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Journal of Substance Abuse Treatment — Sat, 28 Jan 2012 22:09:30 +0100

(Source: Journal of Substance Abuse Treatment)

Editorial Board

Journal of Substance Abuse Treatment — Sat, 28 Jan 2012 22:09:30 +0100

(Source: Journal of Substance Abuse Treatment)

Introduction to the special issue on organizational dynamics within substance abuse treatment: A complex human activity system

Journal of Substance Abuse Treatment — Fri, 09 Dec 2011 05:00:00 +0100

Abstract: Substance abuse treatment programs represent complex human activity systems in which multiple actors, including clients, counselors, and managers, are nested. Furthermore, treatment programs are nested within the broader environmental context of resource allocation and regulatory enforcement. This special issue of the Journal of Substance Abuse Treatment presents 12 empirical papers that address organizational dynamics within specialty treatment programs. In this introduction to the special issue, the guest editors describe a conceptual framework of organizational dynamics, offer an overview of the articles within this issue, and discuss future prospects for research. (Source: Journal of Substance Abuse Treatment)

The impact of organizational stress and burnout on client engagement

Journal of Substance Abuse Treatment — Wed, 07 Dec 2011 05:00:00 +0100

This study sought to explore how aspects of the work environment impact client engagement. The sample included 89 programs located in 9 states across the United States. Work environment measures included counselor perceptions of stress, burnout, and work satisfaction at each program, whereas engagement measures included client ratings of participation, counseling rapport, and treatment satisfaction. Using multiple regression, tests of moderation and mediation revealed that staff stress negatively predicted client participation in treatment. Burnout was related to stress but was not related to participation. Two additional organizational measures—workload and influence—moderated the positive relationship between staff stress and burnout. Implications for drug treatment programs are disc...

Innovation adoption as facilitated by a change-oriented workplace

Journal of Substance Abuse Treatment — Wed, 07 Dec 2011 05:00:00 +0100

Abstract: One of the unique contributions of this study is a glimpse into the process by which counselors decide to try new innovations in their clinical work. Data were collected from 421 counseling staff from 71 outpatient treatment programs in 4 U.S. regions. Using hierarchical linear modeling, results reveal that the propensity to adopt workshop-based interventions is facilitated by two important mechanisms: (a) an innovative organization with creative leadership and (b) change-oriented staff attributes (i.e., seeking professional growth, efficacy, adaptability, and influence on others). Innovative leaders and a climate receptive to change also bolster the development of these change-oriented attributes. One implication of these findings is the cascading effect of leaders' support of i...

Resources and training in outpatient substance abuse treatment facilities

Journal of Substance Abuse Treatment — Wed, 07 Dec 2011 05:00:00 +0100

This study considers the combined influence of actual program fiscal resources and counselors' perceptions of workplace resources on two mechanisms of training: exposure and utilization. Data were collected from 323 counselors nested within 59 programs located in nine states. Multilevel analysis revealed that training exposure and training utilization represent two distinct constructs that are important at different stages in the Program Change Model. Training exposure is associated primarily with physical and financial resources, whereas utilization is associated with professional community and job burnout. These results suggest that financial resources are important in initial exposure to new interventions but that successful utilization of new techniques depends in part on the degree of...

Program needs and change orientation: Implications for counselor turnover

Journal of Substance Abuse Treatment — Wed, 07 Dec 2011 05:00:00 +0100

Abstract: Although evidence suggests that turnover rates are higher in high-stress/high-needs work environments, it is unclear whether agencies' attempts at improving practices influence individuals' decisions to stay at or leave a job. The purpose of this study was to examine whether program needs and change orientation influence individual decisions to quit. A sample of 206 counselors from 25 outpatient substance abuse treatment programs completed the Survey of Organizational Functioning, rating the organization on program needs, leadership, and change. They also rated themselves on stress, burnout, and job satisfaction. Multilevel modeling indicated a significant interaction between program needs and change orientation, even after controlling for stress, burnout, job satisfaction, tenur...

Organizational consequences of staff turnover in outpatient substance abuse treatment programs

Journal of Substance Abuse Treatment — Wed, 07 Dec 2011 05:00:00 +0100

Abstract: The purpose of this study was to examine the impact of staff turnover on perceptions of organizational demands and support among staff who remained employed in substance abuse treatment programs. The sample consisted of 353 clinical staff from 63 outpatient agencies. Two scales from the Survey of Organizational Functioning measured work environment demands (stress and inadequate staffing), and 3 measured supportive work relationships (communication, cohesion, and peer collaboration). Results from a series of multilevel models documented that counselors working in programs that had previously experienced high staff turnover perceived higher demands and lower support within their organization, even after controlling for other potentially burdensome factors such as budget, census, a...

Treatment staff turnover in organizations implementing evidence-based practices: Turnover rates and their association with client outcomes

Journal of Substance Abuse Treatment — Wed, 07 Dec 2011 05:00:00 +0100

In this study, we computed annualized rates of turnover for treatment staff (N = 249) participating in an evidence-based practice implementation initiative and examined the association between organizational-level rates of staff turnover and client-level outcomes. Annualized rates of staff turnover were 31% for clinicians and 19% for clinical supervisors. In addition, multilevel analyses did not reveal the expected relationship between staff turnover and poorer client-level outcomes. Rather, organizational-level rates of staff turnover were found to have a significant positive association with two measures of treatment effectiveness: less involvement in illegal activity and lower social risk. Possible explanations for these findings are discussed. (Source: Journal of Substance Abuse Treatm...

Treatment program operations and costs

Journal of Substance Abuse Treatment — Wed, 07 Dec 2011 05:00:00 +0100

This study investigates how average costs for an episode of care in outpatient drug-free (ODF) treatment relate to clinical intensity (length of stay and weekly counseling hours) and program structure (e.g., size, staffing), controlling for prices paid and selected clientele measures. Based on cost assessments from a naturalistic sample of 67 programs located across the United States (using the Treatment Cost Analysis Tool), robust regression techniques showed that programs having 10% longer treatment stays had episode costs 7% higher; those having 10% more weekly counseling hours per client had 4% higher episode costs. Other important factors included wages, amount of counselors' time conducting sessions, and serving more clients referred from the criminal justice system. The study provid...

Drug treatment program ownership, Medicaid acceptance, and service provision

Journal of Substance Abuse Treatment — Wed, 07 Dec 2011 05:00:00 +0100

Abstract: The Institute of Medicine noted that effective substance abuse treatment (SAT) programs integrate individual therapeutic approaches with transitional/ancillary services. In addition, research suggests that type of ownership impacts SAT services offered and that Medicaid plays a key role in SAT access. Data from the National Survey of Substance Abuse Treatment Services for the years 2000 and 2002–2006 were used to examine relationships among SAT program Medicaid acceptance, program ownership, and transitional/ancillary service accessibility. Multivariate logistic regression models controlling for state- and program-level contextual factors were used to analyze the data. Nonprofit SAT programs were significantly more likely to offer transitional/ancillary services than for-profit...

A multilevel approach to predicting community addiction treatment attitudes about contingency management

Journal of Substance Abuse Treatment — Mon, 05 Dec 2011 05:00:00 +0100

This study examined systemic and idiographic staff predictors of CM adoption attitudes via archival data collected from treatment organizations affiliated with the National Drug Abuse Treatment Clinical Trials Network. Multilevel modeling analyses evaluated potential predictors from organizational, treatment unit, and workforce surveys. Among these were individual and shared perceptions of staff concerning aspects of their clinic culture and climate. Modeling analyses identified three systemic predictors (clinic provision of opiate agonist services, national accreditation, and lesser shared perception of workplace stress) and five idiographic predictors (staff with a graduate degree, longer service tenure, managerial position, e-communication facility, and openness to change in clinical pr...

Impact of a training and certification program on the quality of interviewer-collected self-report assessment data

Journal of Substance Abuse Treatment — Mon, 05 Dec 2011 05:00:00 +0100

Abstract: The purpose of this study was to evaluate the impact of an assessment training and certification program on the quality of data collected from clients entering substance abuse treatment. Data were obtained from 15,858 adult and adolescent clients entering 122 treatment sites across the United States using the Global Appraisal of Individual Needs–Initial (GAIN-I). GAIN Administration and Fidelity Index (GAFI) scores were predicted from interviewer certification status, interviewer experience, and their interactions. We controlled for client characteristics expected to lengthen or otherwise complicate interviews. Initial bivariate analyses revealed effects for certification status and experience. A significant interaction between certification and experience indicates interviewer...

Journal of Substance Abuse Treatment: Tradition, change and opportunity

Journal of Substance Abuse Treatment — Wed, 30 Nov 2011 06:02:37 +0100

At the time of this writing (October 2011), the Journal of Substance Abuse Treatment (JSAT) is experiencing the highest volume of manuscript submissions in the journal's history. Through the first 9 months of the calendar year, we have received 301 submissions from 31 countries. We are on record pace to exceed 375 manuscripts for 2011—a 20% increase over the previous mark (2009). Perhaps enhanced writing productivity among us accounts for this growth? Probably not, instead it is more likely that JSAT is increasingly regarded as an excellent vehicle for the scientific communication of clinically relevant research. The benefit of a rise in submissions is a more stringent acceptance-to-submission rate. We would like to believe that these standards for JSAT contribute to the overall quality ...

Journal of Substance Abuse Treatment — Wed, 30 Nov 2011 06:02:37 +0100

(Source: Journal of Substance Abuse Treatment)

Editorial Board

Journal of Substance Abuse Treatment — Wed, 30 Nov 2011 06:02:37 +0100

(Source: Journal of Substance Abuse Treatment)

The relationship between perceptions of organizational functioning and voluntary counselor turnover: a four-wave longitudinal study

Journal of Substance Abuse Treatment — Thu, 24 Nov 2011 05:00:00 +0100

Abstract: Using data from a nationwide study, we annually track a cohort of 598 substance use disorder counselors over a four-wave period to (a) document the cumulative rates of voluntary turnover and (b) examine how counselor perceptions of the organizational environment (procedural justice, distributive justice, perceived organizational support, and job satisfaction) and clinical supervisor leadership effectiveness (relationship quality, in-role performance, extra-role performance) predict voluntary turnover over time. Survey data were collected from counselors in Year 1, and actual turnover data were collected from organizational records in Years 2, 3, and 4. Findings reveal that 25% of the original counselors turned over by Year 2, 39% by Year 3, and 47% by Year 4. Counselors with more...

Training and retaining staff to competently deliver an evidence-based practice: The role of staff attributes and perceptions of organizational functioning

Journal of Substance Abuse Treatment — Wed, 23 Nov 2011 05:00:00 +0100

Abstract: Within the context of an initiative to implement evidence-based practices (EBPs) for adolescents with substance use disorders, this study examined the extent to which staff factors measured at an initial EBP training workshop were predictive of EBP competence and turnover status of staff (N = 121) measured 6, 9, and 12 months posttraining. By the final assessment point, 52.3% of staff transitioned to the employed/EBP-competent category, 26.6% transitioned to the not employed/not EBP-competent category, 4.6% transitioned to the not employed/EBP-competent category, and 16.5% had not transitioned out of the initial category. Multilevel multinomial regression analysis identified several measures that were significant predictors of staff transitions to the not employed/not EBP-compete...

Integrated treatment programs for individuals with concurrent substance use disorders and trauma experiences: A systematic review and meta-analysis

Journal of Substance Abuse Treatment — Mon, 31 Oct 2011 04:00:00 +0100

Abstract: The purpose of this study was to examine the evidence of psychotherapeutic integrated treatment (IT) programs for individuals with concurrent substance use disorders and trauma histories. Electronic searches of Cochrane Central Register of Controlled Trials, MEDLINE, Web of knowledge, PubMed, PsycINFO, CINAHL, PILOTS, and EMBASE identified 17 IT trials (9 controlled trials). Both narrative review and meta-analysis indicate that IT effectively reduces trauma symptoms and substance abuse from pretreatment to longest follow-up. However, IT and nonintegrated programs appear to produce similar declines in symptoms. Methodological issues limiting the current body of work and recommendations for future research are discussed. Well-designed randomized controlled trials are clearly needed...

Journal of Substance Abuse Treatment — Sat, 29 Oct 2011 01:47:24 +0100

(Source: Journal of Substance Abuse Treatment)

Editorial Board

Journal of Substance Abuse Treatment — Sat, 29 Oct 2011 01:47:24 +0100

(Source: Journal of Substance Abuse Treatment)

How do components of evidence-based psychological treatment cluster in practice? A survey and cluster analysis

Journal of Substance Abuse Treatment — Fri, 23 Sep 2011 04:00:00 +0100

Abstract: Evidence-based psychological treatments (EBPTs) are clusters of interventions, but it is unclear how providers actually implement these clusters in practice. A disaggregated measure of EBPTs was developed to characterize clinicians' component-level evidence-based practices and to examine relationships among these practices. Survey items captured components of evidence-based treatments based on treatment integrity measures. The Web-based survey was conducted with 75 U.S. Department of Veterans Affairs (VA) substance use disorder (SUD) practitioners and 149 non-VA community-based SUD practitioners. Clinician's self-designated treatment orientations were positively related to their endorsement of those EBPT components; however, clinicians used components from a variety of EBPTs. Hie...

