The NODS-CLiP: a rapid screen for adult pathological and problem gambling.

Objectives: To describe and evaluate tests of the performance of the NODS-CLiP, an efficient standardized diagnostic interview instrument for adult pathological and problem gambling. SETTING AND SAMPLES: Identical batteries of diagnostic questions about gambling behavior, motives, and thoughts were administered to participants in eight general adult population field studies conducted in the United States between 1999 and 2003, including six state-level random-digit-dial (RDD) telephone surveys, one national RDD survey, and one in-person systematic random sample survey of commercial gambling patrons in eight states. Total survey N = 17,180.

Patient satisfaction and sustained outcomes of drug abuse treatment.

The authors investigated the relationship between patients' self-rated satisfaction with treatment services during and shortly after treatment with their drug use outcomes at one year follow-up, using a US national panel survey of patients in 62 methadone, outpatient, short-term residential, and long-term residential programs. A favorable evaluation of treatment near the time of discharge had a significant positive relationship with drug use improvement outcomes approximately one year later, independent of the separately measured effects of treatment duration, counseling intensity, patient adherence to treatment protocols, pre-treatment drug use patterns, and other characteristics of patients and treatment programs.

Do mechanisms that link addiction treatment patients to primary care influence subsequent utilization of emergency and hospital care?

Background: Patients with drug use disorders are heavy users of emergency department (ED) and inpatient hospital care. This study examines whether formal mechanisms to link addiction treatment patients to primary medical care, either directly on site or by off-site referral-when compared with an absence of said mechanisms-might reduce these patients' use of ED and hospital services after substance abuse treatment.

Methods: We used longitudinal data from 6 methadone maintenance programs with 232 patients, 24 outpatient nonmethadone programs with 1202 patients, and 14 long-term residential programs with 679 patients in the National Treatment Improvement Evaluation Study.

Criminal involvement among young male ecstasy users.

Ecstasy (MDMA) use increased rapidly in the U.S. between about 1995 and 2001.

The effect of matching comprehensive services to patients' needs on drug use improvement in addiction treatment.

Aims: To examine whether need-service matching in addiction treatment leads to improvements in drug use, and whether treatment duration mediates those improvements.

Design, Participants, Measurements: This analysis utilizes prospective data from a US cohort of addiction treatment patients who reported service needs beyond core rehabilitative services (n = 3103). 'Drug use improvement' is the difference between the patient's peak drug use frequency (in days per month) in the year before intake and in the year after treatment.

Designated case managers as facilitators of medical and psychosocial service delivery in addiction treatment programs.

This study examines whether having designated case management staff facilitates delivery of comprehensive medical and psychosocial services in substance abuse treatment programs. A multilevel, prospective cohort study of 2829 clients admitted to selected substance abuse treatment programs was used to study clients from long-term residential, outpatient, and methadone treatment modalities. Program directors reported whether the program had staff designated as case managers.

A hierarchy of gambling disorders in the community.

Aims: To help refine the definition and diagnosis of gambling disorders, we investigated the distribution among US gamblers of the 10 DSM-IV criteria for Pathological Gambling.

Design: We drew data from two stratified random surveys (n = 2417, n= 530) of gambling behavior and consequences among community-based samples of US adults. A fully structured questionnaire, administered by trained lay interviewers, screened for the life-time prevalence of problem and Pathological Gambling.

A qualitative investigation of antiretroviral therapy among injection drug users.

Recent advances in antiretroviral therapy for HIV/AIDS have improved the quality of life and life expectancies of many with this fatal disease. Nevertheless, a significant proportion of individuals from disadvantaged groups, which traditionally have had difficulty accessing high-quality health care in the United States, have not benefited from these treatments. For example, injection drug users (IDUs), now a principal source of new cases of AIDS, have received antiretroviral therapy at significantly lower rates than other groups.

Does retention matter? Treatment duration and improvement in drug use.

Aim: This study examines whether there is a minimum threshold, continuous or non-linear relationship between the duration of addiction treatment and improvements in drug use.

Design: Longitudinal cohort study of 62 drug treatment units and 4005 clients in the US National Treatment Improvement Evaluation Study, fielded from 1993 to 1995.

Subjects: Baseline and 1-year follow-up interviews with clients in methadone maintenance, out-patient non-methadone, short-term residential and long-term residential treatment programs.

Effect of primary medical care on addiction and medical severity in substance abuse treatment programs.

Objective: To examine whether the availability of primary medical care on-site at addiction treatment programs or off-site by referral improves patients' addiction severity and medical outcomes, compared to programs that offer no primary care.

Design: Secondary analysis of a prospective cohort study of patients admitted to a purposive national sample of substance abuse treatment programs.

Setting: Substance abuse treatment programs in major U.

HIV risk behaviors in African-American drug injector networks: implications of injection-partner mixing and partnership characteristics.

Aims: We explore the mechanisms by which 'partnership-level' variables--the mix of characteristics of individuals who inject drugs together--affect the incidence of HIV risk behaviors, including receptive syringe sharing, and facilitate or impede the spread of HIV.

Design: We apply multivariate analysis techniques to data on injection partnerships (pairs of individuals who inject drugs together) collected using a network sample of 401 African-American IDUs in Washington, DC.

Findings: Drug injectors tended to select injection partners of the same gender and similar age, but risk behaviors were most common in partnerships between individuals who are dissimilar in both gender and age.

HIV prevention services in correctional drug treatment programs: do they change risk behaviors?

This study evaluated receipt of HIV prevention services in correctional substance abuse treatment programs and examined their impact on short-term risk behaviors. The authors performed a secondary analysis of the National Treatment Improvement Evaluation Study (NTIES), a prospective cohort study conducted during 1993 to 1995. The sample included 1,223 adult non-HIV-positive inmates, enrolled in nine correctional substance abuse treatment programs.