Special Populations and Topics Projects


Problem Gambling Prevention – Technical Assistance and Training Needs Assessment

Mary-Lynn Brecht, Ph.D., Principal Investigator
(lbrecht@ucla.edu)
Elizabeth Evans, M.A., Project Director

This needs assessment was designed to gather information to guide the specialization, modification, and expansion of technical assistance and training curricula and materials and other resources about problem gambling. It is part of a larger problem-gambling prevention project that provides technical assistance to meet the needs of a diverse target audience of service providers and community leaders to assist them in preventing problem gambling in their clients and communities. More specifically, the needs assessment addresses the following topics among service providers and community leaders: perception of participants of whether there are gambling problems among clients and in the community; level of awareness of existing resources on problem gambling; current use of existing resources on problem gambling; perceived utility of specific types of technical assistance and training resources directed at service providers as well as those directed at clients; and ways to increase utility of such resources. In order to describe the community context within which these service providers’ needs exist, the needs assessment also obtains relevant parallel information directly from clients and community members. The project uses multiple methods of data collection: phone surveys, in-person, semi-structured interviews, and focus groups. The sample size will be approximately 400 providers and 100 clients.

Problem Gambling Prevention – Technical Assistance and Training Needs Assessment was funded by the National Asian Pacific American Families Against Substance Abuse, through their contract with the California Office of Problem Gambling (05-00238; March 2006 through October 2006).

Top of Page


Women, Methamphetamine, and Sex

Alison Hamilton Brown, Ph.D., Principal Investigator (alisonh@ucla.edu)

This 5-year project focuses on the relationship between methamphetamine (MA) and sex among women MA users. Two waves of in-depth qualitative interviews will be conducted with 30 women in residential treatment. Participants will be asked about their history of using MA and other substances, their life experiences (including any trauma or abuse they may have experienced), and their perspectives on how MA has affected their lives, specifically, their intimate relationships and sexual behaviors. As a career development award, the project also involves training for the principal investigator (PI) in public health and statistics, and subsequent secondary analysis of the “Methamphetamine Abuse: Natural History and Treatment Effects” study dataset (PI: Mary-Lynn Brecht). This analysis, along with analysis of the qualitative data, will add to the body of literature on the impact of substance abuse on life experiences. Considering that women who abuse substances such as MA typically have multiple factors placing them at risk for poor sexual decision-making (e.g., histories of violence and abuse), a more in-depth understanding of how women MA users conceptualize their sexual behaviors and experiences could assist in developing interventions for them. The PI’s co-mentors on the project are Drs. Richard Rawson (UCLA ISAP), Yih-Ing Hser (UCLA ISAP), and Vivian Brown (PROTOTYPES).

Women, Methamphetamine and Sex was funded by the National Institute on Drug Abuse, Grant 1 K01 DA017647 (April 2006 through March 2011).

Top of Page


Linking Substance Abuse Treatment and Child Welfare Outcomes:
Secondary Analyses of Data from
Two Service Delivery Systems

Christine E. Grella, Ph.D., Principal Investigator
(grella@ucla.edu)

This study is conducting secondary analyses of data linked from two existing databases: the California Treatment Outcome Project (CalTOP), which contains information on participants in a statewide substance abuse treatment outcome monitoring project; and the Child Welfare Services/Case Management System, which is the statewide data system containing information on all child welfare events in California. Bivariate analyses and multivariate logistic regression were conducted comparing mothers in CalTOP who were (N = 1,939) and were not (N = 2,217) involved with child welfare (Grella, Hser, & Huang, 2006). Mothers who were involved with child welfare were younger (31.6 vs. 34.4), had more children (2.9 vs. 2.1), and had more employment problems (as measured by ASI severity scores). They were more likely than others to be referred to treatment by the criminal justice system (OR = 1.31, P < .01), to have a history of physical abuse (OR = 1.39, P < .0001), and to be treated in outpatient programs (OR = 1.55, P < .0001). They had lower levels of alcohol severity, but did not differ in regard to psychiatric severity or criminal involvement. Primary users of methamphetamine were disproportionately represented among the child-welfare involved group (47% vs. 37%). We are currently conducting longitudinal analyses of child welfare outcomes using pretreatment characteristics, treatment services received, and status at a 9-month follow-up as predictors. Study findings will have application to policies that aim to improve the outcomes of child-welfare involved mothers in substance abuse treatment.

Linking Substance Abuse Treatment and Child Welfare Outcomes: Secondary Analyses of Data from Two Service Delivery Systems was funded by the Robert Wood Johnson Foundation, Grant 52673 (April 2005 through December 2006).

Top of Page


Children Exposed to
Methamphetamine Use and Manufacture

Nena Messina, Ph.D., Principal Investigator
(nmessina@ucla.edu)
Patricia Marinelli-Casey, Ph.D., & Richard Rawson, Ph.D., Co-Investigators
Florentina Marcu, M.S., Project Director

With the cooperation of the existing Drug Endangered Children (DEC) program in Los Angeles County and the Los Angeles County Department of Children and Family Services (DCFS), UCLA ISAP is conducting a 2-year pilot study to analyze existing Los Angeles DEC case data to enhance our understanding of the extent, epidemiology, and medical (e.g., respiratory, dental, dermatological, etc.) and developmental (e.g., cautions or delays) problems of drug-exposed children, as well as child-welfare case management services, treatment, and placement for these children. The study will further provide the basis for ongoing and expanded research applications on drug-endangered children state- and nationwide.