Motivational and mindfulness intervention for young adult female marijuana users

Journal of Substance Abuse Treatment — Thu, 22 Sep 2011 04:00:00 +0100

Abstract: This pilot study tested the efficacy of a brief intervention using motivational interviewing (MI) plus mindfulness meditation (MM) to reduce marijuana use among young adult females. Thirty-four female marijuana users between the ages of 18 and 29 were randomized to either the intervention group (n = 22), consisting of two sessions of MI-MM, or an assessment-only control group (n = 12). The participants' marijuana use was assessed at baseline and at 1, 2, and 3 months posttreatment. Fixed-effects regression modeling was used to analyze treatment effects. Participants randomized to the intervention group were found to use marijuana on 6.15 (z = −2.42, p = .015), 7.81 (z = −2.78, p = .005), and 6.83 (z = −2.23, p = .026) fewer days at Months 1, 2, and 3, respectively, than con...

Outcome of heroin-dependent adolescents presenting for opiate substitution treatment

Journal of Substance Abuse Treatment — Thu, 22 Sep 2011 04:00:00 +0100

Abstract: Because the outcome of methadone and buprenorphine substitution treatment in adolescents is unclear, we completed a retrospective cohort study of 100 consecutive heroin-dependent adolescents who sought these treatments over an 8-year recruitment period. The participants' average age was 16.6 years, and 54 were female. Half of the patient group remained in treatment for over 1 year. Among those still in treatment at 12 months, 39% demonstrated abstinence from heroin. The final route of departure from the treatment program was via planned detox for 22%, dropout for 32%, and imprisonment for 8%. The remaining 39% were transferred elsewhere for ongoing opiate substitution treatment after a median period of 23 months of treatment. Males were more likely to exit via imprisonment (p < ....

Journal of Substance Abuse Treatment — Mon, 05 Sep 2011 18:21:30 +0100

(Source: Journal of Substance Abuse Treatment)

Editorial Board

Journal of Substance Abuse Treatment — Mon, 05 Sep 2011 18:21:30 +0100

(Source: Journal of Substance Abuse Treatment)

Client–Provider relationship in comprehensive substance abuse treatment: Differences in residential and nonresidential settings

Journal of Substance Abuse Treatment — Fri, 26 Aug 2011 04:00:00 +0100

This study uses a moderator–mediator analysis of a comprehensive service model to examine how the relation between client–provider relationship and substance abuse treatment outcomes may differ in residential and nonresidential settings. The study used data collected for the National Treatment Improvement Evaluation Study, a prospective, cohort-based study of U.S. substance abuse treatment programs and their clients, with an analytic sample of 59 publicly funded service delivery units and 3,027 clients. Structural equation modeling is used to assess the structural relations and causal connections between treatment process and treatment outcome variables. Results indicate that for nonresidential settings, a better client–provider relationship is directly related to improved outcomes o...

Twelve-month follow-up of aftercare for adolescents with alcohol use disorders

Journal of Substance Abuse Treatment — Thu, 25 Aug 2011 04:00:00 +0100

Abstract: Adolescents with alcohol use disorders (AUDs) previously completed a randomized controlled outpatient aftercare study (Y. Kaminer, J. A. Burleson, & R. H. Burke, 2008) in which they were randomly assigned to in-person, brief telephone, or no-active aftercare. Youth were assessed at end of aftercare and at 3-, 6-, and 12-month follow-up on frequency and quantity of alcohol use. It was predicted that active aftercare (in-person and brief telephone) would be superior to no-active aftercare in reducing alcohol use, as shown in the original study. No subject or therapy group attributes were significant moderators of outcome. Active aftercare in general maintained short-term favorable effects by reducing relapse in youth with AUD and should be considered as part of standard procedures ...

Computerized continuing care support for alcohol and drug dependence: A preliminary analysis of usage and outcomes

Journal of Substance Abuse Treatment — Mon, 22 Aug 2011 04:00:00 +0100

Abstract: The central aim of this administrative data analysis was to examine usage of a Web-based disease management program designed to provide continuing recovery support to patients discharged from residential drug and alcohol treatment. Tailored clinical content was delivered in a multimedia format over the course of 18 months posttreatment. The program also included access to a recovery coach across the 18 months. Consistent with other disease management programs, program usage decreased over time. A small subsample of patients accessed a large number of program modules in the year following treatment; these patients had significantly higher abstinence rates and consumed less alcohol than patients accessing few or no modules. Regression analyses revealed a significant relationship be...

Benefits of concurrent syringe exchange and substance abuse treatment participation

Journal of Substance Abuse Treatment — Mon, 22 Aug 2011 04:00:00 +0100

In the article “Benefits of concurrent syringe exchange and substance abuse treatment participation” by Kidorf et al. (Journal of Substance Abuse Treatment 2011;40(3):265–271), the third author's correct name is Jessica Peirce. (Source: Journal of Substance Abuse Treatment)

Comparing alternative specifications of quality measures: Access to pharmacotherapy for alcohol use disorders

Journal of Substance Abuse Treatment — Fri, 12 Aug 2011 04:00:00 +0100

This study compares three competing specifications of the proportion of patients with AUD receiving approved medications. We examined how altering the numerator and denominator definitions affects observed rates of pharmacotherapy use and facilities' percentile ranks. Using pharmacy and administrative data from the Veterans Health Administration (VHA), three measures of pharmacotherapy receipt were calculated for 129 VHA facilities. Difference in measure specifications alters the overall estimates of pharmacotherapy receipt but unevenly across facilities, with some experiencing no change in percentile rank and others decreasing or increasing by over a quartile. The results demonstrate that the quality measures are not interchangeable, and the choice of which version to implement is of high...

Correlates of participation in peer recovery support groups as well as voluntary and mandated substance abuse treatment among rural and urban probationers

Journal of Substance Abuse Treatment — Fri, 12 Aug 2011 04:00:00 +0100

This study explores the correlates of probationers' participation in 12-step programs, voluntary treatment, and mandated treatment, with respect to the geographic location of where the services are being provided as the primary covariate of interest. Data were derived from face-to-face interviews with rural and urban probationers (N = 1,464). Results of the three logistic regression models suggested that even when all the covariates are taken into account, urban probationers were significantly more likely to have been involved in 12-step programs, voluntary treatment, and mandated treatment over their lifespan. Despite high levels of self-reported substance use among all participants, treatment services were underused by rural probationers. These data suggest that individuals residing in r...

Criminal convictions among dependent heroin users during a 3-year period prior to opioid maintenance treatment: A longitudinal national cohort study

Journal of Substance Abuse Treatment — Fri, 12 Aug 2011 04:00:00 +0100

This study investigates frequency and types of criminal convictions among a national sample of heroin users during a 3-year period prior to opioid maintenance treatment (OMT). All heroin users (N = 3,789) in Norway who applied for and were eligible for OMT (1997–2003) were included. The OMT records were cross-linked to Norwegian crime statistics. During observation, 24,478 convictions were recorded among 60.9% of the sample. Differences of criminal convictions were found within the group; a large proportion (39.1%) had no convictions, whereas 10% of the sample was responsible for 37.8% of all convictions. Convictions for acquisitive crimes and drug crimes were the most common. Variations in the cohort's individual crime sequences were found. The heavy involvement of heroin users with the...

Patterns of prescription opioid abuse and comorbidity in an aging treatment population

Journal of Substance Abuse Treatment — Wed, 10 Aug 2011 04:00:00 +0100

Abstract: Very little is known about the impact of age and gender on drug abuse treatment needs. To examine this, we recruited 2,573 opioid-dependent patients, aged from 18 to 75 years, entering treatment across the country from 2008 to 2010 to complete a self-administered survey examining drug use histories and the extent of comorbid psychiatric and physical disorders. Moderate to very severe pain and psychiatric disorders, including polysubstance abuse, were present in a significant fraction of 18- to 24-year-olds, but their severity grew exponentially as a function of age: 75% of those older than 45 years had debilitating pain and psychiatric problems. Women had more pain than men and much worse psychiatric issues in all age groups. Our results indicate that a “one-size-fits-all” ap...

Timing of buprenorphine adoption by privately funded substance abuse treatment programs: The role of institutional and resource-based interorganizational linkages

Journal of Substance Abuse Treatment — Wed, 10 Aug 2011 04:00:00 +0100

Abstract: Identifying facilitators of more rapid buprenorphine adoption may increase access to this effective treatment for opioid dependence. Using a diffusion of innovations theoretical framework, we examine the extent to which programs' interorganizational institutional and resource-based linkages predict the likelihood of being an earlier adopter, later adopter, or nonadopter of buprenorphine. Data were derived from face-to-face interviews with administrators of 345 privately funded substance abuse treatment programs in 2007–2008. Results of multinomial logistic regression models show that interorganizational and resource linkages were associated with timing of adoption. Programs reporting membership in provider associations were more likely to be earlier adopters of buprenorphine. P...

How is tobacco treatment provided during drug treatment?

Journal of Substance Abuse Treatment — Wed, 10 Aug 2011 04:00:00 +0100

Abstract: The purpose of this study was to obtain descriptions of tobacco treatment services across different substance abuse treatment settings. We conducted mixed-method assessments in eight facilities among eight directors, 25 staff, 29 clients, and 82 client charts. Measures included systems assessment, chart reviews, and semistructured interviews. Although many programs reported they offer key components of evidence-based treatment, few actually provided any treatment and none did so systematically. Many addressed tobacco as part of drug education or part of a health promotion session. Chart reviews suggested that provision of tobacco treatment is rare. By many reports, clients had to specifically request treatment and few staff reported encouraging unmotivated smokers to quit. System...

Adolescent Community Reinforcement Approach outcomes differ among emerging adults and adolescents

Journal of Substance Abuse Treatment — Wed, 10 Aug 2011 04:00:00 +0100

This study compares outcomes between adolescents and emerging adults with substance use disorders who received the Adolescent Community Reinforcement Approach (A-CRA). Propensity score matching was used to create a weighted comparison group of adolescents (n = 151) who had similar demographic characteristics, clinical severity, and treatment retention as the group of emerging adults (n = 152). We examined age differences in abstinence and other psychosocial outcomes at the last available follow-up. Emerging adults and adolescents both reduced their substance use at follow-up. However, emerging adults were less likely to be abstinent and in remission and had more days of alcohol use when compared with adolescents. This study's findings are consistent with prior work on emerging adults. Addi...

A treatment reengagement intervention for syringe exchangers

Journal of Substance Abuse Treatment — Wed, 10 Aug 2011 04:00:00 +0100

This study evaluated the efficacy of a novel treatment reengagement intervention for a subset of syringe-exchange program (SEP) participants (N = 113) that had enrolled in treatment as part of a 4-month clinical trial (M. Kidorf et al., 2009). Three reengagement conditions for participants leaving treatment were compared. Motivational referral condition (MRC) participants (n = 31) could attend group sessions that focused on renewing treatment interest. MRC plus incentive (MRC + I) participants (n = 49) could receive modest monetary incentives for attending these sessions and reenrolling in treatment. Standard referral condition participants (n = 33) could not attend groups or receive incentives. Across a 1-year observation window, almost all study participants (86%) were discharged from tr...

A qualitative investigation of barriers to entry into couples' treatment for alcohol problems

Journal of Substance Abuse Treatment — Wed, 10 Aug 2011 04:00:00 +0100

This study used qualitative methodology to evaluate barriers to entry into couples' treatment for alcohol problems. Data were collected using semistructured interviews. Patients were recruited from (a) treatment for primary substance use disorders, (b) treatment for psychiatric disorders (other than substance use disorders), and (c) court-mandated outpatient domestic violence programs. Mental health experts were recruited based on expertise in (a) couples' treatment, (b) alcohol treatment, and (c) couples' treatment for alcohol problems. Patients (N = 57) met criteria for hazardous drinking and were in committed romantic relationships. Partners (n = 19) and mental health experts (n = 12) also completed interviews. Interviews were analyzed using accepted qualitative strategies. Barriers to ...

G. Alan Marlatt: 1941–2011

Journal of Substance Abuse Treatment — Wed, 10 Aug 2011 04:00:00 +0100

This article briefly reviews and comments on his contributions to addiction psychology, cognitive–behavior therapy, alcohol expectancies, relapse prevention, moderation goals, harm reduction, and mindfulness meditation research. He departed suddenly and too soon, but left us with a rich heritage for more effective and humane treatment of those who suffer with addiction. (Source: Journal of Substance Abuse Treatment)

Patterns in admission delays to outpatient methadone treatment in the United States

Journal of Substance Abuse Treatment — Mon, 08 Aug 2011 04:00:00 +0100

Abstract: Waiting lists for methadone treatment have existed in many U.S. communities, but little is known nationally about what patient and service system factors are related to admission delays that stem from program capacity shortfalls. Using a combination of national data sources, this study examined patterns in capacity-related admission delays to outpatient methadone treatment in 40 U.S. metropolitan areas (N = 28,920). Patient characteristics associated with admission delays included racial/ethnic minority status, lower education, criminal justice referral, prior treatment experience, secondary cocaine or alcohol use, and co-occurring psychiatric problems. Injection drug users experienced fewer delays, as did self-pay patients and referrals from health care and addiction treatment p...

