Contrasting outcomes of older versus middle-aged and younger adult chemical dependency patients in a managed care program.

Satre, Derek D.; Mertens, Jennifer R.; Areán, Patricia A.; Weisner, Constance

doi:10.15288/jsa.2003.64.520

Cited by 97 publications

(96 citation statements)

References 31 publications

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“…We did not have sufficient power to examine this question in those aged 50 years or older. In prior studies of this sample we have found that late-middle aged and older individuals (aged 55 and older) in treatment have better outcomes than those younger (ages 18-39) (Satre et al, 2003) in general. Future research should examine whether this is also true of those with SAMCs.…”

Section: Health Stressors and Long-term Outcomementioning

confidence: 61%

The role of medical conditions and primary care services in 5-year substance use outcomes among chemical dependency treatment patients

Mertens¹,

Flisher²,

Satre³

et al. 2008

Drug and Alcohol Dependence

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Introduction-Health problems are prevalent in chemical dependency (CD) treatment populations, and often precede reductions in substance use among untreated populations. Few studies have examined whether medical problems predict better long-term outcomes in treated individuals, or how primary care utilization and CD/primary care service integration affects long-term outcomes among those with health problems Method-In a sample of 598 CD patients in a private health plan, logistic regression models examined whether Substance Abuse-related Medical Conditions (SAMCs), integrated medical and CD care, and on-going primary care predicted remission of CD problems at 5 years.Results-Those with SAMCs were no more likely than others to be remitted at 5 years except among young adults and those with medical, but not psychiatric SAMCs. Higher levels of medical problem severity at intake and receiving integrated CD and primary care in the index treatment episode predicted remission in the full sample and among those with SAMCs. Among those with SAMCs, individuals with ongoing medical care-two to ten primary care visits-in the 5 years following intake were more likely to be remitted at 5 years than those with fewer visits.Conclusions-This study highlights the potentially important role of medical services in the longterm treatment of CD disorders. CD treatment may benefit from a disease management approach similar to that recommended for other chronic medical problems: specialty care when the condition is severe followed by services in primary care when the condition is stabilized.

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Section: Health Stressors and Long-term Outcomementioning

confidence: 61%

The role of medical conditions and primary care services in 5-year substance use outcomes among chemical dependency treatment patients

Mertens¹,

Flisher²,

Satre³

et al. 2008

Drug and Alcohol Dependence

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“…This gender difference in the proportion abstinent at six months did not persist after controlling for greater length of stay in treatment. However, gender differences in the number of heavy drinking days at six-month follow-up were found with women eliminating heavy drinking days completely, as compared to an average of four heavy drinking days in the past month for the men (Satre et al, 2004). In a different study of patients in an alcohol and drug treatment program, abstinence at six months post-treatment predicted abstinence at five years .…”

Section: Substance Abuse Outcomes Versus Predictors Of Outcomesmentioning

confidence: 94%

“…A secondary analysis of data from the prospective U.S. National Treatment Improvement Evaluation Study including 1,123 women and 2,019 men in 59 treatment facilities (Marsh et al, 2004) found that receipt of comprehensive services, including educational, housing, and income support, were related to post-treatment outcomes for both men and women. When gender differences have been found, adult women generally have had better outcomes than men, despite differences in populations targeted, type of treatment, problem drug, and treatment setting (de Leon and Jainchill, 1981;Hser et al, 2005;Fiorentine et al, 1997;Jarvis., 1992;Kosten et al, 1993;Kranzler et al, 1996;McKay et al, 2003;Nurco et al, 1988;Project MATCH, 1997;Rivers et al, 2001;Sanchez-Craig et al, 1991;Satre et al, 2004;Stephens et al, 1994;Timko et al, 2002). For example, while women had more severe family and social problems at treatment entry in a study of cocaine-dependent individuals admitted to an inpatient treatment program , there were no gender differences in family and social problems at follow-up, and women were more likely than men to have remained abstinent at six-month follow-up.…”

Section: Substance Abuse Outcomes Versus Predictors Of Outcomesmentioning

confidence: 99%

“…In a study of patients recruited from drug treatment programs in Los Angeles County (Hser et al, 2003), longer treatment retention was associated with drug abstinence and crime desistence for both men and women at oneyear follow-up. A study of older adult men and women in outpatient alcohol treatment found that greater length of stay in treatment predicted abstinence at six months for both men and women (Satre et al, 2004).…”