Study Aims: UCLA ISAP proposes to assist the DEC initiative by achieving the following aims:

  1. To document and describe the epidemiology (e.g., number, age-range, gender, race/ethnicity, rates of neglect, abuse, or MA-related accidental or purposeful deaths) of children removed from home-based MA labs in Los Angeles County;
  2. To explore the nature and extent of the medical problems (e.g., respiratory, dental, dermatological, burns) associated with children removed from home-based MA labs in Los Angeles County;
  3. To explore the nature and extent of the developmental problems (e.g., cautions or delays) associated with children removed from home-based MA labs in Los Angeles County;
  4. To describe the child welfare placement outcomes (e.g., termination of parental rights, kinship care, foster care, adoption) of children removed from home-based MA labs in Los Angeles County.

Children Exposed to Methamphetamine Use and Manufacture was funded by the National Institute on Mental Health, Contract 1 R21 DA019566 (August 2005 through May 2007).

Top of Page


Drug Treatment and Mental Health Services: Ethnic Differences in
Access and Outcomes

Noosha Niv, Ph.D., Principal Investigator
(noosha23@yahoo.com)
Yih-Ing Hser, Ph.D., Co-Investigator

The goal of this study was to provide an analysis of ethnic differences in utilization of mental health services and psychiatric outcomes among drug-abusing patients with mental health problems. The study addressed the following objectives: 1) to examine the mental health service histories and needs among patients in substance abuse treatment by ethnicity (African American, Hispanic, White); 2) to explore if ethnicity and patients’ mental health severity are related to how mental health services and drug treatment were structured (Integrated, Partnership, No Mental Health); 3) to compare ethnic groups by the type, frequency, and sources of mental health services received; 4) to examine treatment satisfaction and rates of treatment completion; and 5) to investigate the relationship between ethnicity and outcomes (e.g., mental health, drug and alcohol, recidivism), controlling for patient characteristics.

Data for this study were collected in the California Treatment Outcome Project, a statewide outcome monitoring system, which included all adult patients admitted to 43 substance abuse programs in 13 counties. All patients completed the Addiction Severity Index (ASI) at intake. Three-month and 9-month follow-up interviews were conducted with a subset of the intake sample. This subset completed the Treatment Service Review (TSR) and a treatment satisfaction questionnaire at the 3-month follow-up. The TSR was used to collect information regarding services received in each of the seven domains of the ASI. A subset also completed the ASI at the 9-month follow-up. Pretreatment and posttreatment administrative records regarding mental health treatment, substance abuse treatment, and criminal justice involvement were obtained as well. (Additional information is available at www.rwjf.org).

Drug Treatment and Mental Health Services: Ethnic Differences in Access and Outcomes was funded by the Robert Wood Johnson Foundation, Grant 053085 (June 2005 through November 2006).

Top of Page


Prenatal Methamphetamine Exposure
and Child Development

Barry Lester, M.D., Brown University, Principal Investigator
Richard A. Rawson, Ph.D., Co-Investigator
(rrawson@mednet.ucla.edu)
Jeffrey Annon, M.A., Project Director

Despite the fact that methamphetamine (MA) use is very high in some regions, little is known about the potential neurotoxic effects of prenatal MA exposure on the development of children. The IDEAL (Infant Development, Environment and Lifestyle) study was initiated to study these effects. The investigators enrolled 1,618 mothers at four clinical centers in cities where MA use was known to be a problem, Los Angeles, Des Moines, Tulsa, and Honolulu, and identified 84 newborns who were exposed to MA in utero, and 1,534 who were not exposed. The investigators looked at neonatal birth weight and gestational ages in weeks. They also looked at the relationship between MA exposure and the rate of small-for-gestational-age births. The study found that the children who were exposed in utero to MA were 3.5 times more likely than unexposed children to be small for their gestational age. MA-exposed infants were also more likely to be born pre-term (less than 37 weeks gestation). In all, 12.5% of the drug-exposed infants were born pre-term, compared with 6.5% of those who were not exposed (P = 0.036). Mothers who used MA were more likely to have a lower socioeconomic status, live in a household earning less than $10,000 per year, be on Medicaid, live without a partner, and were more likely not to have finished high school. They also tended to be younger, to seek prenatal care later in pregnancy, have fewer visits for prenatal care, and, somewhat surprisingly, to gain more weight during pregnancy relative to non-users. The latter finding reflects the fact that those who quit MA use earlier in gestation gained 10 pounds more than those who continued to use MA throughout their pregnancy, suggesting that the anorexic effects of MA are limited to continuous use. For more information, see Smith, L.M., et al. (2006). The Infant Development, Environment, and Lifestyle Study: Effects of prenatal methamphetamine exposure, polydrug exposure, and poverty on intrauterine growth. Pediatrics, 118(3),1149-1156.