A multi-level analysis of counselor attitudes toward the use of buprenorphine in substance abuse treatment

Journal of Substance Abuse Treatment — Mon, 08 Aug 2011 04:00:00 +0100

This study uses hierarchical linear modeling to examine National Treatment Center Study data to identify counselor characteristics (attitudes, training, and beliefs) and organizational factors (accreditation, caseload, access to buprenorphine, and other evidence-based practices) that influence implementation of buprenorphine for treatment of opiate dependence. Analyses showed that provider training about buprenorphine, higher prevalence of opiate-dependent clients, and less treatment program emphasis on a 12-step model predicted greater counselor acceptance and perceived effectiveness of buprenorphine. Results also indicate that program use of buprenorphine for any treatment purpose (detoxification, maintenance, and/or pain management) and time (calendar year in data collection) was associ...

Journal of Substance Abuse Treatment — Mon, 25 Jul 2011 23:18:15 +0100

(Source: Journal of Substance Abuse Treatment)

Editorial Board

Journal of Substance Abuse Treatment — Mon, 25 Jul 2011 23:18:15 +0100

(Source: Journal of Substance Abuse Treatment)

Interventions targeting substance abuse among women survivors of intimate partner abuse: A meta-analysis

Journal of Substance Abuse Treatment — Fri, 15 Jul 2011 04:00:00 +0100

Abstract: In this article, meta-analytic techniques are used to examine existing intervention studies (n = 11) to determine their effects on substance abuse among female samples of intimate partner abuse (IPA) survivors. This research serves as a starting point for greater attention in research and practice to the implementation of evidence-based, integrated services to address co-occurring substance abuse and IPA victimization among women as major intersecting public health problems. The results show greater effects in three main areas. First, greater effect sizes exist in studies where larger numbers of women experienced current IPA. Second, studies with a lower mean age also showed greater effect sizes than studies with a higher mean age. Lastly, studies with smaller sample sizes have g...

A systematic review of interventions for co-occurring substance use disorder and borderline personality disorder

Journal of Substance Abuse Treatment — Mon, 11 Jul 2011 04:00:00 +0100

Abstract: Rates of borderline personality disorder (BPD) among individuals with substance use disorder (SUD) are estimated to be as high as 65%. Such elevated rates present considerable challenges for drug treatment services given that individuals with co-occurring SUD and BPD have higher rates of relapse, treatment noncompliance, and poorer outcomes than those with either diagnosis alone. A systematic review investigating current treatment options for co-occurring SUD and BPD was conducted using Medline and PsycINFO. Randomized controlled trials were the focus. Six studies were included that examined the use of three psychosocial therapies: dialectical behavior therapy, dual focused schema therapy and dynamic deconstructive psychotherapy. Despite all studies demonstrating some treatment g...

Delay discounting, impulsiveness, and addiction severity in opioid-dependent patients

Journal of Substance Abuse Treatment — Fri, 08 Jul 2011 04:00:00 +0100

This study compared methadone maintenance treatment (MMT) patients (n = 30) who had not used illegal drugs for 2 years with drug-using MMT patients (n = 30) and controls (n = 25) in terms of addiction severity, DD rate, and impulsiveness. Methadone patients abstinent from illegal drugs scored significantly lower on a number of addiction severity measures than the drug-using methadone patients. In addition, both groups of MMT patients showed significantly higher rates of DD and impulsiveness than the control group; however, no differences in DD rate or impulsiveness were found between the groups of patients. Results suggest that DD rate and impulsiveness may not covary with indicators of addiction severity in MMT patients. (Source: Journal of Substance Abuse Treatment)

Changes in methadone maintenance therapy during and after pregnancy

Journal of Substance Abuse Treatment — Fri, 08 Jul 2011 04:00:00 +0100

Conclusions: Daily doses of methadone increased until the third trimester, then remained essentially unchanged through the sixth postpartum week. (Source: Journal of Substance Abuse Treatment)

Comparative utility of a single-item versus multiple-item measure of self-efficacy in predicting relapse among young adults

Journal of Substance Abuse Treatment — Wed, 22 Jun 2011 23:00:00 +0100

Abstract: Single-item measures of psychological experiences are often viewed as psychometrically suspect. The purpose of this study was to evaluate the validity and utility of a single-item measure of self-efficacy in a clinical sample of treatment-seeking young adults. Inpatient young adults (N = 303, age = 18–24, 26% female) were assessed at intake to residential treatment, end of treatment, and at 1, 3, and 6 months following discharge. The single-item measure of self-efficacy consistently correlated positively with a well-established 20-item measure of self-efficacy and negatively with temptation scores from the same scale, demonstrating convergent and discriminant validity. It also consistently predicted relapse to substance use at 1-, 3-, and 6-month assessments postdischarge, even...

Substance abuse treatment utilization among adults living with HIV/AIDS and alcohol or drug problems

Journal of Substance Abuse Treatment — Wed, 22 Jun 2011 23:00:00 +0100

Abstract: This is a prospective cohort study to identify factors associated with receipt of substance abuse treatment (SAT) among adults with alcohol problems and HIV/AIDS. Data from the HIV Longitudinal Interrelationships of Viruses and Ethanol study were analyzed. Generalized estimating equation logistic regression models were fit to identify factors associated with any service utilization. An alcohol dependence diagnosis had a negative association with SAT (adjusted odds ratio [AOR] = 0.36, 95% confidence interval [95% CI] = 0.19–0.67), as did identifying sexual orientation other than heterosexual (AOR = 0.46, CI = 0.29–0.72) and having social supports that use alcohol/drugs (AOR = 0.62, CI = 0.45–0.83). Positive associations with SAT include presence of hepatitis C antibody (AOR ...

Does clinician continuity over two brief motivational sessions improve outcomes in college students?

Journal of Substance Abuse Treatment — Tue, 21 Jun 2011 23:00:00 +0100

Abstract: Previous research has shown that brief motivational interventions (BMIs) are an effective treatment approach for reducing college student alcohol use and associated negative consequences. The purpose of this study was to determine whether clinician continuity (having the same vs. a different clinician) across an initial BMI and follow-up booster session was related to differences in session satisfaction, self-reported alcohol use, and alcohol-related negative consequences. Participants included 358 undergraduate students who were part of a larger randomized clinical trial. Results revealed no significant differences in alcohol use and associated consequences at follow-up between participants who met with the same versus a different clinician. Clinician continuity was not signific...

Preliminary evaluation of extended-release naltrexone in Michigan and Missouri drug courts

Journal of Substance Abuse Treatment — Tue, 21 Jun 2011 23:00:00 +0100

Abstract: This pilot study, a retrospective case series analysis, examined the feasibility and effectiveness of treating alcohol dependence with extended-release naltrexone (XR-NTX) in the drug court setting. In two Michigan courts and in one Missouri court, 32 clients were treated with XR-NTX and were matched with 32 clients with standard care in an open-label, voluntary recruitment design. Treatment with XR-NTX was associated with relative risk reductions (RRRs; p = ns) of 57% fewer missed drug court sessions, a 35% reduction in the monthly ratio of positive drug and alcohol tests to total tests, and 35% fewer individuals with greater than 25% overall positive alcohol or drug tests. In the principal end-point analysis of annualized number of new arrests, 26% of standard-care clients were...

Risk of drug-related mortality during periods of transition in methadone maintenance treatment: A cohort study

Journal of Substance Abuse Treatment — Tue, 21 Jun 2011 23:00:00 +0100

This study aims to identify periods of elevated risk of drug-related mortality during methadone maintenance treatment (MMT) in primary care using a cohort of 3,162 Scottish drug users between January 1993 and February 2004. Deaths occurring during treatment or within 3 days after last methadone prescription expired were considered as cases “on treatment.” Fatalities occurring 4 days or more after leaving treatment were cases “off treatment.” Sixty-four drug-related deaths were identified. The greatest risk of drug-related death was in the first 2 weeks of treatment (adjusted hazard ratio 2.60, 95% confidence interval 1.03–6.56). Risk of drug-related death was lower after the first 30 days following treatment cessation, relative to the first 30 days off treatment. History of psych...

Efficacy of continuing medical education to reduce the risk of buprenorphine diversion

Journal of Substance Abuse Treatment — Sun, 12 Jun 2011 23:00:00 +0100

This study evaluated the efficacy of continuing medical education (CME) in two U.S. regions with surveillance signals of buprenorphine misuse/diversion. Four surveys (before, on-site, and 1 and 3 months post CME) evaluated physician characteristics, practice behaviors, and buprenorphine pharmacology and legislative knowledge. The results show that physicians had limited addictions training. Knowledge and practice behaviors significantly improved after the CME, which should enhance the quality of OBOT and may decrease risk of buprenorphine misuse and diversion from their practices. Mandatory CME targeting OBOT-certified physicians could have a positive impact on patient and public health outcomes. (Source: Journal of Substance Abuse Treatment)

If substance use disorder treatment more than offsets its costs, why don't more medical centers want to provide it? A budget impact analysis in the Veterans Health Administration

Journal of Substance Abuse Treatment — Sun, 12 Jun 2011 23:00:00 +0100

This article attempts to explain this puzzling discrepancy by analyzing 1998–2006 data from the national Veterans Affairs (VA) health care system. The main outcome measures were annual cost and utilization for VA SUD-diagnosed patients. The key independent variable was the medical centers' annual spending for SUD treatment. There was no evidence that SUD spending was associated with lower medical center costs over time within the medical center that paid for the treatment. Health care system managers may not be influenced by research suggesting that the costs of SUD treatment are more than fully offset because they bear the cost of providing treatment while the savings largely accrue to other systems. (Source: Journal of Substance Abuse Treatment)

Journal of Substance Abuse Treatment — Mon, 06 Jun 2011 22:05:42 +0100

(Source: Journal of Substance Abuse Treatment)

Editorial Board

Journal of Substance Abuse Treatment — Mon, 06 Jun 2011 22:05:42 +0100

(Source: Journal of Substance Abuse Treatment)

Factors that influence trajectories of change in frequency of substance use and quality of life among adolescents receiving a brief intervention

Journal of Substance Abuse Treatment — Thu, 02 Jun 2011 23:00:00 +0100

This study aimed to identify factors influencing trajectories of change in two outcome domains, frequency of substance use and quality of life (QOL), among adolescents receiving a brief evidence-based intervention. Participants were 106 adolescents, aged 13 to 21 years, who met criteria for a substance use disorder. The adolescents received a five-session intervention and completed four assessments over 12 months. Based upon a theoretical and empirical review, five putative predictors were tested: gender, age, severity of conduct disorder, severity of depression, and peer substance involvement. Results of a parallel-process latent growth curve model indicated that higher peer substance involvement and conduct severity predicted higher frequency of use at baseline, whereas higher peer subst...

Determining the efficacy of auricular acupuncture for reducing anxiety in patients withdrawing from psychoactive drugs

Journal of Substance Abuse Treatment — Tue, 31 May 2011 23:00:00 +0100

In this study, we hypothesize that AA reduces the anxiety associated with withdrawal from psychoactive drugs. The study used a randomized, controlled design and included a sample of 101 patients recruited from an addiction treatment service. Subjects were assigned to one of three treatment groups (National Acupuncture Detoxification Association [NADA] AA, AA at sham points, or treatment setting control) and were instructed to attend treatment sessions for 3 days. The primary outcome measure state anxiety was assessed using a pretest–posttest treatment design. The study hypothesis was not confirmed. The NADA protocol was not more effective than sham or treatment setting control in reducing anxiety. The widespread acceptance of AA in the treatment of addiction remains controversial. (Sourc...

Who uses online interventions for problem drinkers?

Journal of Substance Abuse Treatment — Tue, 31 May 2011 23:00:00 +0100

Abstract: The goal of this research was to understand why some people use online interventions for drinking problems, whereas others with comparable access to the interventions do not. As part of a randomized controlled trial, 92 participants in the experimental condition were provided access to a password-protected version of a Web-based personalized feedback intervention (the Check Your Drinking [CYD] screener, www.CheckYourDrinking.net). Information collected at baseline was compared between those who accessed the Web site and those who did not. Those who accessed the Web site tended to be more frequent users of the Internet, to drink less, and to perceive that others of the same age and gender drank less as compared with those who did not access the intervention. Some of these results ...

