Natural History/Treatment Process and Outcomes Projects
(2010-2012)


A Comparison of Methadone Treatment Systems
in California and British Columbia

Bohdan Nosyk, Ph.D., Principal Investigator (bnosyk@cfenet.ubc.ca)
David Huang, Libo Li, Darren Urada, Richard A. Rawson, M. Douglas Anglin, Yih-Ing Hser, Co-Investigators
Elizabeth Evans, M.A., Project Director

Opioid dependence is a chronic, recurrent disorder with periods of stabilization during treatment and frequent relapse into chronic use.  Methadone Maintenance Treatment (MMT) has been found to be the most effective form of treatment for opioid dependence. The behavioral benefits and economic merits of maximizing access to MMT are well-established; increased access to quality MMT may also help contain the spread of HIV among injection drug users. Differences in drug treatment and criminal justice policies in California and British Columbia likely result in disparate health and economic outcomes for opioid-dependent individuals in these jurisdictions.  Our broad objective is to quantify these differences to determine the effects of actual and simulated policies and practices and how they are manifested in the long-term in these contrasting regions. Simulation modeling provides the advantage of being able to determine how specific policies and practices impact health benefits and costs, holding other factors constant.  The respective drug treatment systems and the policies shaping them will be described through a series of state/province-level individually linked administrative databases on drug treatment and other health resource utilization, arrests and other criminal justice system involvement, and vital statistics.  We expect that the model can subsequently be used as a tool by these and other jurisdictions to study hypothetical effects of policy changes on opioid treatment systems and the clients they serve.

A Comparison of Methadone Treatment Systems in California and British Columbia was funded by the National Institute on Drug Abuse, grant 1 R01 DA031727, from July 2011 to April 2014.

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Center for Advancing Longitudinal
Drug Abuse Research (CALDAR)

Yih-Ing Hser, Ph.D., Principal Investigator (yhser@ucla.edu)
Mary-Lynn Brecht, Ph.D., Christine E. Grella, Ph.D., Debra A. Murphy, Ph.D.,
Michael Prendergast, Ph.D., & Constance Weisner, Dr.P.H., M.S.W., Co-Investigators
Cheryl Teruya, Ph.D., Project Director

The overarching theme of the UCLA Center for Advancing Longitudinal Drug Abuse Research (CALDAR), a multidisciplinary research unit, is the development and application of rigorous scientific approaches for advancing longitudinal research on substance abuse and its interplay with HIV infection, substance abuse treatment, and other service systems. The aims of CALDAR are to: (1) increase knowledge of longitudinal patterns of drug addiction and their interplay with HIV infection, drug treatment, and other service systems (e.g., mental health, criminal justice, welfare, medical care); (2) enhance the quality and efficiency of research conducted by Center-supported projects by providing centralized support to serve common project functions; (3) provide opportunities for scientific collaboration and cross-project analyses, stimulating conceptual development and integration, and advancing improved research methodologies and statistical approaches; and (4) enhance the relevance and application of longitudinal research on drug use by facilitating dissemination of integrated project findings to a variety of communities. Infrastructure and activities of the Center are designed to provide intensive training for enhancing the conceptualization of and methodological approaches to conducting longitudinal research, and to disseminate empirical findings on life-course drug-use trajectories and their interplay with social and service systems. Special emphasis is placed on minority and/or underserved populations, who often carry a disproportionate burden of the social problems related to substance abuse and HIV/AIDS. The Center hosts the biennial CALDAR Summer Institute on Longitudinal Research Findings and Methods. Additional information is available at www.CALDAR.org.

The Center for Advancing Longitudinal Drug Abuse Research was funded by the National Institute on Drug Abuse, Grant 5 P30 DA016383, from September 2005 through August 2015.

The CALDAR Institute on Longitudinal Research Findings and Methods was funded by the National Institute on Drug Abuse, Grant 5 R13 DA024494, from January 2008 through December 2012.

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Expectations of “Recovery” –
Changes Associated with Seeking and Entering Treatment

Adi Jaffe, Ph.D., Principal Investigator (adi@ucla.edu)

This project provides a pilot of an online treatment-seeking system as well as evaluating recovery-relevant behavior, attitudes, and knowledge over the 6-month period immediately following initial treatment seeking. For more information, please visit www.allaboutaddiction.com/Rehab-Finder.

Expectations of “Recovery” – Changes Associated with Seeking and Entering Treatment was funded by the National Institute on Drug Abuse, grant 5 P30 DA016383, from September 2010 to August 2015.

