Assessment of drug abuser treatment needs in Rhode Island.

McAuliffe, William; Breer, Paul; Ahmadifar, N W; Spino, Cathie

doi:10.2105/ajph.81.3.365

Cited by 32 publications

(20 citation statements)

References 26 publications

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“…37 In this report, 3 groups were identified as likely to benefit from specialty treatment: drug users (drug abuse treatment), alcoholic persons with or without drug use who met the DSM-IV alcohol dependence or abuse criteria (alcohol abuse treatment), and those meeting DSM-IV criteria for PTSD with or without drug use (psychiatric treatment). Although our criteria for individuals potentially needing drug abuse treatment differ from others, 38 the inclusion of all current and recent drug users was judged optimal, given the long-term nature of drug use in this cohort.…”

Section: Comorbiditymentioning

confidence: 99%

Remission from drug abuse over a 25-year period: patterns of remission and treatment use

Price

Risk²,

Spitznagel³

2001

Am J Public Health

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A B S T R A C TObjectives. Using an epidemiologically obtained sample, we examined patterns of illicit drug use, abuse, and remission over a 25-year period and recent treatment use.Methods. The surviving members of the cohort (n = 841), previously surveyed in 1972 and 1974, comprised 3 subsamples of Vietnam War enlisted men and civilian controls. Retrospectively obtained year-to-year measures from the 1996-1997 survey included use and remission of sedatives, stimulants, marijuana, cocaine, and opiates, as well as substance abuse and psychiatric treatment use.Results. Relatively stable patterns of frequent use in adulthood were found, with the mean duration from initiation to the last remission ranging from 9 to 14 years. A majority attempted to quit; however, most did not use traditional drug treatment in their last attempts. Fewer than 9% of the then-current drug users were treated in inpatient or outpatient settings at the time of data collection.Conclusions. Most drug abusers who had started using drugs by their early 20s appeared to gradually achieve remission. Spontaneous remission was the rule rather than the exception. Nonetheless, considerable unmet needs existed for those who had continued use into middle age. (Am J Public Health.

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Section: Comorbiditymentioning

confidence: 99%

Remission from drug abuse over a 25-year period: patterns of remission and treatment use

Price

Risk²,

Spitznagel³

2001

Am J Public Health

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“…We identified only one such study in our review [57]. Unlike health services research, epidemiological or psychosocial research typically does not prioritize service system planning.…”

Section: Discussionmentioning

confidence: 99%

The role of consumer perspectives in estimating population need for substance use services: a scoping review

Hyshka

Karekezi

Tan

et al. 2017

BMC Health Serv Res

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BackgroundA growing body of research assesses population need for substance use services. However, the extent to which survey research incorporates expert versus consumer perspectives on service need is unknown. We conducted a large, international review to (1) describe extant research on population need for substance use services, and the extent to which it incorporates expert and consumer perspectives on service need, (2) critically assess methodological and measurement approaches used to study consumer-defined need, and (3) examine the potential for existing research that prioritizes consumer perspectives to inform substance use service system planning.MethodsSystematic searches of seven databases identified 1930 peer-reviewed articles addressing population need for substance use services between January 1980 and May 2015. Empirical studies (n = 1887) were categorized according to source(s) of data used to derive population estimates of service need (administrative records, biological samples, qualitative data, and/or quantitative surveys). Quantitative survey studies (n = 1594) were categorized as to whether service need was assessed from an expert and/or consumer perspective; studies employing consumer-defined need measures (n = 217) received further in-depth quantitative coding to describe study designs and measurement strategies.ResultsAlmost all survey studies (96%; n = 1534) used diagnostically-oriented measures derived from an expert perspective to assess service need. Of the small number (14%, n = 217) of survey studies that assessed consumer’s perspectives, most (77%) measured perceived need for generic services (i.e. ‘treatment’), with fewer (42%) examining self-assessed barriers to service use, or informal help-seeking from family and friends (10%). Unstandardized measures were commonly used, and very little research was longitudinal or tested hypotheses. Only one study used a consumer-defined need measure to estimate required service system capacity.ConclusionsRhetorical calls for including consumer perspectives in substance use service system planning are belied by the empirical literature, which is dominated by expert-driven approaches to measuring population need. Studies addressing consumer-defined need for substance use services are conceptually underdeveloped, and exhibit methodological and measurement weaknesses. Further scholarship is needed to integrate multidisciplinary perspectives in this literature, and fully realize the promise of incorporating consumer perspectives into substance use service system planning.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2153-z) contains supplementary material, which is available to authorized users.

