns of Asians with those of Whites, Blacks, and Hispanics in New York State. Methods: Cox regressions were employed to examine the differences in treatment admission patterns among Asians and other ethnic groups, while controlling a number of demographic, treatment-related, and non-treatment-related factors. A sample of 408,158 clients was selected from the Client Data System of the New York State Office of Alcoholism and Substance Abuse Services for the analysis. Results: While Asians in general are less likely to use treatment services and to have multiple treatment admissions compared with other groups, those Asians with multiple admissions tend to show utilization patterns – the period of greatest risk for readmission, the rate at which readmissions occur, and the likelihood of readmission – similar to the other groups at each subsequent admission. Conclusion: These findings suggest both similarities and differences in treatment readmission patterns between Asians and other clients of substance abuse treatment services. Future research on the cultural and linguistic factors related to Asians’ recovery and service utilization patterns after the initial treatment experience may be particularly important for systems of care seeking to be responsive to Asians’ needs.     

Depression,Abuse, Relationship Power and Condom Use by Pregnant and Postpartum Women with Substance Abuse History

Substance-abusing pregnant and postpartum women are less likely to maintain consistent condom use and drug and alcohol abstinence, which is particularly concerning in high HIV-prevalence areas. Data from 224 pregnant and postpartum women in substance abuse treatment were analyzed to examine effects of history of substance use, child abuse, and mental health problems on current substance use and condom-use barriers. Mediators were depression, relationship power and social support. Most participants (72.9 %) evidenced current depression. Less social support (?0.17, p < 0.05) and relationship power (?0.48, p < 0.001), and greater depression (?0.16, p < 0.05) predicted more condom-use barriers. History of mental health problems predicted condom-use barriers, mediated by recent depression and relationship power (0.15, p < 0.001). These findings suggest depression and diminished relationship power limit highest-risk women’s ability to negotiate condom use and abstain from substance use, increasing their risk of acute HIV infection and vertical transmission.     

Substance Abuse,Aggression, and Violence

The authors review the scientific literature linking the use of specific psychoactive substances with aggressive and violent behavior. In general, the effects of alcohol and other drugs on aggression and violence are influenced through the complex interaction of 1) the particular pharmacological effects and dose of the specific drug, 2) the psychological and biological characteristics of substance-using individuals, and 3) the situational context in which the drug use occurs. Furthermore, a model is advanced that delineates the relationship between individual dispositional factors promoting aggression and the resultant occurrence of violent behavior. The authors conclude that the multifactorial nature of this problem emphasizes the need for multimodal strategies of intervention and prevention to reduce the societal impact of violence involving alcohol and other drugs.     

Course,Severity, and Treatment of Substance Abuse Among Women Versus Men

Objective: To assess the course and severity of substance-related disorder (SRD) in relation to gender. Design: Retrospective data on course were obtained for several indices of substance use, abuse, and related morbidity. Setting: Two university medical centers with alcohol-drug programs located in departments of psychiatry. Subjects: A total of 642 patients were assessed, of whom 365 (57%) were men and 277 (43%) were women. Methods: Data on course included demographic characteristics, family history of substance abuse, lifetime use, age at first use, years of use, use in the last year, periods of abstinence, and current diagnosis. Data on severity included two measures of SRD-associated problems (one patient rated and one interviewer rated), substance abuse versus dependence, self-help activities, and previous treatment. Results: Women were more apt to be homemakers; to have a sibling or, if married, a spouse who abused substances; to be less apt to have ever used hallucinogens or inhalants; to have used substances for fewer years; to have used cannabis and inhalants for fewer days in the last year; to have a lower rate of current cannabis abuse/dependence; to have fewer legal problems related to substances (especially driving while intoxicated [DWI] charges); to have fewer outpatient admissions to treatment; to have fewer admissions to substance abuse treatment (all categories together), fewer lifetime days in treatment, and lower overall treatment cost (for all categories of treatment together). Conclusions: These data confirm earlier reports of a shorter course, less deviant drug usage, and—if married—a substance-abusing spouse. In addition, we found higher rates of familial substance abuse and lower rates of lifetime admissions, treatment days, and total cost of substance abuse treatment. Homemaking responsibilities, a substance-abusing spouse, a male-oriented treatment system, and/or a more rapid course may reduce substance abuse treatment for women.     

Processes and Outcomes of Substance Abuse Treatment Between Two Programs for Clients Insured Under Managed Care

The purpose of this research (N = 160) was to describe and compare substance abuse treatment in two programs under managed care: one residential (RT) and one outpatient (OP). Clients in both settings improved significantly from before to after treatment in relation to substance use and quality of life. However, intensity of treatment (hours of care/week) was much greater in RT and days of sobriety were significantly higher after treatment in RT than in OP (p = .04). Intensity was negatively related to incidents of substance use during treatment (SUdT), which predicted substance use after treatment; SUdT averaged. 2 for RT, and 1.6 for OP (p = .0001). Importantly, treatment was completed by 74 patients (over 90%) from RT, with 8 dropping out, and 53 (almost 70%) of those in OP completed treatment while 25 dropped out. Intensity, as seen in the RT program, rather than duration, was more effective in substance use reduction and treatment completion.     

Characteristics of Opinion Leaders in Substance Abuse Treatment Agencies

Objective. This study was part of a larger effort to test the effectiveness of technology transfer approaches related to evidence‐based treatment of co‐occurring substance abuse and mental health disorders. Specifically, this study examined characteristics of “opinion leaders” as technology transfer agents. Method. A network analysis was conducted within four large substance abuse treatment agencies to identify individuals that other counselors sought out for consultation on co‐occurring issues. The identified opinion leaders were then compared with other counselors on demographic variables, education and experience, and attitudes and knowledge about working with individuals with co‐occurring disorders. Results. The analyses demonstrate that opinion leaders differed from other counselors in competency‐related characteristics including more postgraduate education, relevant professional credentials, and years of experience in mental health treatment. They also had greater knowledge of the dynamics and treatment of co‐occurring disorders as well as a greater willingness and confidence in working with such clients. Conclusion. These results suggest that opinion leaders are used within agencies for information and consultation regarding treatment issues. Therefore, opinion leaders may provide an important vehicle for dissemination and adoption of evidence‐based treatment practices in community treatment settings.     

The Application of Maharishi Ayur-Veda to Mental Health and Substance Abuse Treatment

No abstract available for this article.