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The past decade has seen a marked increase in the illicit use of opioids, as well as a doubling of the percentage of individuals seeking treatment for opioid use disorders. However, little is known about the differences between opioid users and nonopioid users in residential treatment. Further, no studies have been published that compare opioid users and nonopioid users in treatment for co-occurring substance use and mental disorders. To address this gap, this study examined differences between opioid and nonopioid substance users in residential treatment for co-occurring disorders. Data was drawn from 1,972 individuals treated between 2009 and 2011 at one of three private residential treatment centers that provide integrated treatment for co-occurring substance use and mental disorders. Data was collected at program intake, and 1- and 6-month postdischarge using the Addiction Severity Index and the University of Rhode Island Change Assessment. To examine within-group changes in substance use, addiction severity, and mental health across time, linear mixed-model analyses were conducted with facility, year, age, gender, and race included as covariates. The authors found more similarities than differences between the two groups on baseline characteristics, treatment motivation, length of stay, and outcomes on measures of substance use, addiction severity, and mental health. The results demonstrate that though opioid users entered treatment with higher levels of substance use–related impairment, they were just as successful in treatment outcomes as their non-opioid-using peers. [ABSTRACT FROM PUBLISHER]

Like many areas of the country, the state of Tennessee is experiencing a recent and growing rise in the rate of methamphetamine use, particularly in rural areas of the state. While substance use is a known risk factor for contracting HIV/AIDS, there is limited information regarding the risk behaviors of rural methamphetamine users. This paper seeks to document the existence of known HIV risk behaviors as they relate to rural southern methamphetamine use. Qualitative interviews with ninety-seven current and former methamphetamine users from the Cumberland Plateau area, a rural mountainous region in the state of Tennessee, suggest that methamphetamine users are putting themselves at risk for contracting HIV/AIDS and other blood-borne diseases through high-risk injection and sexual behaviors. Additionally, the results present the perceptions of respondents regarding the impact of methamphetamine use on rural communities and related service needs. [ABSTRACT FROM AUTHOR]

Drug courts have been recognized and empirically supported as an effective means of reducing recidivism and use of substances for both juveniles and adults. The paper reports the results of an outcome evaluation of a juvenile drug court in the Upper Cumberland area of Middle Tennessee. As with previous studies, the program showed impressive outcomes for many juveniles. Improvements, however, may be possible. Adding a residential component similar to the one for adults currently operated by the Davidson County Drug Court might enhance program retention, provide housing opportunities during treatment for neglected and abused youth, and offer opportunities for more regular and intensive supervision of specific juveniles. Such programs would likely be both practical and fundable, and should be considered by courts and treatment providers. [ABSTRACT FROM AUTHOR]

African American women involved in high-risk, substance use-related behaviors are affected by extremely high rates of HIV infection. While research has demonstrated that HIV is preventable, in order for prevention efforts to be successful in reducing disparities, perceptions of African American women who use crack cocaine need to be taken into account. This qualitative study presents results of eleven focus groups with eighty-nine African American women respondents presenting their perceptions of service needs and preferences for service delivery. The results indicate two important findings for social service providers: the respondents' lack of a perceived need for HIV prevention services as a spontaneously identified need, and respondents' desires for more basic services such as childcare, safe shelter, basic necessities, and especially substance abuse treatment before they could be approached about HIV prevention services. The findings are relevant for developing gender- and culture-specific prevention strategies to reduce the spread of HIV. [ABSTRACT FROM AUTHOR]

Substance abuse can have such a destructive impact on a family that it can both interrupt and transform the entire family's life. The impact of chronic illness on the family has been researched primarily from a stress-coping paradigm. Within the mental health literature, the impact of one family member's mental illness on other family members has begun to be investigated in a systema-tic and scientific manner. Within a stress-coping paradigm, the results of this empirical research have borne out the tremendous objective and subjective burdens placed on family caregivers (Biegel, Song, and Chakravarthy, 1994; Lefley, 1996). This article suggests that the impact of substance abuse on families may also be conceptualized within this paradigm and posits an evidence-based stress-coping model for conceptualizing this process. [ABSTRACT FROM AUTHOR]

The article focuses on spiritual mechanisms underlying substance abuse behavior change in faith-based substance abuse treatment. Several definitions of faith-based organizations are being discussed. An integrative conceptual framework articulating connections between spiritual intervention components, behavior change processes and substance abuse outcomes is presented. Faith-based substance abuse treatment programs concerns the distinction between religion and spirituality. The article states that the ecological perspective and the model of social work practice provide for the incorporation of the element of personal spirituality, and therefore spiritual change, in viewing any individual presenting for services. A number of human and social service organizations have been addressed by faith-based programs. It has been found that religious or spiritual involvement may serve as a protective factor against the development of substance abuse problems. During substance abuse treatment some spiritual changes occur and substance abuse interventions may be effective for those for whom religion or spirituality is salient.

