Thesis (M.S.)--Boston University / This study is concerned with eight alcoholic adult patients at the Washingtonian Hospital. The parent-child relationships of these adult patients, when they were children, will be investigated to gain some understanding as to the factors involved in their present alcoholism.

Efforts to increase employment rates through vocational skills training and job interview skills development have yielded mixed results. While initial studies of Job Seekers Workshop (JSW) found greater employment success for participants randomized to JSW as compared to a control condition (Hall, Loeb & Norton, 1977), a more recent Clinical Trials Network (CTN) study found no differences in employment outcomes between the JSW and control groups and the rate of employment overall was substantively lower than those reported in the early studies (Svikis et al., 2012). To better understand these discrepant findings, the present study conducted secondary analyses using the 2012 RCT dataset. It examined whether JSW participants engaged in more types and higher frequencies of various job-seeking behaviors than SC controls. The study also examined the relationship between JSW intervention dose and employment outcomes. Finally, the study sought to identify individual and treatment variables associated with getting a job. The results showed comparable rates of job-seeking behavior in JSW and SC controls. However, JSW intervention dose (number of sessions attended) was related to the likelihood of employment at 6-month follow-up. Univariate analysis found a variety of demographic, treatment, and psychosocial variables associated with becoming employed during study follow-up. Multivariate analyses found the most parsimonious model for predicting employment during the 6- month follow up period including being male, attending psychosocial outpatient treatment, attending more JSW sessions, submitting a job application, and living with a sexual partner or children. Future research should look more closely at barriers to employment and how to better measure client motivation to get a job.

The purpose of the current study was to investigate predictors of therapeutic alliance among a sample of 46 adults with substance misuse who were convicted of felony offenses and court-mandated to attend substance use treatment as part of their probation requirements. For this study, I purposed four hypotheses: (1) older participants will report a stronger therapeutic alliance with their therapist. (2) women will form a stronger therapeutic alliance with their therapist than men, (3) higher levels of distress will be associated with lower therapeutic alliance, and (4) people with more extensive criminal and substance use histories to have poorer therapeutic alliance. Data was collected quantitatively, utilizing a questionnaire method. Bivariate correlations were run on all study variables, as well as a multiple linear regression model. Results of this study found that older participants and number of months incarcerated predicted weaker therapeutic alliance. No statistically significant findings were found in relation to the DASS-21 or gender.

Introduction: Race/ethnicity and sex disparities in substance use and substance use treatment completion are well documented in the literature. Previous literature has shown that participation in self-help groups is associated with higher rates of substance use treatment completion. While most of this research has focused on the completion of treatment for alcohol and stimulant use, research examining this relationship using an intersectional approach for individuals in treatment for opioid use is limited. Methods: Thus, the current study utilized responses from the Treatment Episodes Data Set–Discharges, 2015–2017 to examine disparities in the relationship between participation in self-help groups and substance use treatment completion for individuals undergoing treatment for opioid use based on sex, race, and ethnicity. Results: Results revealed a positive association between participation in self-help groups and treatment completion among those in treatment for opioid use across race, ethnicity, and sex. Further, the study found several differences in this association based on one's race, ethnicity, and sex. When compared to men of other races/ethnicities, the association between self-help group participation and treatment completion was highest among Black men. Conclusions: The results of the current study extend the knowledge-base about self-help participation's role in promoting successful substance use treatment completion to individuals in treatment for opioid use. Results also highlight the need to examine treatment outcomes with an intersectional lens.

Doctor of Philosophy / School of Family Studies and Human Services / Jared R. Anderson / Addiction to mood-altering substances i.e., drugs and alcohol is a public health concern impacting society in many contexts (e.g., employment, financial costs, family welfare, healthcare, and criminal activity). As a result of the substantial personal and societal costs associated with substance abuse, significant federal dollars have been spent on addiction recovery services in an attempt to ameliorate the negative impacts of these disorders. Like many chronic diseases, relapse (40-60%; National Institute on Drug Abuse, 2012) and dropout (23-50%) rates for clients in drug and alcohol outpatient treatment tend to be high (McHugh et al., 2013; Santonja-Gomez et al., 2010; Evans, Li, and Hser 2009; Stark, 1992). Over time, it has become clear that a single course of treatment is simply not enough to meet the needs of a person in recovery from alcohol and/or other drug abuse. The field of addiction treatment and recovery has been dominated by an acute-care model of treatment. A new model, recovery-oriented systems of care (ROSC), defined as “networks of organizations, agencies, and community members that coordinate a wide spectrum of services to prevent, intervene in, and treat substance use problems and disorders” (Sheedy & Whitter, 2013, p. 227), has been endorsed by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Center for Substance Abuse Treatment (CSAT). As communities begin to implement ROSC it is imperative to understand the barriers to transitioning out of the traditional, acute-care model. Findings from in-depth qualitative interviews revealed that both treatment and probation professionals described more alignment with the ROSC model than the acute-care model. For treatment professionals, this alignment was stronger at an individual level and for probation professionals it was stronger at the system level. For both professional groups, the system-level barriers to moving toward a ROSC model were much greater than any individual-level barriers. Facilitators were found evenly split for the most part between individual and system level codes. For communities making movement toward the ROSC model, the systems of treatment and probation have great potential at the individual level for ROSC alignment and have available facilitators for overcoming system-level barriers in place. Although the acute-care model served a purpose at one time, it is now time for the ROSC model to be implemented as a comprehensive response to addiction and needs in recovery.

