Assessing Adolescent Substance Abuse Programs with Updated Quality Indicators: The Development of a Consumer Guide for Adolescent Treatment.

When adolescent substance abuse requires treatment, few parents know which treatment features are important and which treatment programs are effective. There are few resources to help them select appropriate care. We describe early work on an evaluation method and comparative treatment guide for parents based upon the premise that the quality of a program and its potential effectiveness is a function of the number and frequency of evidence-based treatment practices (EBPs) delivered.

National Trends in Adolescent Substance Use Disorders and Treatment Availability: 2003-2010.

This study examines trends in adolescent substance use disorders (SUDs) and treatment utilization in the US using data from the National Household Survey on Drug Use and Health (NSDUH) and data from the National Survey of Substance Abuse Treatment Services (N-SSATS). Results indicate an overall decrease in the percent of adolescents meeting past year criteria for an alcohol or illicit drug disorder between 2003 and 2010, but the percent of adolescents meeting criteria who had not received any treatment in the past year was substantial and has remained stable since 2003. In 2010, less than 30% of facilities participating in the N-SSATS survey indicated that they offered special programming for adolescents, reflecting an overall decrease since 2003.

Effect of patient choice in an adaptive sequential randomization trial of treatment for alcohol and cocaine dependence.

Objective: To evaluate the effect of providing choice of treatment alternatives to patients who fail to engage in or drop out of intensive outpatient programs (IOPs) for substance dependence.

Method: Alcohol- and/or cocaine-dependent patients (N = 500) participated in a sequential, multiple-assignment, randomized trial (SMART). Those who failed to engage in an IOP at Week 2 (N = 189) or who dropped out after engagement (N = 84) were randomized for motivational-interviewing (MI) telephone calls that focused on engagement in an IOP (MI-IOP) or provided a choice of IOP type or 3 treatment options (MI-PC, or patient choice).

A critical component of the continuum of care for substance use disorders: recovery homes in Philadelphia.

For many struggling with addiction, the ability to achieve stable recovery is often jeopardized by untenable housing or unsupportive living environments. Despite promising research on recovery residences, there are still significant gaps in the research on them. Using data collected from a stratified random sample of recovery homes in Philadelphia (N = 25), this study describes the organizational, operational, and programmatic characteristics of these homes and explores potential differences in these characteristics by funding source and gender of residents served.

Using Web searches to track interest in synthetic cannabinoids (a/k/a 'herbal incense').

Introduction And Aims: This article reports a content analysis of Internet websites related to an emerging designer drug, synthetic cannabinoids. The number of synthetic cannabinoids searchers in the USA has steadily increased from November 2008 to November 2011.

Design And Methods: To determine the information available on the Internet in relation to synthetic cannabinoids, sites were identified using the Google search engine and the search term 'herbal incense'.

Providing alcohol for underage youth: what messages should we be sending parents?

Objective: There have been conflicting findings in the literature concerning the risks to adolescents when parents provide them with alcohol. Studies have examined various ways in which parents directly affect adolescent alcohol consumption through provision (e.g.

Addiction Severity Index (ASI) summary scores: comparison of the Recent Status Scores of the ASI-6 and the Composite Scores of the ASI-5.

The characteristics and the validity of the Recent Status Scores (RSSs), the new summary scores generated by the sixth version of the Addiction Severity Index (ASI-6), are compared to the fifth version of the ASI summary scores, the Composite Scores (CSs). A sample of 82 randomly selected patients from substance abuse treatment programs were interviewed with the ASI-6, the ASI-5 and were administered a validity battery of questionnaires that included measures corresponding to each of the ASI domains. Each ASI-6 RSS was significantly correlated with its corresponding ASI-5 CS.

Development and initial evaluation of the Brief Addiction Monitor (BAM).

