Assessment of Co-Occurring Substance Use During Opiate Treatment Programs in the United States

2020 ◽  
Author(s):  
Mirinda Ann Gormley ◽  
Courtney T Blondino ◽  
DaShaunda D H Taylor ◽  
Elizabeth Lowery ◽  
James S Clifford ◽  
...  
Keyword(s):  
United States ◽  
Substance Use ◽  
Best Practice ◽  
The United States ◽  
Treatment Programs ◽  
Polydrug Use ◽  
Best Practice Guidelines ◽  
The Status ◽  
Study Intervention ◽  
Opiate Treatment

Abstract The effectiveness of opiate treatment programs (OTPs) can be significantly influenced by co-occurring substance use, yet there are no standardized guidelines for assessing the influence of co-occurring substance use on treatment outcomes. In this review, we aim to provide an overview on the status of the assessment of co-occurring substance use during participation in OTPs in the United States. We searched 4 databases—MEDLINE/PubMed, EMBASE, PsychINFO, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL)—from database inception to November 2018 to select relevant publications on OTPs that assessed participants’ co-occurring substance use. We used a standardized protocol to extract study, intervention, and co-occurring substance use characteristics. Methodological quality was assessed using the Quality in Prognosis Studies tool. Of the 3,219 titles screened, 614 abstracts and 191 full-text original publications were assessed, leaving 85 eligible articles. Co-occurring substance use was most often assessed during opioid treatments using combined (pharmacological and behavioral) (n = 57 studies) and pharmacological (n = 25 studies) interventions. Cocaine, alcohol, marijuana, and benzodiazepines were frequently measured, while amphetamines and tobacco were rarely assessed. Great variation existed between studies in the timing and measurement of co-occurring substance use, as well as definitions for substances and polysubstance/polydrug use. Inconsistencies in the investigation of co-occurring substance use make comparison of results across studies challenging. Standardized measures and consensus on research on co-occurring substance use is needed to produce the evidence required to develop personalized treatment programs for persons using multiple substances and to inform best-practice guidelines for addressing polydrug use during participation in OTPs.

scholarly journals Availability of Outpatient Substance Use Disorder Treatment Programs in the United States

2010 ◽  
Vol 45 (7-8) ◽  
pp. 1097-1111 ◽  
Author(s):  
Brian E. Perron ◽  
David F. Gillespie ◽  
Ben Alexander-Eitzman ◽  
Jorge Delva
Keyword(s):  
United States ◽  
Substance Use ◽  
Substance Use Disorder ◽  
The United States ◽  
Treatment Programs ◽  
Substance Use Disorder Treatment ◽  
Disorder Treatment

The Association of Co-Occurring Substance Use and the Effectiveness of Opiate Treatment Programs by Intervention Type: A Systematic Review

2020 ◽  
Author(s):  
Courtney T Blondino ◽  
Mirinda Ann Gormley ◽  
Da Shaunda D H Taylor ◽  
Elizabeth Lowery ◽  
James S Clifford ◽  
...  
Keyword(s):  
Systematic Review ◽  
Substance Use ◽  
Treatment Outcomes ◽  
Positive Association ◽  
The United States ◽  
Treatment Retention ◽  
Treatment Programs ◽  
Significant Positive Association ◽  
The Relationship ◽  
Opiate Treatment

Abstract This systematic review describes the influence of co-occurring substance use on the effectiveness of opiate treatment programs. MEDLINE/PubMed, EMBASE, PsychINFO, and Cumulative Index to Nursing and Allied Health Literature were searched from database inception to November 28, 2018 to identify eligible opioid treatment studies in the United States that assessed the relationship between co-occurring substance use and treatment outcome (i.e., opioid abstinence and treatment retention). A total of 34 eligible studies were included. Overall, co-occurring substance use was associated with negative treatment outcomes regardless of intervention type. However, patterns varied by substance and intervention type. In particular, co-occurring use of cocaine or marijuana with opioids was associated with reduced treatment retention and opioid abstinence regardless of intervention type. Co-occurring use of amphetamines, compared to no use or reduced use of amphetamines, decreased treatment retention. Co-occurring use of alcohol was both positively and negatively associated with treatment outcomes. One study reported a significant positive association between sedative use and opioid abstinence. Generally, findings suggest that combined interventions reported better health outcomes compared to pharmacological or behavioral intervention studies alone. The findings of this review emphasize the need to comprehensively study and address co-occurring substance use to improve opiate treatment programs.

Multicultural Assessment of Personality and Psychopathology in the United States: Still Art, Not Yet Science, and Controversial

1998 ◽  
Vol 14 (1) ◽  
pp. 62-70 ◽  
Author(s):  
Richard H. Dana
Keyword(s):  
United States ◽  
Racial Identity ◽  
The United States ◽  
Therapeutic Assessment ◽  
Culturally Competent ◽  
Research Attention ◽  
The Status ◽  
Training Research ◽  
Multicultural Assessment ◽  
Personality Description

This paper describes the status of multicultural assessment training, research, and practice in the United States. Racism, politicization of issues, and demands for equity in assessment of psychopathology and personality description have created a climate of controversy. Some sources of bias provide an introduction to major assessment issues including service delivery, moderator variables, modifications of standard tests, development of culture-specific tests, personality theory and cultural/racial identity description, cultural formulations for psychiatric diagnosis, and use of findings, particularly in therapeutic assessment. An assessment-intervention model summarizes this paper and suggests dimensions that compel practitioners to ask questions meriting research attention and providing avenues for developments of culturally competent practice.

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