Frontline counselors in organizational contexts: A study of treatment practices in community settings

Journal of Substance Abuse Treatment — Tue, 31 May 2011 23:00:00 +0100

This study addresses the challenge of implementing evidence-based treatment approaches in typical community settings. It identifies individual and organizational characteristics associated with two contrasting treatment approaches used by frontline practitioners. One treatment approach involves techniques supported by research; the other approach involves techniques primarily supported by experience and tradition. The study uses a nested probability sample of 45 organizations and 279 frontline practitioners. Multilevel (hierarchical linear modeling) regression models appropriately address the nested sample. The findings indicate that practitioner beliefs and components of organizational social contexts are associated with treatment approach. The use of an evidence-supported treatment appro...

Drug assertiveness and sexual risk-taking behavior in a sample of HIV-positive, methamphetamine-using men who have sex with men

Journal of Substance Abuse Treatment — Mon, 09 May 2011 23:00:00 +0100

This study examined the association between drug assertiveness and methamphetamine use, psychological factors, and sexual risk behaviors in a sample of 250 HIV-positive men who have sex with men enrolled in a safer sex intervention in San Diego, CA. Less assertiveness in turning down drugs was associated with greater frequency and larger amounts of methamphetamine use, lower self-esteem, higher scores on a measure of sexual sensation seeking, and greater attendance at risky sexual venues. These data suggest that drug assertiveness training should be incorporated into drug abuse treatment programs and other risk reduction interventions for methamphetamine users. (Source: Journal of Substance Abuse Treatment)

Mortality rate among crack/cocaine-dependent patients: A 12-year prospective cohort study conducted in Brazil

Journal of Substance Abuse Treatment — Sun, 08 May 2011 23:00:00 +0100

This study examined a range of mortality indicators within a cohort of 131 crack/cocaine-dependent patients admitted into treatment and meeting criteria for dependence of crack (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition). After 12 years of treatment discharge, 107 individuals were reassessed and 27 death cases were confirmed by official records, wherein in its majority were caused by homicide (n = 16). In this group, survival rate was 0.77 (95% confidence interval [CI] = 0.74–0.81) and previous history of IV cocaine use was identified as a predictor of mortality (2.5, 95% CI = 1.08–5.79). High mortality rates among Brazilian crack/cocaine-dependent patients, exposure to violence, and HIV/AIDS were topics discussed in this study. This research highlights the ...

Childhood sexual abuse and substance abuse treatment utilization among substance-dependent incarcerated women

Journal of Substance Abuse Treatment — Sun, 08 May 2011 23:00:00 +0100

This study reports an exploratory project on service utilization among incarcerated substance-dependent women (N = 40) in southeastern Idaho. Using self-report and interview tools, most participants reported some substance abuse treatment history, although extent and types of treatment varied. Most of the women also reported some type of childhood abuse. Age, income, and consequences of alcohol and other drug use related positively to substance abuse treatment. However, severity of childhood sexual abuse and current trauma symptoms were negatively correlated with substance abuse treatment episodes. These women may use substances to cope with childhood trauma or may not perceive the substance abuse system as responsive to their co-occurring trauma symptoms. (Source: Journal of Substance Abu...

Depressive symptoms as a predictor of alcohol relapse after residential treatment programs for alcohol use disorder

Journal of Substance Abuse Treatment — Thu, 05 May 2011 23:00:00 +0100

Abstract: Alcohol use disorder (AUD) and depressive disorders often co-occur. Findings on the effects of major depressive disorder (MDD) or depressive symptoms on posttreatment alcohol relapse are controversial. The study's aim is to examine the association of MDD and depressive symptoms with treatment outcomes after residential AUD programs. In a naturalistic-prospective, multisite study with 12 residential AUD treatment programs in the German-speaking part of Switzerland, 64 patients with AUD with MDD, 283 patients with AUD with clinically significant depressive symptoms at admission, and 81 patients with AUD with such problems at discharge were compared with patients with AUD only on alcohol use, depressive symptoms, and treatment service utilization. MDD was provisionally identified at...

Baseline functioning among individuals with posttraumatic stress disorder and alcohol dependence

Journal of Substance Abuse Treatment — Thu, 05 May 2011 23:00:00 +0100

Abstract: Comorbid posttraumatic stress disorder (PTSD) and alcohol dependence (AD) may lead to a complicated and potentially severe treatment profile. Our study examined 167 individuals with both PTSD and AD compared with 105 individuals with PTSD without an alcohol use disorder (AUD) and 240 individuals with AD without PTSD on baseline psychosocial functioning. We hypothesized that individuals with PTSD/AD would be more socially and functionally impaired than individuals with only one disorder. Results indicated that participants with PTSD/AD were more likely to be unemployed, have less education, and report less income and were less likely to live with a partner than the participants with only a single disorder. However, they did not differ on symptom severity within these disorders (dr...

Call for Papers

Journal of Substance Abuse Treatment — Mon, 25 Apr 2011 17:35:32 +0100

(Source: Journal of Substance Abuse Treatment)

Journal of Substance Abuse Treatment — Mon, 25 Apr 2011 17:35:32 +0100

(Source: Journal of Substance Abuse Treatment)

Editorial Board

Journal of Substance Abuse Treatment — Mon, 25 Apr 2011 17:35:32 +0100

(Source: Journal of Substance Abuse Treatment)

Prevalence and correlates of nonmedical use of prescription opioids in patients seen in a residential drug and alcohol treatment program

Journal of Substance Abuse Treatment — Wed, 13 Apr 2011 23:00:00 +0100

Abstract: Population-based data indicate that rates of nonmedical use of prescription opioids (POs) have increased dramatically over the past decade. However, data are lacking on nonmedical use of POs in individuals seeking treatment for substance use disorders. Patients (N = 351) seeking treatment from a residential drug and alcohol treatment program were assessed for nonmedical use of POs prior to treatment entry. Approximately 68% (65% men and 78% women) of patients reported at least some nonmedical PO use in the 30 days prior to treatment. Our results indicate that nonmedical PO use was more common in those with higher levels of depressive symptoms and pain intensity and in those with lower physical functioning. Treatment programs should consider actively screening participants for non...

An exploratory study of alternative configurations of governing boards of substance abuse treatment centers

Journal of Substance Abuse Treatment — Wed, 13 Apr 2011 23:00:00 +0100

This article explores alternative configurations of governing boards in a national sample of 500 substance abuse treatment centers. The study proceeds from the premise that boards may be configured with varying levels of engagement in five aspects of internal management and external connections in treatment center operating environments. Based on interviews with treatment center administrative directors, four clusters emerge, describing boards that are (a) active and balanced across internal and external domains, (b) active boundary spanners concentrating primarily on external relationships, (c) focused primarily on internal organizational management, and (d) relatively inactive. In post hoc analysis, we found that placement in these clusters is associated with treatment center attributes ...

Pay-for-performance in a community substance abuse clinic

Journal of Substance Abuse Treatment — Tue, 12 Apr 2011 23:00:00 +0100

This study investigated whether P4P could improve treatment utilization and retention at a community drug treatment clinic. Counselors had the opportunity to earn cash bonuses based on therapy attendance rates of individual clients and on the quarterly retention rates of their caseload. Using a pre–post study design, average therapy sessions attended during the first month of treatment increased from 4.6 sessions prior to the intervention to 5.5 sessions per client during the intervention. The 90-day client retention rate increased from 40% to 53%. Additional analyses suggest that the improvement in the 90-day retention was mediated by the increase in attendance during the first month of treatment. This project demonstrates that implementing a P4P incentive program in community drug abus...

Motivational interviewing integrated with social network counseling for female adolescents: A randomized pilot study in urban primary care

Journal of Substance Abuse Treatment — Tue, 12 Apr 2011 23:00:00 +0100

This study tested the efficacy of a brief preventive intervention for substance use and associated risk behaviors among female adolescent patients of an urban primary care health clinic. We integrated an evidenced-based motivational interviewing (MI) approach with a social network component to develop a 20-minute session, a social network intervention delivered in an MI-consistent style. Female adolescents (N = 28) 14 to 18 years old were recruited, provided consent/assent, were screened, and were randomly assigned to the treatment or control (no treatment) condition. The sample was 82% African American and 18% mixed race, with 32% living below the U.S. poverty line. At 1-month follow-up, teens in the treatment condition reported less trouble due to alcohol use, less substance use before s...

Brief assessment of readiness to change tobacco use in treated youth

Journal of Substance Abuse Treatment — Tue, 12 Apr 2011 23:00:00 +0100

This study examined the concurrent and predictive validity of four brief measures of readiness to change tobacco use for use with adolescents in clinical practice (Readiness Ruler, Thoughts About Abstinence, motivation to abstain, and confidence to abstain) and a single-item measure of difficulty to abstain. Participants were 154 adolescent smokers recruited from outpatient addictions treatment, who completed assessments shortly after admission and at 6- and 12-month follow-up. Concurrent validity analyses indicated that the four readiness measures were moderately correlated at each time point. Predictive validity analyses indicated that the Ruler and the motivation to abstain ratings predicted number of cigarettes smoked at 6 and 12 months. Perceived difficulty to abstain predicted cigare...

Brief intervention for women with risky drinking and medical diagnoses: A randomized controlled trial

Journal of Substance Abuse Treatment — Tue, 12 Apr 2011 23:00:00 +0100

Abstract: This is a randomized controlled trial of 511 eligible women treated for diabetes, hypertension, infertility, or osteoporosis on an outpatient basis to test the hypothesis that those randomized to a brief intervention (BI) will drink less than those in the control condition 12 months later. A secondary goal was to identify the characteristics associated with changes in drinking outcome. All 511 completed the initial alcohol assessment, and 96% completed the 12-month follow-up interview. Those receiving the BI also had 3- and 6-month interviews. Four outcomes were assessed: (a) mean drinks per drinking day, (b) percent drinking days, (c) binge episodes defined as four or more drinks per occasion, and (d) weeks of drinking exceeding the National Institute on Alcohol Abuse and Alcoho...

The economic costs of quarterly monitoring and recovery management checkups for adults with chronic substance use disorders

Journal of Substance Abuse Treatment — Wed, 06 Apr 2011 23:00:00 +0100

The objectives of this article are to calculate and compare the economic costs of providing outcome monitoring (OM) only with those of providing OM + RMC to help understand the feasibility of disseminating this model more widely. We estimate the total and incremental costs of OM and OM + RMC using data from a recently completed randomized controlled trial with adult chronic substance users (N = 446). Adding RMC to OM increased total intervention costs by about 50% per person per year ($707 to $1,283) and quarter ($177 to $321). It cost an average of $834 to identify a person in relapse and $2,699 to identify, link, and retain them in treatment. The increased costs of RMC are modest relative to the substantial societal costs of chronic substance users returning to regular use, crime, and ot...

Oral health of substance-dependent individuals: Impact of specific substances

Journal of Substance Abuse Treatment — Wed, 06 Apr 2011 23:00:00 +0100

Abstract: Little is known about how different types of substances affect oral health. Our objective was to examine the respective effects of alcohol, stimulants, opioids, and marijuana on oral health in substance-dependent persons. Using self-reported data from 563 substance-dependent individuals, we found that most reported unsatisfactory oral health, with their most recent dental visit more than 1 year ago. In multivariable logistic regressions, none of the substance types were significantly associated with oral health status. However, opioid use was significantly related to a worse overall oral health rating compared to 1 year ago. These findings highlight the poor oral health of individuals with substance dependence and the need to address declining oral health among opioid users. Gene...

Research to practice in addiction treatment: Key terms and a field-driven model of technology transfer

Journal of Substance Abuse Treatment — Wed, 06 Apr 2011 23:00:00 +0100

Abstract: The transfer of new technologies (e.g., evidence-based practices) into substance abuse treatment organizations often occurs long after they have been developed and shown to be effective. Transfer is slowed, in part, due to a lack of clear understanding about all that is needed to achieve full implementation of these technologies. Such misunderstanding is exacerbated by inconsistent terminology and overlapping models of an innovation, including its development and validation, dissemination to the public, and implementation or use in the field. For this reason, a workgroup of the Addiction Technology Transfer Center (ATTC) Network developed a field-driven conceptual model of the innovation process that more precisely defines relevant terms and concepts and integrates them into a co...

Long-term outcomes among drug-dependent mothers treated in women-only versus mixed-gender programs

Journal of Substance Abuse Treatment — Wed, 06 Apr 2011 23:00:00 +0100

This study examined the long-term outcomes of women who were pregnant or parenting at admission to women-only (WO; n = 500) versus mixed-gender (MG; a matched sample of 500) substance abuse treatment programs. Administrative records on arrests, incarcerations, mental health services utilization, and drug treatment participation were collected, covering 3 years preadmission and 8 years postadmission. Women treated in WO programs had lower levels of arrest, mental health services utilization rates, and drug treatment participation during the first year after drug treatment. No differences were found between the two groups in the long-term trajectories except that the WO program participants had lower incarceration rates during the third year after treatment. The study findings suggest a posi...

