Listed by Topics
Drug Abuse and Psychological Disorders
Trends in Treatment Program Services
Services needed and provided to clients admitted
to treatment in DATOS during 1991-1993 were examined and also compared
to those of clients admitted to treatment in TOPS during 1979-1981 (Etheridge,
Craddock, Dunteman, & Hubbard, 1995). The study focused on seven
major categories of services medical, psychological, family, legal,
educational, vocational, and financial.
- Roughly half of all clients admitted to
OMT, LTR, and ODF programs in DATOS and TOPS needed each type of service
surveyed after 3 months in treatment, with rates usually varying between
25% to 75% depending on type of service and modality.
- Overall, client needs for services in
DATOS were greater than for clients admitted to TOPS 10 years earlier.
was a remarkable increase, however, in unmet needs among DATOS clients
(compared to TOPS). These are illustrated in two of the major types
of services needed by this population that is, medical and psychological
services. In TOPS, unmet needs for medical services in the three modalities
were 6-18%, and for psychological services, 7-20%; in contrast, the
rate of unmet needs for these services in DATOS rose to 25-40% and 54-57%,
respectively. (See Client
Needs for Medical Services; Client
Needs for Psychological Services)
- Consistent with this trend was the finding
that clients receiving services from two or more of these categories
in DATOS was only 5% of OMT (down from 20% in TOPS), 50% of LTR (down
from 77% in TOPS), and 15% of ODF (down from 60% in TOPS). (See Changes
in Treatment Services)
of program structure and treatment services in DATOS were examined
further and compared with similar data from the TOPS studies (Etheridge,
Hubbard, Anderson, Craddock, & Flynn, 1997).
- Primary treatment components for both
DATOS and TOPS included treatment planning with client involvement,
individual counseling with an emphasis on abstinence from drug misuse,
group therapy, relapse prevention, urine monitoring, and supportive
- These "core" drug counseling
services improved, generally to highly positive levels, in all three
modalities (OMT, LTR, and ODF) during the past 10 years. (See Changes
in Core Services: for OMT,
for LTR, for ODF)
there have been major erosions in the comprehensive (sometimes called
"wrap-around") services provided in conjunction with basic
drug abuse treatment. This especially includes medical, psychological,
family, and educational services designed to restore fundamental elements
of the recovery process. (See Changes in Comprehensive Services: for
OMT, for LTR,
- Declines have been the smallest in OMT
settings, in part because this modality has historically been widely
lacking in the availability of these supportive services; only 1 in
4 DATOS clients received medical services, and 1 in 10 received psychological,
family, or educational services in the first 3 months of treatment.
- Low rates of delivery for these comprehensive
services were virtually the same among ODF clients, and they only doubled
among residential clients in LTR programs; in both of these modalities,
there were major declines from comparable records for treatment services
in TOPS approximately 10 years earlier.
Etheridge, R. M.,
Craddock, S. G., Dunteman, G. H., & Hubbard, R. L. (1995). Treatment
services in two national studies of community-based drug abuse treatment
programs. Journal of Substance Abuse, 7(1), 9-26.
Etheridge, R. M.,
Hubbard, R. L., Anderson, J., Craddock, S. G., & Flynn, P. M. (1997).
Treatment structure and program services in the Drug Abuse Treatment
Outcome Study (DATOS). Psychology of Addictive Behaviors, 11(4),
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Abuse and Psychological Disorders
Evidence suggests that psychological disorders
frequently co-occur with drug abuse problems. Clinical assessment instruments
were included in Intake 2 of DATOS (n=8,755) in order to examine the prevalence
of these diagnoses in a national sample of drug abuse treatment admissions
Craddock, Luckey, Hubbard, & Dunteman, 1996). Special attention
was given to antisocial personality disorder, depression, and general
- Overall, approximately 40% of substance
dependent clients in DATOS were diagnosed with antisocial personality
- Men were twice as likely as women to have
- Approximately 14% of substance dependent
clients in DATOS met DSM diagnostic criteria for an Axis I lifetime
depressive or anxiety disorder.
- Women were twice as likely as men to have
experienced major depression.
- Clients with co-dependencies on three
substances had the highest rates of antisocial personalities and a lifetime
diagnosis of generalized anxiety disorder.
Flynn, P. M., Craddock,
S. G., Luckey, J. W., Hubbard, R. L., & Dunteman, G. H. (1996).
Comorbidity of antisocial personality and mood disorders among psychoactive
substance-dependent treatment clients. Journal of Personality Disorders,
10(1), 56-67. [Abstract]
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