This project developed and tested a 17-item monitoring instrument covering important substance use related behaviors to support measurement-based care and outcomes assessment. The study consisted of two phases, an instrument development phase and an initial study to examine its psychometric properties. Participants were 175 patients entering VA outpatient substance abuse treatment.

Comparison of two ASI-based standardized patient placement approaches.

This study evaluated the predictive validity of two automated approaches based on the Addiction Severity Index (ASI) to patient placement criteria. Patients (N = 2,429) in 78 substance abuse treatment programs completed an ASI at intake and were assigned a treatment modality based on availability and clinical considerations. Treatment completion and self-reported abstinence 6 months post-discharge were collected.

Psychometric properties of the sixth version of the Addiction Severity Index (ASI-6) in Brazil.

Background: There are few research tools in Brazil to assess more broadly the alcohol and other drug related problems.

Objective: To test the psychometric properties of ASI in its sixth version (ASI-6).

Methods: A multicenter cross-sectional study was conducted in four Brazilian state capitals.

The effect of telephonic patient support on treatment for opioid dependence: outcomes at one year follow-up.

Objective: The present study examined the impact of a telephonic patient support program known as HereToHelp™ (HTH) on compliance and treatment outcomes among opioid dependent (OD) patients new to buprenorphine treatment (BUP).

Method: A total of 1426 OD patients new to BUP were randomized to receive BUP alone (standard care) or BUP plus the HTH patient support program. All patients completed the Addiction Severity Index (ASI) at the time of enrollment, and at 12months post-enrollment.

Compliance with buprenorphine medication-assisted treatment and relapse to opioid use.

Opioid dependence (OD), often characterized as a chronic relapsing disorder, affects millions of people worldwide. The purpose of this study was to examine the effect of compliance with buprenorphine on reducing relapse among a sample of patients in treatment for OD. Patients new to buprenorphine (N = 703) completed the Addiction Severity Index (ASI) at baseline, and at 1, 2, and 3 months postbaseline.

Recent status scores for version 6 of the Addiction Severity Index (ASI-6).

Aims: To describe the derivation of recent status scores (RSSs) for version 6 of the Addiction Severity Index (ASI-6).

Design: 118 ASI-6 recent status items were subjected to nonparametric item response theory (NIRT) analyses followed by confirmatory factor analysis (CFA). Generalizability and concurrent validity of the derived scores were determined.

Relationship of Mental Health and Illness in Substance Abuse Patients.

This study examined the latent structure of a number of measures of mental health (MH) and mental illness (MI) in substance use disorder outpatients to determine whether they represent two independent dimensions, as Keyes (2005) found in a community sample. Seven aspects of MI assessed were assessed - optimism, personal meaning, spirituality/religiosity, social support, positive mood, hope, and vitality. MI was assessed with two measures of negative psychological moods/states, a measure of antisociality, and the Addiction Severity Index's recent psychiatric and family-social problem scores.

A national study of a telephone support service for patients receiving office-based buprenorphine medication-assisted treatment: study feasibility and sample description.

Opioid-dependent (OD) patients seeking treatment have multiple treatment options including abstinence-based and medication replacement therapies. A recent and growing addition to medication replacement therapy is buprenorphine medication-assisted treatment (B-MAT), which may be provided by certified physicians practicing in private offices. Research on OD treatment is often performed on samples of patients recruited from specialty treatment facilities, which may not generalize to B-MAT patients.

Measurement of mental health in substance use disorder outpatients.

Few studies have examined mental health (MH) attributes of patients with substance use disorder (SUD). This study examines the internal consistency, concurrent validity, and comparative level of MH attributes (i.e.

Reliability and validity of the alcohol short index of problems and a newly constructed drug short index of problems.

Objective: This study evaluated the psychometric properties of the 15-item alcohol Short Index of Problems (SIP) instrument and those of a newly constructed 15-item drug Short Index of Problems (SIP-D) instrument in 277 newly entered substance-abuse patients.