Factors associated with Medicaid patients' access to buprenorphine treatment

Journal of Substance Abuse Treatment — Sun, 03 Apr 2011 23:00:00 +0100

This study compares Massachusetts Medicaid beneficiaries who received buprenorphine, methadone or other treatment for opioid addiction in 2007. Patients' characteristics and comorbidities were identified through claims data, and associations between these factors and treatment type were investigated using multivariate analysis. Among patients receiving opioid agonist treatments, patients with prior buprenorphine treatment, HIV, bipolar disease, and other substance use disorders were more likely to receive buprenorphine treatment compared with methadone, whereas patients with heart failure, diabetes, hepatitis C, major depression, and anxiety were less likely to receive buprenorphine treatment. These differences may suggest variability in patient access, treatment preferences, and a need fo...

Comparison of clinical trial recruitment populations: Treatment-seeking characteristics of opioid-, cocaine-, and cannabis-using participants

Journal of Substance Abuse Treatment — Fri, 25 Mar 2011 00:00:00 +0100

This study examined the treatment history and intention to seek treatment among 489 individuals interested in substance use disorder clinical trial participation. Opioid and cocaine users were more likely than cannabis users to report having received treatment for substance use in the past and more likely than cannabis users to report planning to seek treatment for substance use before exposure to recruitment advertising. Free cost was the aspect of clinical trial participation that most influenced the decision to make an intake evaluation appointment for opioid-dependent patients as compared with cocaine- and cannabis-dependent participants, and the availability of individual psychotherapy most influenced those who were cannabis dependent. Cannabis-dependent individuals evaluated for clin...

Journal of Substance Abuse Treatment — Wed, 16 Mar 2011 01:05:38 +0100

(Source: Journal of Substance Abuse Treatment)

Editorial Board

Journal of Substance Abuse Treatment — Wed, 16 Mar 2011 01:05:38 +0100

(Source: Journal of Substance Abuse Treatment)

The influence of abuse victimization on attendance and involvement in mutual-help groups among dually diagnosed male veterans

Journal of Substance Abuse Treatment — Fri, 11 Mar 2011 00:00:00 +0100

This study examined the impact of physical or sexual abuse victimization on MHG attendance and involvement and the influence of abuse on the association between MHG involvement and outcomes of abstinence and psychiatric health. Participants were 217 dually diagnosed men assessed at intake into mental health treatment and 6 months later. Compared with nonabused patients, sexually abused patients exhibited more substance use, psychiatric, and social problems at baseline and attended and were involved with MHGs more than nonabused patients at follow-up. Moreover, MHG involvement was most predictive of abstinence for sexually abused patients, as compared with nonabused and physically abused patients. Although dually diagnosed patients with abuse histories demonstrate more severe initial proble...

Injection drug users' experience with and attitudes toward methadone clinics in Denver, CO

Journal of Substance Abuse Treatment — Thu, 03 Mar 2011 00:00:00 +0100

Abstract: Clients' perceptions and attitudes toward methadone treatment programs are frequently overlooked in substance abuse research. Given the importance of methadone maintenance as a harm-reduction strategy and clients' concerns about treatment, it is essential to understand perceptions and attitudes toward existing programs. Using data from the 2009 National HIV Behavioral Surveillance system with injection drug users in Denver, CO, we evaluated participants' experiences with methadone clinics and examined predictive factors associated with ever being a client of a methadone clinic. Costs of services, perceptions of staff not caring about the client, and attitudes toward the counseling services seemed to be the major barriers to program retention. Besides heroin use, previous attempt ...

Effect of waiting time on substance abuse treatment completion in pregnant women

Journal of Substance Abuse Treatment — Mon, 28 Feb 2011 00:00:00 +0100

Abstract: Although substance abuse treatment is associated with improved maternal and neonatal outcomes, pregnant women may be at increased risk of attrition. To explore the hypothesis that shorter waiting time for treatment is associated with increased completion, we analyzed all pregnant treatment admissions and discharges in the Treatment Episode Data Set—Discharges. There were 10,661 pregnant admissions in 2006. The effect of waiting time on treatment completion was modified by treatment setting. Immediate entry into ambulatory treatment, where most pregnant women are treated, was significantly associated with completion (odds ratio = 1.27, 95% confidence interval = 1.14–1.41). Criminal justice referral and a high school education were identified as completion predictors in all tre...

The role of criminal justice system in treating drug abusers: The Chinese experience

Journal of Substance Abuse Treatment — Mon, 28 Feb 2011 00:00:00 +0100

This study explores the role of China's criminal justice system in treating drug abusers and provides a preliminary assessment of the mandatory treatment centers administered by police and reeducation-through-labor camps managed by correction agencies in China. The exploration and assessment are conducted using data collected from recent surveys of drug users in several mandatory treatment centers and a reeducation-through-labor camp in a large city of China in 2009. The data reveal that the treatment involvement levels of drug users in these mandatory treatment centers and reeducation-through-labor camps varied and their perceptions of the treatments they had received for their recovery seem fairly positive. The implication of these findings was discussed in the context of Chinese social ...

Analyzing performance in addiction treatment: An application of data envelopment analysis to the state of Maryland system

Journal of Substance Abuse Treatment — Mon, 28 Feb 2011 00:00:00 +0100

Abstract: The pressure is on to measure performance and to increase accountability in health care in general and in addiction treatment in particular. The pressure in the world of addiction treatment comes in large measure from the limited resources that are available in relation to the very large numbers of potential patients. Using data on 161 clinics in the state of Maryland, this article illustrates how data envelopment analysis (DEA), a methodology used widely in other settings, can be used to measure the performance of addiction treatment clinics and can help to identify appropriate benchmarks for clinics wishing to improve their performance. The potential utility of DEA is not only limited to the analysis of state networks but extends to analyses of organizations that have a number ...

Screening for mental disorder comorbidity in Australian alcohol and other drug residential treatment settings

Journal of Substance Abuse Treatment — Mon, 28 Feb 2011 00:00:00 +0100

In this study, the mental disorder status of 278 participants resident in AOD treatment settings across Australia was estimated using the Addiction Severity Index—Self Report (J.S. Cacciola, A. Pecoraro, & A.I. Alterman, 2008) and the Mental Health Screening Form III (J.F.X. Carroll & J.J. McGinley, 2001). The estimated rate of diagnosable Axis I mental disorder comorbidity varied from 64% to 71% depending upon which cutoff score was used with the MHSF-III. Missing data emerged as a major limitation of the self-report version of the Addiction Severity Index psychiatric composite score in this population. (Source: Journal of Substance Abuse Treatment)

Hospitalizations and hospital charges for co-occurring substance use and mental disorders

Journal of Substance Abuse Treatment — Mon, 28 Feb 2011 00:00:00 +0100

Abstract: Most published studies have examined co-occurring disorders among mental health patients. Our objective was to compare the length of stay and hospital charges between hospitalized patients with alcohol- or substance-related disorders with and without co-occurring disorders. We analyzed nationally representative hospital discharge data (Nationwide Inpatient Sample, 2003–2007) and examined factors associated with length of stay and hospital charges. Forty-four percent of patients who were hospitalized with alcohol- or substance-related disorders were diagnosed with co-occurring mental disorders, representing 979,421 such disorders nationwide between 2003 and 2007. Females, those of White race, those who paid with insurance, and those who stayed in large, rural, nonteaching, and M...

Incidence of psychopathology in a cohort of young heroin and/or cocaine users

Journal of Substance Abuse Treatment — Fri, 25 Feb 2011 00:00:00 +0100

Abstract: A prospective study was carried out in Barcelona, Spain, to determine the incidence of mental disorders including substance use disorders (SUDs). From a cohort of 288 young adult (aged 18–30 years) cocaine and/or heroin users recruited in nonclinical settings, 158 were reinterviewed 18 months later using the Psychiatric Research Interview for Substance and Mental Disorders. During follow-up, 18% of subjects presented a new SUD, and nearly 11% a new non-SUD Axis I disorder. Incidence was highest for mood disorders (8%). Being a woman, a lower frequency of substance use at baseline, a younger age of heroin first use, and a worsening of SUD were associated with a higher likelihood of presenting a new Axis I disorder. Having received drug treatment ever (at baseline) or during foll...

12-Step involvement among a U.S. national sample of Oxford House residents

Journal of Substance Abuse Treatment — Fri, 25 Feb 2011 00:00:00 +0100

Abstract: A longitudinal analysis was conducted among a U.S. national sample of persons affiliated with Alcoholics Anonymous and Narcotics Anonymous living in self-run recovery homes (Oxford Houses). Categorical involvement in a set of 12-step activities (i.e., having a sponsor, reading 12-step literature, doing service work, and calling other members for help) and averaged summary scores of involvement were examined in relation to abstinence and self-efficacy for abstinence. Participants who were categorically involved in all 12-step activities reported significantly higher levels of abstinence and self-efficacy for abstinence at 1 year compared with those who were less involved, whereas averaged summary scores of involvement were not a significant predictor of abstinence. Participants' n...

Interim methadone treatment compared to standard methadone treatment: 4-Month findings

Journal of Substance Abuse Treatment — Fri, 25 Feb 2011 00:00:00 +0100

Abstract: Interim methadone (IM; with emergency counseling only) is an effective but highly restricted alternative to methadone treatment program (MTP) waiting lists. However, it is not known whether IM disadvantages patients as compared with standard methadone treatment (SM). In this clinical trial, conducted in two MTPs, 230 newly admitted patients were randomly assigned to IM, SM, and “restored” methadone treatment (SM with a counselor with a reduced caseload). Data were analyzed using generalized estimating equations and generalized linear modeling. There were no significant differences among conditions in days in treatment or of heroin or cocaine use and heroin- or cocaine-positive urine drug tests. The IM as compared to the SM group had significantly fewer self-reported days of c...

How safe are adolescents at Alcoholics Anonymous and Narcotics Anonymous meetings? A prospective investigation with outpatient youth

Journal of Substance Abuse Treatment — Fri, 25 Feb 2011 00:00:00 +0100

Abstract: Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) have proven to be cost-effective recovery resources for adults and also appear helpful for youth. However, anecdotal concerns about adolescents' safety at meetings have dampened enthusiasm regarding youth participation. Unfortunately, little information exists to evaluate such concerns. Outpatients (N = 127; 24% female) were assessed at intake and at 3, 6, and 12 months regarding perceived safety at AA/NA, experience of negative incidents, and reasons for nonattendance/discontinuation. By 12-month follow-up, 57.5% reported some AA/NA attendance with a combined lifetime exposure of 5,340 meetings. Of these, 21.9% reported at least one negative experience, which was more common among NA than AA attendees. Overall, youth reporte...

Non-injection drug use and HIV disease progression in the era of combination antiretroviral therapy

Journal of Substance Abuse Treatment — Fri, 25 Feb 2011 00:00:00 +0100

Abstract: Little is known about the effects of non-injection drug use (NIDU) on HIV antiretroviral treatment outcomes. We conducted a systematic literature search and identified nine publications from prospective cohort studies investigating the relationship between NIDU and clinical HIV disease progression. Hazard ratios from studies estimating the effect of drug use on time to AIDS-related mortality ranged from 0.89 to 3.61, and only two of these were statistically significant. Hazard ratios from studies assessing time to an AIDS-defining event ranged from 1.19 to 2.51, with 8 of the 14 estimates falling between 1.55 and 1.65 regardless of drug use definition and measurement of use or frequency. It is suggested that NIDU may have a moderate effect of increasing the risk of progression to...

Effectiveness of varenicline for smoking cessation: A 1-year follow-up study

Journal of Substance Abuse Treatment — Thu, 24 Feb 2011 00:00:00 +0100

In conclusion, we found that the combination of counseling and VAR is effective at promoting abstinence at 1 year even when compliance with the medication is not 100%. (Source: Journal of Substance Abuse Treatment)

The relationship between injection and noninjection drug use and HIV disease progression

Journal of Substance Abuse Treatment — Thu, 24 Feb 2011 00:00:00 +0100

Conclusions: This study shows no relationship between noninjection drug use and HIV disease progression. This study is limited by using history of drug use and combining different types of drugs. Further studies ascertaining specific type and extent of noninjection drug use prospectively, and with longer follow-up, are needed. (Source: Journal of Substance Abuse Treatment)

Program, counselor, and patient variability in the alliance: A multilevel study of the alliance in relation to substance use outcomes

Journal of Substance Abuse Treatment — Thu, 24 Feb 2011 00:00:00 +0100

Abstract: We explored patient, therapist, and program variability in the alliance in relation to drug and alcohol use during treatment, and whether alliance mediates the relation of program characteristics to drug/alcohol use. Data (N = 1,613 patients) were drawn from a randomized clinical trial investigating the efficacy of an intervention that provided alliance and outcome feedback to 112 counselors across 20 community-based outpatient substance abuse treatment clinics in the northeast United States. Program characteristics were measured using the Organization Readiness for Change scale. Using multilevel modeling, we found that alliance was related to both drug and alcohol use during the past week at the patient and program levels of analysis, but not the counselor level. Several program...