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“…The cost estimate of eliminating unmet need could be more precise because it would reflect the characteristics of those who still needed treatment, rather than those who had obtained it. In an earlier effort, McAuliffe et al (1991) lacked this information and therefore had to assume that the mix of needed drug treatment services would be the same as Rhode Island's mix. The authors recognized that the assumption was unlikely to be entirely accurate.…”

Section: Discussionmentioning

confidence: 99%

“…The 2002 National Survey of Drug Use and Health (NSDUH) estimated that only 10.3% of the 22.8 million individuals with a substance use disorder had received treatment at a specialty substance abuse facility in the past year (SAMHSA, 2003a). Other national surveys, as well as studies of the treatment gap in Maryland, New Jersey, Rhode Island, and other states and communities, have also found that large percentages of individuals with substance abuse and dependence diagnoses have not obtained treatment (Johnson, Brems, & Fisher, 1996;Mammo, 1993;McAuliffe, Breer, Ahmadifar, & Spino, 1991;Petronis & Wish, 1996). To provide services to all of the people identified in these surveys as needing treatment, substance abuse treatment services would typically have to increase 5-10 times the current service levels.…”

mentioning

confidence: 99%

“…Following the Epidemiological Catchment Area (ECA) studies of unmet treatment needs (Shapiro et al, 1985), a state-level study of unmet drug treatment needs in Rhode Island by McAuliffe et al (1991) and a Boston-area alcohol study by Hingson, Scotch, Day, and Culbert (1980), the Center for Substance Abuse Treatment of the Substance Abuse and Mental Health Services Administration (SAMHSA) funded the State Treatment Needs Assessment Program (STNAP) via its Division of State and Community Assistance (DSCA) in the early 1990s. STNAP featured telephone household surveys and indicator studies of substance abuse treatment gaps in all 50 states (Mammo, 1993;McAuliffe, Woodworth, Zhang, & Dunn, 2002;Petronis & Wish, 1996;Sherman, Gillespie, & Diaz, 1996).…”

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confidence: 99%

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Unmet need for Substance Abuse Treatment of Adults in Massachusetts

Shepard

Strickler

McAuliffe

et al. 2005

Adm Policy Ment Health

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This article presents a methodology to estimate the size and cost of eliminating unmet need for substance abuse treatment services among adults who have clinically significant substance use disorders, and applies the approach to Massachusetts' information. Unmet treatment needs were derived using a statewide household telephone survey of 7,251 Massachusetts residents aged 19 and older conducted in 1996-1997, and an index of treatment mix and cost information from state and Medicaid financial data. The study estimates that 39,450 adult state residents (0.81% of the total sample) had a clinically significant past-year substance use disorder, but had not received treatment in the past year. Providing substance abuse treatment and outreach services to them would have required an additional cost of approximately 109 million dollars (17 dollars per capita), of which the state's payer of last resort, the Massachusetts Department of Public Health Bureau of Substance Abuse Services (BSAS), would need to fund 31 million dollars (5 dollars per capita). The share paid by BSAS (28%) would represent an increase of 42% over its current spending. This paper quantifies an important but sometimes overlooked objective of managed care: to improve access for substance abusers who need but do not seek treatment.

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Assessment of drug abuser treatment needs in Rhode Island.

Cited by 32 publications

References 26 publications

Remission from drug abuse over a 25-year period: patterns of remission and treatment use

Remission from drug abuse over a 25-year period: patterns of remission and treatment use

The role of consumer perspectives in estimating population need for substance use services: a scoping review

Unmet need for Substance Abuse Treatment of Adults in Massachusetts

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