Method: The SIP is derived from the longer, 50-item Drinker Inventory of Consequences (DrInC), which was designed to assess adverse consequences of alcohol use. The SIP-D was constructed by substituting the term "drug use" for the term "drinking" in each SIP item.

Treatment history: relationship to treatment outcomes.

It is important to understand whether the number of prior treatment episodes relate to treatment completion, discharge status, and 6-month outcomes. The data set contains information on 2,429 clients in treatment. A modified Addiction Severity Index was administered at the time of admission and at 6-months postdischarge.

Posttraumatic stress disorder and other psychopathology in substance abusing patients.

Studies demonstrating greater problem severity in substance abuse patients with posttraumatic stress disorder (PTSD) versus those without have rarely considered other co-occurring psychiatric disorders. This study of 466 male veterans recently admitted to outpatient substance abuse treatment attempts to identify problems associated with PTSD versus those associated with other nonsubstance use Axis I disorders. Problem severity, particularly psychiatric, was examined across four groups of patients with substance use disorders (SUDs).

Extending residential care through telephone counseling: initial results from the Betty Ford Center Focused Continuing Care protocol.

There is increasing evidence that a chronic care model may be effective when treating substance use disorders. In 1996, the Betty Ford Center (BFC) began implementing a telephone-based continuing care intervention now called Focused Continuing Care (FCC) to assist and support patients in their transition from residential treatment to longer-term recovery in the "real world". This article reports on patient utilization and outcomes of FCC.

Individual characteristics of the literally homeless, marginally housed, and impoverished in a US substance abuse treatment-seeking sample.

Background: Many researchers and clinicians believe that understanding substance use problems is key to understanding homelessness. This study's purpose was to test, in a national sample of urban substance abuse treatment seekers, whether (1) income was related to amount of money spent on substances and (2) homeless chronic substance users had more severe psychosocial problems or histories than housed chronic substance users.

Method: Questions assessing homelessness were inserted into the Drug Evaluation Network System-a computer-assisted intake interview (including the Addiction Severity Index) implemented in addiction treatment programs across the U.

Initial reliability and validity studies of the revised Treatment Services Review (TSR-6).

Objective: Report the results of initial reliability and validity analyses for a revised Treatment Services Review (TSR-6) instrument which measures a broader range of services than the original TSR.

Method: First, the number of services for a 28-day period was compared for three versions of the instrument varying in their reporting timeframes. Accordingly, four successive 7-day TSR-6s, two 14-day TSR-6s, or one 28-day TSR-6 were administered to more than 300 clients (30% women) in substance abuse treatment (SAT).

Addiction Severity Index Recent and Lifetime summary indexes based on nonparametric item response theory methods.

Baseline Addiction Severity Index (5th ed.; ASI-5) data of 2,142 substance abuse patients were analyzed with two nonparametric item response theory (NIRT) methods: Mokken scaling and conditional covariance techniques. Nine reliable and dimensionally homogeneous Recent Problem indexes emerged in the ASI-5's seven areas, including two each in the Employment/Support and Family/Social Relationships areas.

Initial evidence for the reliability and validity of a "Lite" version of the Addiction Severity Index.

Purpose: To evaluate the psychometric properties of a shortened version of the baseline ASI-5, the ASI-L-VA.

Method: Two samples were recruited from intensive outpatient treatment and a methadone maintenance clinic. For Sample A (n=145), two versions of the Addiction Severity Index (i.

Predicting DSM-IV dependence diagnoses from Addiction Severity Index composite scores.

This study, using data from the Drug Evaluation Network System and a study conducted through the Center for Studies on Addiction of the University of Pennsylvania/Philadelphia Veterans Administration Medical Center, sought to determine the potential of the Addiction Severity Index (ASI) to serve as a screening instrument for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) substance dependence. A significant positive correlation was found between ASI composite scores (CSs) and DSM-IV diagnoses of dependence in both the alcohol (r > .7) and drug (r > .