Integration of Patient-reported Outcomes Assessment Into Routine Care for Patients Receiving Residential Treatment for Alcohol and/or Substance Use Disorder.

Background: More than 3 million individuals receive treatment for alcohol use disorder (AUD) and/or substance use disorder each year, yet there exists no standardized method for measuring patient success in treatment. Quantifying a more comprehensive assessment of treatment outcomes could identify the relative efficacy of different treatment strategies for individuals with AUD/substance use disorders, and help patients to identify, in advance, appropriate treatment options.

Methods: This study developed and embedded patient-reported outcome measures into the routine clinical operations of a residential treatment program.

An evaluation of intravenous ethanol in hospitalized patients.

Alcohol withdrawal is a serious complication of heavy alcohol use and a condition requiring patient stabilization before initiating surgery or implementing lifesaving procedures for injury. Intravenous ethanol (IVE) is used to prevent withdrawal during these maneuvers. This report explores the use and potential problems of this practice in an academic urban medical center.

A substance abuse consultation service. Enhancing the care of hospitalized substance abusers and providing training in addiction psychiatry.

The authors review the literature on the high prevalence but underrecognition of substance abuse among hospitalized patients and the general unavailability of hospital-based substance abuse consultation services. They describe the development, clinical operations, staffing, and teaching activities of a large substance abuse consultation service in one urban academic medical center and detail the service's growth and changing utilization patterns over an 8-year period, reporting the clinical characteristics of 1,819 patients seen over a 1-year period. Differences in patient demographics, patterns of substance use, and diagnoses were highly significant from one referring service to another.

Outcome of trauma patients after brief intervention by a substance abuse consultation service.

The Substance Abuse Consultation Service (SACS) at the University of Maryland Medical System (UMMS) conducts assessments and brief interventions for patients at the University Hospital and the Shock Trauma Center of the UMMS. This project examined a 10-week sample of trauma patients (N = 30) seen by the SACS, for whom consultations and recommendations (including participation in formal treatment programs as well as 12-step meetings) were provided. The authors used medical record reviews for background information and telephone interviews for follow-up.

Psychiatric consultation with substance abusers in early recovery.

The frequent co-occurrence of mental and substance use disorders ("dual diagnosis") has created a role for addiction-trained psychiatric consultants in drug and alcohol treatment programs. The complex treatment needs of the dually diagnosed required that the consultant psychiatrist have knowledge about the existing treatment models of chemical dependency, the recovery process, and the complex relationship between substance abuse and psychopathology. This paper reviews the existing clinical models for understanding and treating chemical dependency and then proposes an approach to consultation practice that employs a developmentally-based clinical model.