The impact of pay-for-performance on therapists' intentions to deliver high-quality treatment

Journal of Substance Abuse Treatment — Mon, 14 Feb 2011 00:00:00 +0100

This article examined the extent to which assignment to a pay-for-performance (P4P) experimental condition impacted therapists' intentions to deliver high-quality treatment and the extent to which therapists' intentions could be explained by the theory of planned behavior. Data were collected from 95 therapists who agreed to participate in a P4P experiment related to their implementation of an evidence-based treatment (EBT) for adolescents with substance use problems. Relative to those in the control condition, therapists in the P4P condition reported significantly greater intentions to achieve monthly competence (B = 1.41, p < .001) and deliver a targeted threshold level of treatment to clients (B = 1.31, p < .001). In addition, therapists' intentions could be partially explained by the t...

The impact of craving and impulsivity on aggression in detoxified cocaine-dependent patients

Journal of Substance Abuse Treatment — Mon, 14 Feb 2011 00:00:00 +0100

This study assessed the unique contribution of cocaine craving and impulsivity in predicting aggression by means of correlational and mediational analyses. Forty inpatient detoxified cocaine-dependent patients and 40 matched healthy controls were enrolled. These participants filled out the Obsessive Compulsive Drug Use Scale, the Dickman Impulsivity Inventory, and the Aggression Questionnaire. The patient group showed elevated levels of impulsivity and aggression as compared with the control group. Although cocaine craving is positively correlated with both impulsivity and aggression, craving did not mediate the relationship between both constructs. It is concluded that craving does not have an impact on the relationship between impulsivity and trait aggression in this patient sample. (Sou...

A criterion-based stepwise approach for training counselors in motivational interviewing

Journal of Substance Abuse Treatment — Mon, 14 Feb 2011 00:00:00 +0100

Abstract: This pilot study evaluated a criterion-based stepwise approach for training counselors in motivational interviewing (MI). Three sequential steps of training in MI were provided to 26 counselors who worked within the U.S. State of Connecticut Veterans Administration addiction treatment programs: a distance learning Web course (Step 1), a skill-building workshop (Step 2), and a competency-based individual supervision (Step 3). Counselors first participated in the course and then only received the next step of training if they failed to meet an independently rated criterion level of adequate MI performance. The results showed that counselors who showed inadequate MI performance immediately after taking the Web course and who subsequently participated in a workshop or supervision imp...

The relative effectiveness of women-only and mixed-gender treatment for substance-abusing women

Journal of Substance Abuse Treatment — Mon, 14 Feb 2011 00:00:00 +0100

Abstract: Following research indicating that the treatment needs of women are different from those of men, researchers and clinicians have argued that drug treatment programs for women should be designed to take their needs into account. Such programs tend to admit only women and incorporate philosophies and activities that are based on a social, peer-based model that is responsive to women's needs. To assess the relative effectiveness of women-only (WO) outpatient programs compared with mixed-gender (MG) outpatient programs, 291 study volunteers were recruited (152 WO, 139 MG), and a 1-year follow-up was completed with 259 women (135 WO, 124 MG). Using bivariate, logistic regression, and generalized estimating equation analysis, the following four outcomes were examined: drug and alcohol ...

A comparison of buprenorphine induction strategies: Patient-centered home-based inductions versus standard-of-care office-based inductions

Journal of Substance Abuse Treatment — Thu, 10 Feb 2011 00:00:00 +0100

Abstract: Although novel buprenorphine induction strategies are emerging, they have been inadequately studied. To examine our newly developed patient-centered home-based inductions, we conducted a subgroup analysis of 79 opioid-dependent individuals who had buprenorphine inductions at an urban community health center. Participants chose their induction strategy. Standard-of-care office-based inductions were physician driven, with multiple assessments, and observed, and the patient-centered home-based inductions emphasized patient self-management and included a “kit” for induction at home. We conducted interviews and extracted medical records. Using mixed nonlinear models, we examined associations between induction strategy and opioid use and any drug use. Compared with those with stand...

Reducing high-risk drinking in mandated college students: Evaluation of two personalized normative feedback interventions

Journal of Substance Abuse Treatment — Tue, 08 Feb 2011 00:00:00 +0100

This study evaluated the efficacy of two brief personalized normative feedback interventions aimed at reducing heavy drinking among mandated college students (N = 135). Students were randomly assigned to one of two conditions: Web-based assessment with self-guided personalized normative feedback (SWF) or Web-based assessment with counselor-guided personalized normative feedback (CWF). Results indicated that students in the CWF condition reported significantly greater reductions in weekly drinking quantity and binge drinking frequency than those in the SWF group at follow-up (M = 8 months). Students in the CWF group also reported significantly greater reductions in estimates of peer drinking from baseline to the follow-up assessment than students in the SWF group. In addition, changes in es...

Journal of Substance Abuse Treatment — Fri, 28 Jan 2011 01:56:14 +0100

(Source: Journal of Substance Abuse Treatment)

Editorial Board

Journal of Substance Abuse Treatment — Fri, 28 Jan 2011 01:56:12 +0100

(Source: Journal of Substance Abuse Treatment)

Gender and treatment response in substance use treatment-mandated parolees

Journal of Substance Abuse Treatment — Thu, 27 Jan 2011 00:00:00 +0100

This study examined gender main effects and gender × treatment interactions in a multisite randomized trial (N = 431) comparing a new form of correctional supervision for drug-involved offenders (collaborative behavioral management [CBM]) to standard parole. Outcomes included repeated measures of yes/no use of primary drug, alcohol use, and recidivism during 9 months postrelease. Generalized estimating equation analyses indicated that despite using harder drugs at baseline, women were less likely than men to use their primary drug and to use alcohol during the follow-up period. No gender-related differences in recidivism were found. Treatment interacted with gender to predict alcohol use, with women in CBM reporting the best alcohol outcomes (only 5% of women used alcohol during the follo...

A randomized controlled trial of fluoxetine in the treatment of cocaine dependence among methadone-maintained patients

Journal of Substance Abuse Treatment — Thu, 27 Jan 2011 00:00:00 +0100

Conclusions: Fluoxetine was not efficacious in reducing cocaine use in patients dually dependent on cocaine and opioids. (Source: Journal of Substance Abuse Treatment)

Burnout among the addiction counseling workforce: The differential roles of mindfulness and values-based processes and work-site factors

Journal of Substance Abuse Treatment — Mon, 24 Jan 2011 00:00:00 +0100

In this study, we explored how strongly experiential avoidance, cognitive fusion, and values commitment related to burnout after controlling for well-established work-site factors (job control, coworker support, supervisor support, salary, workload, and tenure). We conducted a cross-sectional survey among 699 addiction counselors working for urban substance abuse treatment providers in six states of the United States. Results corroborated the importance of work-site factors for burnout reduction in this specific population, but we found that mindfulness and values-based processes had a stronger and more consistent relationship with burnout as compared with work-site factors. We conclude that interventions that target experiential avoidance, cognitive fusion, and values commitment may provi...

Lessons from five states: Public sector use of the Washington Circle performance measures

Journal of Substance Abuse Treatment — Mon, 24 Jan 2011 00:00:00 +0100

Abstract: Five states (Connecticut, Massachusetts, New York, North Carolina, and Oklahoma) have incorporated the Washington Circle (WC) substance abuse performance measures in various ways into their quality improvement strategies. In this article, we focus on what other states and local providers might learn from these states' experiences as they consider using WC performance measures. Using a case study approach, we report that the use of WC measures differs across these five states, although there are important common themes required for adoption and sustainability of performance measures, which include leadership, evaluation of specification and use of measures over time, state-specific adaptation of the WC measure specifications, collaboration with consultants and partners, inclusion ...

Higher maternal doses of methadone does not increase neonatal abstinence syndrome

Journal of Substance Abuse Treatment — Fri, 21 Jan 2011 00:00:00 +0100

Conclusion: Higher maintenance dosing of methadone is not associated with increased rate or severity of NAS or other adverse perinatal outcomes. Concerns about NAS should not restrict the methadone dosing during pregnancy. Methadone dosing should not be restricted to lower dosing during pregnancy. (Source: Journal of Substance Abuse Treatment)

Correlates of motivation to change in adolescents completing residential substance use treatment

Journal of Substance Abuse Treatment — Fri, 21 Jan 2011 00:00:00 +0100

Abstract: This research identified psychosocial correlates of motivation to change in adolescents being discharged from residential treatment for substance use disorders. Using a naturalistic longitudinal design, adolescents in a residential treatment program in southeast Ohio were assessed at intake and discharge using self-administered questionnaires. Surveys assessed motivation to change one's drug and alcohol use, ways of coping to avoid future alcohol/substance use, and social support. The 68 participants (mean age = 16.0, range = 12–18) were predominantly Caucasian (87%) and male (69%). Over the course of treatment, adolescents reported significant increases in active-cognitive coping, avoidant-behavioral coping, and attachment and marginally significant increases in motivation to ...

Benefits of concurrent syringe exchange and substance abuse treatment participation

Journal of Substance Abuse Treatment — Fri, 21 Jan 2011 00:00:00 +0100

This study evaluated rates of drug use, other risk behaviors, and illegal activities in newly registered SEP participants (N = 240) enrolled versus not enrolled in substance abuse treatment over a 4-month observation window and examined the effect of days in treatment on these outcomes. After controlling for baseline differences, SEP registrants enrolled in treatment (n = 113) reported less days of opioid and cocaine use, injection drug use, illegal activities, and incarceration than those not enrolled in treatment (n = 127). For those enrolled in treatment, days of treatment was strongly correlated with each of these outcomes. These findings provide good evidence for a dose–response effect of treatment in syringe exchangers and suggest that substance abuse treatment significantly expand...

College alcohol citations result in modest reductions in student drinking

Journal of Substance Abuse Treatment — Thu, 30 Dec 2010 00:00:00 +0100

Abstract: College students who are cited for violating campus alcohol policy are often fined or sanctioned to complete an intervention or public service. Although some interventions have been found efficacious for mandated students, it is possible that being cited for an alcohol-related incident alone may be sufficient to reduce alcohol consumption. The purpose of this study was to investigate the course of alcohol consumption patterns following a citation for an alcohol policy violation. Participants were college students (N = 445) who received a citation for a campus alcohol policy violation at a small northeastern liberal arts college. Participants completed a Timeline Follow-Back indicating their daily alcohol use 2 weeks prior to the citation through 2 weeks after the citation. Result...

Readiness to change and risk drinking women

Journal of Substance Abuse Treatment — Thu, 30 Dec 2010 00:00:00 +0100

Abstract: The predictive value of the Readiness to Change Questionnaire (RTCQ) for subsequent drinking was evaluated in 499 women. These women had medical problems potentially exacerbated by alcohol use and were enrolled in an intervention study. Correlates and predictors of stage of change were analyzed. Results indicated that the categorical application of the RTCQ did not predict drinking in the 6–12 months after enrollment. Preliminary findings support rescoring the RTCQ into a continuous measure. Following this conversion, situational risks factors for drinking were examined as potential mediators of readiness to change (RTC). Heightened risk for alcohol consumption during argument or boredom was found to attenuate the association between one's RTC and later drinking. Finally, medic...

Prescription and over-the-counter drug treatment admissions to the California public treatment system

Journal of Substance Abuse Treatment — Thu, 30 Dec 2010 00:00:00 +0100

This article reports on treatment admission data to the California addiction public system for prescription and OTC drugs among two age subgroups: adolescents 12–17 years and adults 18 years and older. Of the 6,841 admissions for primary abuse of prescription and OTC drugs in California (during 2006–2007), most adolescent admissions (12–17) were for stimulant prescription and OTC drugs (45.3% and 32.1%, respectively), whereas opioid prescription drugs (88.9%) were most common for adults 18 years and older. Differences in psychosocial, treatment, and substance use characteristics between these two age subgroups are described. Results from this study offer useful treatment admission information about prescription and OTC drug abuse within the California public addiction treatment syste...

Integrated employee assistance program/managed behavioral health plan utilization by persons with substance use disorders

Journal of Substance Abuse Treatment — Mon, 27 Dec 2010 00:00:00 +0100

This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral health care (MBHC) organization's integrated EAP/MBHC product (N = 1,158). In 2004, 25.0% of clients used the EAP first for new treatment episodes. After initial EAP utilization, 44.4% received no additional formal services through the plan, and 40.4% received regular outpatient services. Overall, outpatient care, intensive outpatient/day treatment, and inpatient/residential detoxification were most common. About half of the clients had co-occurring psychiatric diagnoses. Mental health service utilization was extensive. Findings suggest that for service users with primary SUD diagnoses in an integrated EAP/MBHC product, the EAP benefit plays a key role at the...

Predictors of substance abuse treatment need and receipt among homeless women

Journal of Substance Abuse Treatment — Mon, 27 Dec 2010 00:00:00 +0100

This study identified social network and other predisposing factors associated with perceived need for and receipt of substance abuse treatment among 273 homeless women who screened positive for past-year substance abuse. Perceived treatment need was more likely among women with drug-using sex partners, a denser network, and an arrest history but less likely for those with a minor child and a longer history of homelessness. Receiving treatment was more likely among women who received informational support from their sex partners and who had an arrest history but less likely among those who had a more street-based social network, had a minor child, considered themselves homeless, and recently needed mental health treatment. Treatment services researchers should attend more closely to social...