This study explores the impact of managed care on the substance abuse service system by reviewing the current status of the programs that were among the elite service providers in 1988. A survey was conducted assessing the status of the one hundred centers touted as "the 100 best treatment centers for alcoholism and drug abuse" (Sunshine & Wright, 1988). Findings include the following: Almost a third of these centers (31 %) are no longer providing services, the majority of the programs who reported data continue to provide services primarily at a residential level of care (92%); however occupancy rates haye dropped, the number of annual inpatient admissions have risen, and the length of treatment episodes has significantly decreased. In 1988, almost all (97.5%) facilities adhered to the 28-day treatment regiment, as evidenced by average treatment episodes of 26 days or longer. However, in 2001, the majority of programs (57.5%) reported treatment episodes of 25 days or less. While these facilities represent a fraction of the number of facilities that provide substance abuse services, they do exemplify elite programs that should be insulated from economic troubles, and help to document the changes that have occurred in the delivery system. Awareness of these changes is important for every social worker that advocates for substance abuse services. [ABSTRACT FROM AUTHOR]

Significant health disparities in the rates of HJV infection exist that primarily impact African American women. While research has demonstrated that HIV is preventable through changes in high-risk behaviors facilitated by substance abuse treatment, an individual must first be able to access and engage with treatment to derive any benefit from these services. While there is some research that identifies barriers to treatment access and engagement for African American women who use crack cocaine, these barriers require further examination. Current lit erature has focused primarily on internal motivation and treatment readiness without placing these concepts within the unique environmental context of social stressors for crack cocaine-using African American women. This study presents the results of eleven focus groups with eighty-nine African American women in which respondents document the HIV risk behaviors of crack cocaine users, present their experiences [ABSTRACT FROM AUTHOR]

The article presents an analysis of literature on substance abuse among U.S. Latinos. High fertility and high immigration rates have made Latinos the largest minority in the U.S. Therefore, alcohol and illicit drug use within this population give reason for concern. Beginning in early adolescence, Latinos and native Americans lead the nation in alcohol and illicit drug use. They also have a high need for alcohol and illicit drug treatment compared to Whites and African-Americans. Even though family and peers have been shown to play an important role in the etiology of substance abuse across ethnic groups, research indicates that important differences exist within ethnic groups on these and other factors. In the article, research concerning ethnic differences has been reviewed in order to gain an understanding of the patterns and trajectories of substance use within the Latino community. Prevention and treatment interventions specific to Latinos have been described, and gaps in the literature are noted. Finally, implications of the current research findings for social workers and recommendations for future research have been discussed.

The purpose of this article is to present the Harm Reduction Model and its potential as a framework from which to provide prevention services for adolescents. While it may be uncomfortable for service providers to acknowledge, the vast majority of adolescents in the United States will have used mood-altering substances sometime during their teen years. While non-abstinence-based prevention services have existed for some time, they are not without controversy. This article proposes Harm Reduction as a complimentary or alternative perspective for work with adolescents for whom abstinence may not be immediately possible and/or may not be a realistic outcome for services. This article outlines the abstinence-oriented and Harm Reduction perspectives, as well as the Stages of Change model; utilizing empirical support, it then discusses how these perspectives can work together in social work practice in the adolescent substance abuse prevention arena. [ABSTRACT FROM PUBLISHER]

A structured diagnostic interview (Practical Adolescent Diagnostic interview) designed to gather basic information about substance use disorders, other mental health conditions, and related experiences was used in a variety of clinical settings. Anonymous data from 279 adolescents interviewed as part of routine clinical assessments in a variety of clinical programs were analyzed to assess the ability of the questions to identify potential problem areas and to provide a preliminary exploration of interrelationships between those problems. Results demonstrated that the vast majority of individuals manifested indications of multiple problems. For a given diagnostic condition, the trend is for those meeting at least the minimal DSM-IV criteria to exhibit substantially more than the minimum number of symptoms. Internal consistencies for item groups defining the various conditions range from more than .700 to over .900 indicating adequate to excellent internal consistency and reliability. Utility of the instrument for routine clinical use is also discussed. [ABSTRACT FROM AUTHOR]

It is estimated that approximately half of all new HIV infections are related to injection drug use (Holmberg, 1996), as used syringes can harbor blood with traces of viable HIV for over 4 weeks (Abdala, Stephens, Griffith, & Heimer, 1999). Due to this concern, Syringe Exchange Programs (SEPs) and other related HIV prevention programs for active injection drug users have been developed and expanded in many urban areas of the United States over the past 15 years. Based on the Harm Reduction model of service provision, SEPs seek to reduce the harm associated with injection drug use through the elimination of the primary means by which HIV risk is spread, the shared syringe. Despite extensive research supporting the efficacy of SEPs, significant barriers exist to the delivery of these services, as SEPs are often viewed as being outside the traditional continuum of care for HIV/AIDS and/or substance abuse. All social workers involved in HIV/AIDS services should be aware of these programs and continued expansion and integration with other HIV/AIDS services should be a priority. [ABSTRACT FROM PUBLISHER]