Organizational Capacity to Address Co-Occurring Substance Use and Psychiatric Disorders: Assessing Variation by Level of Care.

Organizational Capacity to Address Co-occurring Substance Use and Psychiatric Disorders: Assessing Variation by Level of Care.

Filed under: Addiction Rehab

J Addict Med. 2012 Nov 22;
Lambert-Harris C, Saunders EC, McGovern MP, Xie H

OBJECTIVES:: There is widespread recognition that services to persons with co-occurring substance use and psychiatric disorders should be accessible, yet most persons with these disorders do not receive care for both problems. Estimates of available services vary widely and have not examined potential variation by level of care. METHODS:: The present study samples 180 community addiction treatment programs and utilizes a standardized observational assessment of these programs using the dual diagnosis capability of addiction treatment (DDCAT) index. By level of care, the sample consisted of 53 outpatient programs, 50 intensive outpatient programs, and 77 residential programs. RESULTS:: Overall, approximately 81.1% of programs across levels of care offered addiction-only services, 18.3% dual diagnosis capable services, and less than 1% dual diagnosis enhanced services. Relative to residential and intensive outpatient programs, outpatient programs were more likely to have greater dual diagnosis capability (dual diagnosis capable services). Outpatient programs scored significantly higher on the DDCAT dimensions associated with program policies and continuity of care. Specific DDCAT benchmark items revealing detailed differences were found in these dimensions and specific assessment and treatment practices. Access to physician-prescriber or to psychotropic medications did not differ by level of care. CONCLUSIONS:: The findings suggest that across levels of care, addiction-treatment systems and programs must continue to improve capacity for patients with co-occurring disorders. The application of a standardized, objective, and observational instrument may be useful to guide and measure the effectiveness of these efforts.
HubMed – addiction

 

Mind the Gap! Failure in Understanding Key Dimensions of a Drug User’s Life.

Filed under: Addiction Rehab

Subst Use Misuse. 2012 Nov; 47(13-14): 1651-7
Hellman M

This article discusses the failure to succeed in the treatment of the heterogeneous population of substance users, in terms of too little, or a total absence of, necessary available knowledge from an ethnographic perspective of the user’s mental geographies. I suggest three dimensions that are critical to be knowledgeable about at the beginning planning stages of any intervention and on any level of policy, namely, insights into time, space, and bodily perceptions of drug users. In these scopes, barriers are drawn and upheld between caregiver and intervention planners, on the one hand, and the client, on the other. In cases when treatment has proven successful, however success is defined, the gap between the addict’s mental geography and the surrounding world has been overcome to some degree. Previous research in the area of substance users’ perspective of time, space, and body, and estimates of its value for success in and posttreatment, support, and care of people with severe drug-use-related problems, are discussed.
HubMed – addiction

 

Michael G. Farnworth on Brian Ferguson’s “Is Addiction a Failure of Rationality?”.

Filed under: Addiction Rehab

Subst Use Misuse. 2012 Nov; 47(13-14): 1648-50
Farnworth MG

HubMed – addiction

 


 

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