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Four Models of Telephone Support
for Stimulant Recovery

David Farabee, Ph.D., Principal Investigator (dfarabee@ucla.edu)
Richard Rawson, Ph.D., & Mitchell Karno, Ph.D, Co-Investigators
Valerie Pearce, MPH, Project Director
Sarah Cousins, B.S., B.A., Project Coordinator

The purpose of this study was to develop and compare the efficacy of four low-cost, telephone support protocols for patients who completed the intensive phase of a structured, outpatient stimulant abuse treatment protocol. Patients (N = 300) who had successfully completed a Primary Outpatient model of stimulant abuse treatment were randomly assigned to one of five aftercare counseling conditions: (1) unstructured/non-directive, (2) unstructured/directive, (3) structured/non-directive, (4) structured/directive, or (5) standard referral to aftercare without telephone counseling (control). The two structured conditions were based on the behavioral “prompts” identified by Farabee et al. (2002) as being associated with drug avoidance. In the non-directive conditions, patients stated their own goals and how they intended to achieve them. In the directive conditions, the coaches provided specific recommendations for the adoption of as many drug-avoidance activities as possible. Certain patient personality traits or styles were also assessed for their possible interaction with the telephone counseling dimensions. Outcomes were tracked at 3 and 12 months following completion of primary treatment and included measurement of participation in drug-avoidance activities (including aftercare participation), as well as self-reported and objective measures of substance use and associated prosocial behavior change.

Four Models of Telephone Support for Stimulant Recovery was funded by the National Institute on Drug Abuse, grant 1 R01 DA018208, from August 2005 through July 2010.

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Methamphetamine Abuse:
Long-Term Trajectories, Correlates, Treatment Effects

Mary-Lynn Brecht, Ph.D., Principal Investigator (lbrecht@ucla.edu)
Diane Herbeck, MA, Project Director

This project is an 8-year follow-up of 596 previously studied methamphetamine (meth) users, half recruited from drug treatment participation in Los Angeles County and half with no prior meth treatment at recruitment. As of March 2012, 438 (80%) of the 549 surviving non-incarcerated participants who agreed to be re-interviewed have completed the 8-year follow-up study. The project uses the Natural History Interview to collect detailed histories of substance use, treatment, and criminal careers; these new data combined with previously collected data will produce life-course trajectories averaging at least 28 years in duration, covering teen and adult periods. Additional data will come from administrative records from several state agencies. The sample is 35% female, 33% Hispanic, 38% non-Hispanic White, 17% African American, and 12% other ethnicity.  Participants were 28-74 years of age (average 42) at the beginning of the follow-up study. Analyses will describe the current status and extended patterns of meth and other substance use including escalation, deceleration, and possible cessation and recovery; examine drug treatment utilization patterns and their relationship to meth-use patterns; describe health morbidity and mortality; assess long-term outcomes (14 or more years) of a previously identified drug treatment episode (for the subsample recruited from treatment); and estimate cumulative social costs of meth abuse for the sample in terms of criminal activity, incarceration, and drug treatment, and health and mental health services utilization. Analysis methods will include growth models and growth mixture models. Further description of the study can be found in Bolanos et al. (2012):

Bolanos, F., Herbeck, D., Christou, D., Lovinger, K., Pham, A., Raihan, A., Rodriguez, L., Sheaff, P., & Brecht, M-L. (2012). Using Facebook to maximize follow-up response rates in a longitudinal study of adults who use methamphetamine. Substance Abuse: Research and Treatment, 6, 1-11.

Methamphetamine Abuse: Long-Term Trajectories, Correlates, Treatment Effects was funded by the National Institute on Drug Abuse, grant 1 R01 DA025113-01A1, from July 2009 to May 2013.

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Research on Racial and Ethnic Disparities in
Access to Mental Health Care and
Addiction-Related Outcomes among
Clients of Public Sector Substance Abuse
Treatment Programs in California

Kevin Heslin, Ph.D., Principal Investigator
Yih-Ing Hser, Ph.D., Co-Investigator
Elizabeth Evans, M.A., Project Director

Psychiatric comorbidity is highly prevalent among persons with substance abuse problems.  Unfortunately, many substance abusers with psychiatric symptoms do not receive mental health services.  Racial/ethnic minorities are much less likely than are Whites to use mental health or substance abuse treatment; however, the reasons for these disparities are not well understood.  Previous work has not determined whether the geographic maldistribution of providers and other characteristics of poor, predominantly minority neighborhoods has an effect on mental health service use and addiction-related outcomes. This represents a considerable gap in the literature, given the continued need to explain and reduce persistent racial/ethnic health disparities in the United States.  The general aim of this study was to identify individual- and community-level determinants of mental health service use and treatment outcomes among clients of publicly funded substance abuse programs.  We examined the extent to which racial/ethnic disparities in (1) mental health service use and (2) addiction-related outcomes are a function of community-level characteristics.  To accomplish this goal, we conducted a secondary analysis of existing data from the California Treatment Outcome Project (CalTOP), a computer-based system developed for California to standardize assessment, monitor use of services, and support outcomes evaluation of publicly funded substance abuse treatment programs throughout the state.

Research on Racial and Ethnic Disparities in Access to Mental Health Care and Addiction-Related Outcomes among Clients of Public Sector Substance Abuse Treatment Programs in California was funded by the National Institute on Drug Abuse, grant R03 DA018762 to Drew University, with a subcontract between ISAP (Yih-Ing Hser) and Drew University, from November 2008 to August 2010.

Last Updated: 12/04/2012

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2016 ISAP Publications
2015 ISAP Publications