Section: Effects Of Treatment Retention and Completion On Substance Amentioning

confidence: 99%

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Substance abuse treatment entry, retention, and outcome in women: A review of the literature

Greenfield

Brooks

Gordon

et al. 2007

Drug and Alcohol Dependence

881

782

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This paper reviews the literature examining characteristics associated with treatment outcome in women with substance use disorders. A search of the English language literature from 1975 to 2005 using Medline and PsycInfo databases found 280 relevant articles. Ninety percent of the studies investigating gender differences in substance abuse treatment outcomes were published since 1990, and of those, over 40% were published since the year 2000. Only 11.8% of these studies were randomized clinical trials. A convergence of evidence suggests that women with substance use disorders are less likely, over the lifetime, to enter treatment compared to their male counterparts. Once in treatment, however, gender is not a significant predictor of treatment retention, completion, or outcome. Gender-specific predictors of outcome do exist, however, and individual characteristics and treatment approaches can differentially affect outcomes by gender. While women-only treatment is not necessarily more effective than mixed-gender treatment, some greater effectiveness has been demonstrated by treatments that address problems more common to substance-abusing women or that are designed for specific subgroups of this population. There is a need to develop and test effective treatments for specific subgroups such as older women with substance use disorders, as well as those with co-occurring substance use and psychiatric disorders such as eating disorders. Future research on effectiveness and cost-effectiveness of gender-specific versus standard treatments, as well as identification of the characteristics of women and men who can benefit from mixed-gender versus single-gender treatments, would advance the field.

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“…For example, among a nationally representative sample of young adults with alcohol-use disorders perceiving a need for alcoholism treatment but not receiving it, 24.9% said they did not feel their problem was serious enough to warrant professional treatment (Grant, 1997). Furthermore, special efforts are likely needed for engaging and retaining young adults in treatment, because those ages 18-25 appear less motivated for and more difficult to retain in treatment when compared with older adults (Satre et al, 2003;Sinha et al, 2003). Although prior work has shown that accumulating more reasons for quitting (McBride et al, 1994) predicts treatment outcomes for both adolescents and adults (Downey et al, 2001;Godley et al, 2001), and qualitative work has explored trends in adolescents' reasons for quitting (Titus et al, 2007), no empirical study to date has focused on the self-endorsed reasons for quitting among emerging adults.…”

Section: What Is Emerging Adulthood?mentioning

confidence: 99%

Reasons for Quitting Among Emerging Adults and Adolescents in Substance-Use-Disorder Treatment

Smith¹,

Cleeland²,

Dennis³

2010

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: Understanding developmental differences in reasons for quitting substance use may assist clinicians in tailoring treatments to different clinical populations. This study investigates whether alcohol-disordered and problem-drinking emerging adults (i.e., ages 18-25 years) have different reasons for quitting than younger adolescents (i.e., ages 13-17 years) Method: Using a large clinical sample of emerging adults and adolescents, we compared endorsement rates for 26 separate reasons for quitting between emerging adults and adolescents who were matched on clinical severity. Then age group was regressed on total, interpersonal, and personal reasons for quitting, and mediation tests were conducted with variables proposed to be developmentally salient to emerging adults. Results: Among both age groups, self-control reasons were the most highly endorsed. Emerging adults had significantly fewer interpersonal reasons for quitting (Cohen's d = 0.20), and this association was partially mediated by days of being in trouble with one's family. There were no differences in personal reasons or total number of reasons for quitting. Conclusions: Our findings are consistent with developmental theory suggesting that emerging adults experience less social control, which here leads to less interpersonal motivation to refrain from alcohol and drug use. As emerging adults in clinical samples may indicate few interpersonal reasons for quitting, one challenge to tailoring treatments for them will be identifying innovative ways of leveraging social supports and altering existing social networks. (J. Stud. Alcohol Drugs, 71, 400-409, 2010)

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Contrasting outcomes of older versus middle-aged and younger adult chemical dependency patients in a managed care program.

Cited by 97 publications

References 31 publications

The role of medical conditions and primary care services in 5-year substance use outcomes among chemical dependency treatment patients

The role of medical conditions and primary care services in 5-year substance use outcomes among chemical dependency treatment patients

Substance abuse treatment entry, retention, and outcome in women: A review of the literature

Reasons for Quitting Among Emerging Adults and Adolescents in Substance-Use-Disorder Treatment

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