Computer-based interventions for drug use disorders: A systematic review

Journal of Substance Abuse Treatment — Mon, 27 Dec 2010 00:00:00 +0100

Abstract: A range of innovative computer-based interventions for psychiatric disorders have been developed and are promising for drug use disorders due to reduced cost and greater availability compared to traditional treatment. Electronic searches were conducted from 1966 to November 19, 2009, using MEDLINE, Psychlit, and EMBASE. Four hundred sixty-eight nonduplicate records were identified. Two reviewers classified abstracts for study inclusion, resulting in 12 studies of moderate quality. Eleven studies were pilot or full-scale trials compared to a control condition. Interventions showed high acceptability despite substantial variation in type and amount of treatment. Compared to treatment-as-usual, computer-based interventions led to less substance use and higher motivation to change, b...

A brief marijuana intervention for non-treatment-seeking young adult women

Journal of Substance Abuse Treatment — Mon, 27 Dec 2010 00:00:00 +0100

Abstract: We randomized 332 women, 18–24 years old, who were not explicitly seeking treatment for their marijuana use to either a two-session motivationally focused intervention or an assessment-only condition. Assessed by timeline follow-back methodology, participants reported using marijuana 57% of days in the 3 months prior to study entry. Intervention effects on the likelihood of marijuana use were not statistically significant at 1 month (odds ratio [OR] = 0.77, p = .17), significant at 3 months (OR = 0.53, p = .01), and no longer significant at 6 months (OR = 0.74, p = .20). Among the 61% of participants endorsing any desire to quit using marijuana at baseline, significant intervention effects on the likelihood of marijuana use days were observed at 1 month (OR = 0.42, p = .03), 3 ...

Nurse turnover in substance abuse treatment programs affiliated with the National Drug Abuse Treatment Clinical Trials Network

Journal of Substance Abuse Treatment — Wed, 22 Dec 2010 00:00:00 +0100

Abstract: Voluntary nurse turnover, which is costly and disrupts patient care, has not been studied as an organizational phenomenon within substance abuse treatment organizations. In this exploratory study, we examined the frequency and correlates of nurse turnover within treatment programs affiliated with the National Drug Abuse Treatment Clinical Trials Network. During face-to-face interviews conducted in 2005–2006, 215 program administrators reported the number of nurses currently employed. Leaders of programs with nursing staff then described the number of nurses who had voluntarily quit in the past year, the degree to which filling vacant nursing positions was difficult, and the average number of days to fill a vacant position. About two thirds of these programs had at least one nur...

A comparison of the symptoms and short-term clinical course in inpatients with substance-induced psychosis and primary psychosis

Journal of Substance Abuse Treatment — Fri, 03 Dec 2010 21:11:10 +0100

In this study, symptoms associated with psychosis were monitored across admission in two groups of patients: those with SIP (amphetamines or cannabis; n = 47) and those with PPD (n = 51). Sixty-two percent of patients were first admissions, 23% had one previous admission, and a further 14% had had two previous admissions. Symptoms were monitored using the Brief Psychiatric Rating Scale. Scores on the positive symptoms scale, negative symptoms scale, manic excitement, and negative mood were reported as was the extent of observed disturbed behavior at admission and then at Days 4/5, 8/9, 15/16, 22/23, 29/30, 36/37, 43/44, and 50/51. Patients with a SIP experienced more severe mania and disturbed behavior at admission than those with a PPD. However, these symptoms abated more rapidly for the ...

Alcohol expectancy changes over a 12-week cognitive–behavioral therapy program are predictive of treatment success

Journal of Substance Abuse Treatment — Fri, 03 Dec 2010 21:11:04 +0100

This study examines if outcome expectancies (perceived consequences of engaging in certain behavior) and self-efficacy expectancies (confidence in personal capacity to regulate behavior) contribute to treatment outcome for alcohol dependence. Few clinical studies have examined these constructs. The Drinking Expectancy Profile (DEP), a psychometric measure of alcohol expectancy and drinking refusal self-efficacy, was administered to 298 alcohol-dependent patients (207 males) at assessment and on completion of a 12-week cognitive–behavioral therapy alcohol abstinence program. Baseline measures of expectancy and self-efficacy were not strong predictors of outcome. However, for the 164 patients who completed treatment, all alcohol expectancy and self-efficacy factors of the DEP showed change...

Journal of Substance Abuse Treatment — Fri, 03 Dec 2010 21:11:02 +0100

(Source: Journal of Substance Abuse Treatment)

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Journal of Substance Abuse Treatment — Fri, 03 Dec 2010 21:11:02 +0100

(Source: Journal of Substance Abuse Treatment)

A cluster-randomized effectiveness trial of smoking cessation modified for at-risk smoker subgroups

Journal of Substance Abuse Treatment — Fri, 03 Dec 2010 00:00:00 +0100

In the article by Batra et al., “A Cluster-Randomized Effectiveness Trial of Smoking Cessation Modified for At-Risk Smoker Subgroups” [J Subst Abuse Treat 2009;38:128–140], the authors have removed one participant from the data analyses reported in the article because the participant had been mistakenly recruited for a different condition than intended. The main outcomes of the study are not affected by the exclusion of this participant, but the corrected statistics for the primary analyses are presented below. (Source: Journal of Substance Abuse Treatment)

Purpose in life predicts treatment outcome among adult cocaine abusers in treatment

Journal of Substance Abuse Treatment — Fri, 03 Dec 2010 00:00:00 +0100

This study examined pretreatment purpose in life as a predictor of response to a 30-day residential substance use treatment program among 154 participants with cocaine dependence. Purpose in life was unrelated to cocaine or alcohol use during the 6 months pretreatment. After controlling for age, baseline use, and depressive symptoms, purpose in life significantly (p < .01) predicted relapse to any use of cocaine and to alcohol and the number of days cocaine or alcohol was used in the 6 months after treatment. Findings suggest that increasing purpose in life may be an important aspect of treatment among cocaine-dependent patients. (Source: Journal of Substance Abuse Treatment)

Client characteristics within the Chilean National Youth Addiction Treatment Demonstration System

Journal of Substance Abuse Treatment — Mon, 29 Nov 2010 00:00:00 +0100

Abstract: In the context of an evaluation of a national demonstration program for youth addiction treatment in Chile, a sociodemographic and substance use profile of children and adolescents accessing services through this new program was developed. Information regarding sociodemographic factors, substance use, and problem severity; services used; and unmet needs was retrospectively gathered for all clients (685) admitted between January 1 and June 30, 2006. Thirty-two treatment centers (91.4%) provided data. The client population profile reflected severe psychosocial circumstances (e.g., 61.4% early exit from school). Of the population, 64.9% were classified in the highest substance risk level. The primary drug reported was cocaine-paste-base (52.7%). Comparisons to similar data in other ...

Teaching physicians to address unhealthy alcohol use: A randomized controlled trial assessing the effect of a Web-based module on medical student performance

Journal of Substance Abuse Treatment — Mon, 22 Nov 2010 00:00:00 +0100

Conclusion: Use of a Web-based module to teach SBI is associated with greater knowledge gain and skills performance compared with a lecture covering similar content. The module provides an efficient means for training in this area. (Source: Journal of Substance Abuse Treatment)

Performance contracting to engage detoxification-only patients into continued rehabilitation

Journal of Substance Abuse Treatment — Mon, 22 Nov 2010 00:00:00 +0100

Abstract: In 2006, only 18.7% of Delaware's detoxification patients were admitted to continuing recovery-oriented treatment within 30 days after discharge. In response, Delaware established financial contingencies to (1) maintain 90% detoxification occupancy, (2) make receipt of 10% of the facility's monthly reimbursement contingent on 25% of patients entering treatment, and (3) provide a $500 bonus for every patient with three or more prior detoxification visits who was retained in treatment.Under the performance contract, the detoxification provider (1) maintained the 90% occupancy requirement, (2) achieved the 25% treatment entry target for 7 of 12 months, and (3) observed only 8% (27/337) of detoxification completions that met the targeted length of stay. Continuation to and retention ...

The boundaries of addiction treatment services research

Journal of Substance Abuse Treatment — Mon, 08 Nov 2010 00:00:00 +0100

In the United States, at most, only about 10% of persons with substance use disorders obtain services in specialty care such as traditional addiction treatment programs. If such persons receive care at all, it is more likely to occur in routine medical settings: community health centers, hospital emergency departments or inpatient units, or physician offices (). Internationally, despite our efforts to improve access for persons with substance use disorders, the proportion who seek help in specialty programs has remained constant, whereas the number who are identified with substance use problems in other settings (medical, mental health) is growing (). There are multiple layers of barriers to persons accessing specialty care and nonspecialty care, ranging from perceived stigma and shame to ...

Journal of Substance Abuse Treatment — Tue, 02 Nov 2010 05:09:32 +0100

(Source: Journal of Substance Abuse Treatment)

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Journal of Substance Abuse Treatment — Tue, 02 Nov 2010 05:09:32 +0100

(Source: Journal of Substance Abuse Treatment)

Unintended pregnancy in opioid-abusing women

Journal of Substance Abuse Treatment — Mon, 01 Nov 2010 00:00:00 +0100

Abstract: The aim of this study was to estimate the prevalence of unintended pregnancy and its three subtypes (mistimed, unwanted, and ambivalent) among opioid-abusing women. In the general population, 31%–47% of pregnancies are unintended; data on unintended pregnancy in opioid- and other drug-abusing women are lacking. Pregnant opioid-abusing women (N = 946) screened for possible enrollment in a multisite randomized controlled trial comparing opioid maintenance medications completed a standardized interview assessing sociodemographic characteristics, current and past drug use, and pregnancy intention. Almost 9 of every 10 pregnancies were unintended (86%), with comparable percentages mistimed (34%), unwanted (27%), and ambivalent (26%). Irrespective of pregnancy intention, more than 90...

Characteristics and 9-month outcomes of discharged methadone maintenance clients

Journal of Substance Abuse Treatment — Mon, 01 Nov 2010 00:00:00 +0100

This study is a secondary data analysis of a clinical trial assessing the effectiveness of outreach case management (OCM) in linking discharged methadone patients back into treatment. The original trial assessed the effectiveness of the OCM intervention compared to a passive referral among methadone clients who needed treatment postdischarge but had not reengaged. The purpose of this study was to assess the characteristics and long-term outcomes of all clients who were discharged from methadone maintenance treatment including those who had reengaged in treatment. A total of 230 methadone clients were interviewed 3 months and then again at 9 months following discharge from treatment. Compared with participants who needed treatment but had not reengaged (NoTx: 56%), those who had successfull...

Predictors of addiction treatment providers' beliefs in the disease and choice models of addiction

Journal of Substance Abuse Treatment — Mon, 01 Nov 2010 00:00:00 +0100

Abstract: Addiction treatment providers working in the United States (n = 219) and the United Kingdom (n = 372) were surveyed about their beliefs in the disease and choice models of addiction, as assessed by the 18-item Addiction Belief Scale of J. Schaler (1992). Factor analysis of item scores revealed a three-factor structure, labeled “addiction is a disease,” “addiction is a choice,” and “addiction is a way of coping with life,” and factor scores were analyzed in separate hierarchical multiple regression analyses. Controlling for demographic and addiction history variables, treatment providers working in the United States more strongly believe addiction is a disease, whereas U.K.-based providers more strongly believe that addiction is a choice and a way of coping with life. ...

Alcohol use problem among patients in methadone maintenance treatment in Taiwan

Journal of Substance Abuse Treatment — Mon, 01 Nov 2010 00:00:00 +0100

Conclusions: High attendance rate, which is regarded as a component of clinical policy and a key component of therapeutic context, should be incorporated with brief interventions to lower alcohol use problems among MMT patients. (Source: Journal of Substance Abuse Treatment)

Adapting problem-solving therapy for depressed older adults in methadone maintenance treatment

Journal of Substance Abuse Treatment — Mon, 01 Nov 2010 00:00:00 +0100

This article focuses on problem-solving therapy (PST) and presents evidence that PST may be a promising nonpharmacological treatment for older methadone clients with comorbid depressive disorders that can be applied within the staffing and resource limits of methadone maintenance treatment facilities. The advantages of PST relative to other behavioral therapies for this population are based on evidence that PST is less cognitively demanding for an older adult population with mood and substance use disorders. A properly modified PST for an older adult substance-dependent population with subsyndromal or diagnosed depression may be a viable option for methadone maintenance programs with limited resources. (Source: Journal of Substance Abuse Treatment)

Efficacy of indirect dopamine agonists for psychostimulant dependence: A systematic review and meta-analysis of randomized controlled trials

Journal of Substance Abuse Treatment — Mon, 01 Nov 2010 00:00:00 +0100

Abstract: Psychostimulant dependence is characterized by dopamine deficit, which could be reversed with indirect dopamine agonists (IDAs). A systematic review and meta-analysis of randomized, parallel-group, placebo-controlled clinical trials assessing the efficacy of IDAs in psychostimulant-dependent individuals were conducted. The study outcomes were psychostimulant abstinence, assessed by means of urinalysis, and retention in treatment. Risk of bias was determined using a Cochrane Collaboration instrument. Twenty-nine studies fulfilled the inclusion criteria, involving 2,467 participants. Compared with placebo, IDAs increased psychostimulant abstinence (standardized mean difference = 0.20; 95% confidence interval, 0.06–0.35; p = .005) but did not increase retention in treatment. Effic...