Prenatal Methamphetamine Exposure and Child Development was funded by the National Institute on Drug Abuse to the Emma Pendleton Bradley Hospital with collaboration by UCLA ISAP, Subcontract 712-7605-8985 (September 2001 through August 2007).

Top of Page


Prenatal Methamphetamine Exposure and School Age Outcome

Barry Lester, M.D., Brown University, Principal Investigator
Richard A. Rawson, Ph.D., Co-Investigator
(rrawson@mednet.ucla.edu)
Jeffrey Annon, M.A., Project Director

The rapidly escalating abuse of methamphetamine (METH) in the United States, places a sense of urgency on understanding the consequences of METH use during pregnancy for the developing child. To our knowledge, IDEAL (Infant Development Environment and Lifestyle) is the only prospective longitudinal NIH study of prenatal METH exposure and child outcome. This is a competitive renewal application for the 4-7 year follow-up of the IDEAL cohort. The IDEAL data collection sites are from diverse populations in Iowa, Oklahoma, California, and Hawaii where METH use by pregnant women is prevalent. We have followed 204 METH exposed and 208 Comparison children since birth who are now completing assessments at 24 and 30 months. Here, we propose a 4-7 year follow-up, an important age range when executive function neural networks develop and children make the critical transition to school. Our plan is to study a relatively narrow band of executive function domains outcomes supported by the published preclinical and clinical literature and our own preliminary findings. We also plan to study how these executive function domains affect school related academic skills.

Our preliminary findings show effects of prenatal METH exposure on fetal growth, and on behavior between birth and 3 years on arousal-regulation, attention, inhibitory control, motivation and motor control with some effects due to heavy METH exposure. These effects suggest that motor development and precursors of executive function may be affected by prenatal METH exposure. We also found effects of psychosocial risk factors including low SES, family conflict, maternal psychiatric status and abuse potential, and out of home placement. In this proposal, we plan to study the effects of prenatal METH exposure on emerging executive function domains including higher order motivation, attention, memory, inhibitory control, visual motor integration, and motor control, and how the effects of prenatal METH exposure are affected by psychosocial risk factors and by postnatal passive drug exposure (e.g., smoke).

Prenatal Methamphetamine Exposure and School Age Outcome was funded by the National Institute on Drug Abuse to the Emma Pendleton Bradley Hospital with collaboration by UCLA ISAP (September 2007 through May 2012).

Top of Page


UCLA Access to Care Project

Richard A. Rawson, Ph.D. (rrawson@mednet.ucla.edu)
Vivian B. Brown, Ph.D. (protoceo@aol.com),
and Elizabeth Gong-Guy, Ph.D. (egongguy@sps.ucla.edu),

Principal Investigators
Suzanne Spear, M.S., Project Director

The project will develop and implement screening and brief intervention services for students engaging in high-risk use of alcohol and other drugs (AOD). These services will take place at the UCLA Student Psychological Services. Over the course of the 3-year project, Student Psychological Services will screen a minimum of 3,000 students per year and conduct brief interventions with 300 students per year. Staff at Student Psychological Services will use evidence-based tools developed specifically for college students, refined through collaboration with student representatives, campus groups, researchers, and community service providers. Central to the screening and brief intervention activity to be refined, implemented, and tested is the Alcohol, Smoking, and Substance Use Involvement Screening Test (ASSIST) developed by the World Health Organization. The Access to Care Project will harness the energy and activism of students and will build upon existing partnerships between campus and community organizations in an effort to reduce substance abuse and related consequences among students and their communities.

UCLA Access to Care Project was funded by the Substance Abuse & Mental Health Services Administration/Center for Substance Abuse Treatment, Grant 1 H79 TL17244 (July 2005 through June 2008).

Top of Page


Migration, Mental Health, Drug Use, and Access to Health Services:
Binational Project, U.S.-Mexico

Deborah Podus, Ph.D., Principal Investigator (dpodus@ucla.edu)
Arturo Ortiz Castro, Ph.D., & Rosario Martinez Martinez, Co-Investigators

The primary purpose of this project is to bring together researchers from the UCLA Integrated Substance Abuse Programs and the Instituto Nacional de Psiquiatría Ramon de la Fuente to develop a comprehensive grant proposal for extramural funding whose aims are to monitor trends in mental health and substance use among Mexican migrants to Mexico City and to Los Angeles, to identify protective factors and risk factors, and to examine access to care in each of the two metropolitan areas. As part of the project each team will collect pilot data for use in developing the proposal. In addition, the project will lay a foundation for a more sustained collaboration between researchers at these two institutions in the future.

Migration, Mental Health, Drug Use, and Access to Health Services: Binational Project, U.S.-Mexico was funded by the UC MEXUS/CONACYT Collaborative Grants, Grant 1 CN 07-108 (July 2007 to December 2008).

Last Updated:  03/30/2009

Top of Page

2016 ISAP Publications
2015 ISAP Publications