Purpose: Most individuals do not perceive a need for substance use treatment despite meeting diagnostic criteria for substance use disorders and they are least likely to pursue treatment voluntarily. There are also those who perceive a need for treatment and yet do not pursue it. This study aimed to understand which factors increase the likelihood of perceiving a need for treatment for individuals who meet diagnostic criteria for substance use disorders in the hopes to better assist with more targeted efforts for gender-specific treatment recruitment and retention. Using Andersen and Newman’s (1973/2005) model of individual determinants of healthcare utilization, the central hypothesis of the study was that gender moderates the relationship between substance use problem severity and perceived treatment need, so that women with increasing problems due to their use of substances are more likely than men to perceive a need for treatment. Additional predisposing and enabling factors from Andersen and Newman’s (1973/2005) model were included in the study to understand their impact on perceived need. Method: The study was a secondary data analysis of the 2010 National Survey on Drug Use and Health (NSDUH) using logistic regression. The weighted sample consisted of a total 20,077,235 American household residents (The unweighted sample was 5,484 participants). Results of the logistic regression were verified using Relogit software for rare events logistic regression due to the rare event of perceived treatment need (King & Zeng, 2001a; 2001b). Results: The moderating effect of female gender was not found. Conversely, men were significantly more likely than women to perceive a need for treatment as substance use problem severity increased. The study also found that a number of factors such as race, ethnicity, socioeconomic status, age, marital status, education, co-occurring mental health disorders, and prior treatment history differently impacted the likelihood of perceiving a need for treatment among men and women. Conclusion: Perceived treatment need among individuals who meet criteria for substance use disorders is rare, but identifying factors associated with an increased likelihood of perceiving need for treatment can help the development of gender-appropriate outreach and recruitment for social work treatment, and public health messages.

This study explored the treatment of women's substance abuse from a critical theory perspective. The literature indicates that, within substance abuse treatment programs and in the research world, few treatment programs are sensitive to women's specific needs.

No description available.

Indiana University-Purdue University Indianapolis (IUPUI) / Opioid misuse and addiction has been widely identified as a public health problem, contributing substantially to the nation’s morbidity and mortality. Over the past two decades, misuse of prescription opioids pain relievers has substantially increased; heroin use has resurged; and, more recently, abuse of high-potency synthetic opioids such as fentanyl have fueled the epidemic. Nearly 12 million Americans (or 4.4%) aged 12 and older misused some type of opioid (prescribed or illegal) in the past year. Furthermore, the percentage of substance use treatment admissions attributable to opioids nearly doubled in the U.S., from 20.8% in 2000 to 40.5% in 2015. The purpose of this dissertation research was to investigate associations between prescription pain reliever use and subsequent negative health outcomes, including opioid misuse or addiction, and neonatal abstinence syndrome. This research focused on three specific aims: Specific Aim #1: Examine heroin use among Indiana’s substance use treatment population to measure the extent, trends, and patterns of use, as well as to assess the relationship between prescription opioids and subsequent heroin use; Specific Aim #2: Analyze 2014 INSPECT (Indiana’s prescription drug monitoring program) data to identify factors that increase patients’ likelihood to engage in opioidrelated risk behaviors; and Specific Aim #3: Review U.S. trends in neonatal abstinence syndrome (NAS) incidence from 2008-2014, measure regional variability, and identify personal and environmental risk factors associated with NAS. / 2020-08-09

Syftet med studien var att undersöka yrkesverksammas erfarenheter av att använda Alkohol Drog Diagnos Instrumentet ADDIS Ung i missbruksvården. Studien baserades intervjuer medyrkesverksamma som använder sig av bedömningsinstrumentet. Den insamlade informationenfrån intervjuerna har sedan bearbetats med hjälp av innehållsanalys. Resultatet visade attsamtliga intervjupersoner ansåg att ADDIS Ung var ett bra verktyg och att instrumentetsstyrka låg i de djupgående frågorna och den helhet som dessa skapar. Resultatet visade även att intervjupersonerna var samstämmiga gällande svårigheterna avseende att det kan ta långtid att genomföra en ADDIS Ung när klienten använder flera droger. De var ävensamstämmiga angående att vissa frågor var svåra för klienterna att förstå vilket också upplevssom en viss svårighet / The purpose of the study was to examine professionals' experience of the assessmentinstrument ADDIS Ung in substance use treatment. The study was based on qualitative research and the data has been collected through interviews with professionals using theassessment instrument. The data that has been collected through interviews has been analyzed with content analysis. The results showed that all of the interviewees believed that ADDIS Ung is a good tool and that the instrument's strength lies in the depth of the questions and thewholeness that these create. The results also showed that the interviewees were in agreementregarding the difficulties that exist with the instrument.