Moderators of delay tolerance in treatment-seeking cocaine users

Individual and system influences on waiting time for substance abuse treatment

“…In this study, the wait for services was conceptualized as two phases, the first being a preassessment period that lasted from the time a substance abuser called a CIU to the time one was assessed, and the second being a postassessment period that lasted from assessment to actual treatment entry. The view of waiting as two phases, influenced by different characteristics, expands on previous studies that viewed waiting as either preassessment (Chawdhary et al, 2007) or post-assessment (Friedmann et al, 2003). Elsewhere, only total wait time was used in predicting alcohol and drug outcomes (Best et al, 2002).…”

“…Following assessment at a CIU, women waited longer than men to enter both outpatient and residential treatment services, resulting in lower odds of treatment entry (Downey, Rosengren, & Donovan, 2003). Other studies, however, have not confirmed a relationship between gender and waiting time (Brown, Hickey, Chung, Craig, & Jaffe, 1989;Chawdhary et al, 2007;McCaughrin & Howard, 1996). Similarly, age has been associated with longer waiting times in some studies (McCaughrin & Howard, 1996) but not in others (Brown et al, 1989;Friedmann et al, 2003).…”

“…Substance users who wait for treatment services are less likely to enter treatment and often continue to use drugs, placing them at heightened risk for health complications such as overdose and exposure to infectious diseases such as hepatitis and HIV (Chawdhary et al, 2007;Festinger et al, 1995;Hser et al, 1998;Pollini et al, 2006). As an example, 35% of opiate abusers on a waiting list at the time of clinic intake reported resuming or initiating intravenous drug use by the time they were finally admitted to treatment (Schottenfeld et al, 1993).…”

“…Waiting time has been characterized as the period between clinic intake and actual program admission (Schottenfeld, O'Malley, Abdul-Salaam, & O'Connor, 1993), as the time between brief and full assessment, and as the period between full assessment and treatment initiation (Best et al, 2002). More recent conceptualizations of waiting time have included the time substance abusers must wait to initially present for treatment services once they or others recognize a problem (Chawdhary et al, 2007;Rotstein & Alter, 2006).…”

Access to Substance Use Disorder Treatment Services in Canada

“…Treatment initiation is an incredibly sensitive time for individuals, as motivation to follow through is continuously shifting. Numerous studies cite the marked attrition rate of treatment initiation for individuals who are first placed on wait lists [31][32][33]. Pharmacologically, provinces such as British Columbia have made naloxone widely available through the Take Home Naloxone Program, which has surely prevented instances of mortality [34].…”