Outpatient versus inpatient opioid detoxification: A randomized controlled trial

Journal of Substance Abuse Treatment — Mon, 01 Nov 2010 00:00:00 +0100

In this study, 68 opioid-dependent patients receiving community treatment (predominantly with methadone) and requesting detoxification were randomly assigned to an inpatient versus outpatient setting. Both groups received the same medication (lofexidine), and the primary outcome measure was being opioid-free at detoxification completion. More inpatients (n = 18, 51.4%) than outpatients (n = 12, 36.4%) completed detoxification, but this difference was not statistically significant (χ2 = 1.56, p = .21). However, the outpatient group received a significantly longer period of medication, and when the length of detoxification was controlled for, the results favored the inpatient setting (Exp(B) = 13.9, 95% confidence interval = 2.6–75.5, p = .002). Only 11 (16%) participants were opioid-free...

Workforce professionalism in drug treatment services: Impact of California's Proposition 36

Journal of Substance Abuse Treatment — Mon, 01 Nov 2010 00:00:00 +0100

This article investigates whether California's Proposition 36 has promoted the workforce professionalism of drug treatment services during its first 5 years of implementation. Program surveys inquiring about organizational information, Proposition 36 implementation, and staffing were conducted in 2003 and 2005 among all treatment providers serving Proposition 36 clients in five selected California counties (San Diego, Riverside, Kern, Sacramento, and San Francisco). A 1-hour self-administered questionnaire was completed by 118 treatment providers representing 102 programs. This article examines five topics that are relevant to drug treatment workforce professionalism: resources and capability, standardized intake assessment and outcome evaluation, staff qualification, program accreditation...

Varenicline for tobacco dependence treatment in recovering alcohol-dependent smokers: An open-label pilot study

Journal of Substance Abuse Treatment — Fri, 15 Oct 2010 00:00:00 +0100

Abstract: The purpose of this study was to obtain preliminary evidence of the efficacy of a 12-week course of varenicline for 7-day point prevalence smoking abstinence among recovering alcohol-dependent smokers. We enrolled 32 smokers with 6 months or more of recovery from alcohol dependence in an open-label clinical trial. Participants received varenicline 1 mg twice daily and 12 weeks of behavioral counseling. Participants were 69% men, 94% Caucasian, and smoking an average of 20.3 ± 5.0 cigarettes per day. After 12 weeks of treatment, 31% were biochemically confirmed 7-day point prevalence abstinent from smoking and 28% had prolonged smoking abstinence (2 weeks after target quit date onward). The most common adverse effects were mild to moderate nausea (28%) and sleep disturbance (19%)...

Occupational turnover intentions among substance abuse counselors

Journal of Substance Abuse Treatment — Fri, 15 Oct 2010 00:00:00 +0100

This study examined predictor, moderator, and mediator variables of occupational turnover intention (OcTI) among substance abuse counselors. Data were obtained via questionnaires from 929 counselors working in 225 private substance abuse treatment (SAT) programs across the United States. Hierarchical multiple regression models were conducted to assess predictor, moderator, and mediator variables of OcTI. OcTI scores were relatively low on a 7-point scale, indicating that very few counselors definitely intended to leave the SAT field. Age, certification, positive perceptions of procedural and distributive justice, and hospital-based status negatively predicted OcTI. Counselors' substance use disorder–impacted history moderated the association between organizational commitment and OcTI. Or...

Bupropion SR and contingency management for adolescent smoking cessation

Journal of Substance Abuse Treatment — Mon, 11 Oct 2010 00:00:00 +0100

Abstract: There is a significant need for evidence-based treatments for adolescent smoking cessation. Prior research, although limited, has suggested potential roles for bupropion sustained-release (SR) and contingency management (CM), but no previous studies have assessed their combined effect. In a double-blind, placebo-controlled design, 134 adolescent smokers were randomized to receive a 6-week course of bupropion SR + CM, bupropion SR + non-CM, placebo + CM, or placebo + non-CM, with final follow-up at 12 weeks. The primary outcome was 7-day cotinine-verified point prevalence abstinence, allowing for a 2-week grace period. Combined bupropion SR + CM treatment yielded significantly superior abstinence rates during active treatment when compared with placebo + non-CM treatment. In addit...

Advancing performance measures for use of medications in substance abuse treatment

Journal of Substance Abuse Treatment — Mon, 11 Oct 2010 00:00:00 +0100

This article summarizes those findings by identifying a number of critical themes related to advancing SUD pharmacotherapy performance measures, highlighting examples from the field, and recommending actions for policy makers. (Source: Journal of Substance Abuse Treatment)

Child welfare agency ties to providers and schools and substance abuse treatment use by adolescents

Journal of Substance Abuse Treatment — Tue, 28 Sep 2010 00:00:00 +0100

This study examined how child welfare agency ties with substance abuse treatment providers and schools correlated with substance abuse treatment for adolescents receiving child protective services. A sample of adolescents with substance use risk was extracted from a national survey of families engaged with child welfare. Logistic regressions with adjustments for complex survey design used child welfare agency ties to substance abuse treatment providers and schools to predict treatment. As expected, adolescents were more likely to report treatment when child protective services and substance abuse treatment were in the same agency and when child welfare agency directors reported joint planning with schools. However, child welfare agency agreements with substance abuse treatment providers we...

Organizational factors associated with the use of contingency management in publicly funded substance abuse treatment centers

Journal of Substance Abuse Treatment — Fri, 17 Sep 2010 00:00:00 +0100

Abstract: A promising area within technology transfer studies is the identification of organizational factors that influence the adoption of treatment innovations. Although studies have identified organizational factors associated with the adoption of pharmacological innovations, few studies have examined organizational factors in the adoption of psychosocial innovations, among which contingency management (CM) is a significant practice. Using data from a sample (N = 318) drawn from the population of publicly funded treatment centers in the United States, this study modeled organizational factors falling in the domains of structural characteristics, workforce variables, values and norms, and patient characteristics associated with the use of CM. Organizations were more likely to use CM if ...

Estimating statistical power for open-enrollment group treatment trials

Journal of Substance Abuse Treatment — Tue, 14 Sep 2010 00:00:00 +0100

Abstract: Modeling turnover in group membership has been identified as a key barrier contributing to a disconnect between the manner in which behavioral treatment is conducted (open-enrollment groups) and the designs of substance abuse treatment trials (closed-enrollment groups, individual therapy). Latent class pattern mixture models (LCPMMs) are emerging tools for modeling data from open-enrollment groups with membership turnover in recently proposed treatment trials. The current article illustrates an approach to conducting power analyses for open-enrollment designs based on the Monte Carlo simulation of LCPMM models using parameters derived from published data from a randomized controlled trial comparing Seeking Safety to a Community Care condition for women presenting with comorbid po...

Journal of Substance Abuse Treatment — Fri, 10 Sep 2010 12:20:34 +0100

(Source: Journal of Substance Abuse Treatment)

Editorial Board

Journal of Substance Abuse Treatment — Fri, 10 Sep 2010 12:20:34 +0100

(Source: Journal of Substance Abuse Treatment)

Journal of Substance Abuse Treatment via MedWorm.com

Table of Contents

Editorial Board

Introduction to the special issue on organizational dynamics within substance abuse treatment: A complex human activity system

The impact of organizational stress and burnout on client engagement

Innovation adoption as facilitated by a change-oriented workplace

Resources and training in outpatient substance abuse treatment facilities

Program needs and change orientation: Implications for counselor turnover

Organizational consequences of staff turnover in outpatient substance abuse treatment programs

Treatment staff turnover in organizations implementing evidence-based practices: Turnover rates and their association with client outcomes

Treatment program operations and costs

Drug treatment program ownership, Medicaid acceptance, and service provision

A multilevel approach to predicting community addiction treatment attitudes about contingency management

Impact of a training and certification program on the quality of interviewer-collected self-report assessment data

Journal of Substance Abuse Treatment: Tradition, change and opportunity

Contents

Editorial Board

The relationship between perceptions of organizational functioning and voluntary counselor turnover: a four-wave longitudinal study

Training and retaining staff to competently deliver an evidence-based practice: The role of staff attributes and perceptions of organizational functioning

Integrated treatment programs for individuals with concurrent substance use disorders and trauma experiences: A systematic review and meta-analysis

Contents

Editorial Board

How do components of evidence-based psychological treatment cluster in practice? A survey and cluster analysis

Motivational and mindfulness intervention for young adult female marijuana users

Outcome of heroin-dependent adolescents presenting for opiate substitution treatment

Table of Contents

Editorial Board

Client–Provider relationship in comprehensive substance abuse treatment: Differences in residential and nonresidential settings

Twelve-month follow-up of aftercare for adolescents with alcohol use disorders

Computerized continuing care support for alcohol and drug dependence: A preliminary analysis of usage and outcomes

Benefits of concurrent syringe exchange and substance abuse treatment participation

Comparing alternative specifications of quality measures: Access to pharmacotherapy for alcohol use disorders

Correlates of participation in peer recovery support groups as well as voluntary and mandated substance abuse treatment among rural and urban probationers

Criminal convictions among dependent heroin users during a 3-year period prior to opioid maintenance treatment: A longitudinal national cohort study

Patterns of prescription opioid abuse and comorbidity in an aging treatment population

Timing of buprenorphine adoption by privately funded substance abuse treatment programs: The role of institutional and resource-based interorganizational linkages

How is tobacco treatment provided during drug treatment?

Adolescent Community Reinforcement Approach outcomes differ among emerging adults and adolescents

A treatment reengagement intervention for syringe exchangers

A qualitative investigation of barriers to entry into couples' treatment for alcohol problems

G. Alan Marlatt: 1941–2011

Patterns in admission delays to outpatient methadone treatment in the United States

A multi-level analysis of counselor attitudes toward the use of buprenorphine in substance abuse treatment

Table of Contents

Editorial Board

Interventions targeting substance abuse among women survivors of intimate partner abuse: A meta-analysis

A systematic review of interventions for co-occurring substance use disorder and borderline personality disorder

Delay discounting, impulsiveness, and addiction severity in opioid-dependent patients

Changes in methadone maintenance therapy during and after pregnancy

Comparative utility of a single-item versus multiple-item measure of self-efficacy in predicting relapse among young adults

Substance abuse treatment utilization among adults living with HIV/AIDS and alcohol or drug problems

Does clinician continuity over two brief motivational sessions improve outcomes in college students?

Preliminary evaluation of extended-release naltrexone in Michigan and Missouri drug courts

Risk of drug-related mortality during periods of transition in methadone maintenance treatment: A cohort study

Efficacy of continuing medical education to reduce the risk of buprenorphine diversion

If substance use disorder treatment more than offsets its costs, why don't more medical centers want to provide it? A budget impact analysis in the Veterans Health Administration

Contents

Editorial Board

Factors that influence trajectories of change in frequency of substance use and quality of life among adolescents receiving a brief intervention

Determining the efficacy of auricular acupuncture for reducing anxiety in patients withdrawing from psychoactive drugs

Who uses online interventions for problem drinkers?

Frontline counselors in organizational contexts: A study of treatment practices in community settings

Drug assertiveness and sexual risk-taking behavior in a sample of HIV-positive, methamphetamine-using men who have sex with men

Mortality rate among crack/cocaine-dependent patients: A 12-year prospective cohort study conducted in Brazil

Childhood sexual abuse and substance abuse treatment utilization among substance-dependent incarcerated women

Depressive symptoms as a predictor of alcohol relapse after residential treatment programs for alcohol use disorder

Baseline functioning among individuals with posttraumatic stress disorder and alcohol dependence

Call for Papers

Contents

Editorial Board

Prevalence and correlates of nonmedical use of prescription opioids in patients seen in a residential drug and alcohol treatment program

An exploratory study of alternative configurations of governing boards of substance abuse treatment centers

Pay-for-performance in a community substance abuse clinic

Motivational interviewing integrated with social network counseling for female adolescents: A randomized pilot study in urban primary care

Brief assessment of readiness to change tobacco use in treated youth

Brief intervention for women with risky drinking and medical diagnoses: A randomized controlled trial

The economic costs of quarterly monitoring and recovery management checkups for adults with chronic substance use disorders

Oral health of substance-dependent individuals: Impact of specific substances

Research to practice in addiction treatment: Key terms and a field-driven model of technology transfer

Long-term outcomes among drug-dependent mothers treated in women-only versus mixed-gender programs