Women in Substance Use Treatment

Abstract

The objective of this study was to examine the differences between women with children in substance use treatment who are involved in Child Protective Services (CPS+) and those who are not involved (CPS-). Using a sample of all alcohol and other drug (AOD) clients (N = 6,023) receiving substance use treatment over a three-year period (1997-99), the study found that CPS+ women were more likely to be younger, have more children, have been arrested less often, be mandated to receive treatment, to have an unsatisfactory exit status or be transferred to another treatment program at discharge. CPS+ women were also more likely to have attended outpatient or day treatment for the AOD treatment. This study points out that there may be specific risk factors in place for a subgroup of women with children in AOD treatment.     

Optimal Betting in Casino Blackjack II: Back-Counting

The card counting technique known as ‘back-counting’ is treated analytically. The true count at which the back-counter should optimally enter the game is derived, based on maximising his effective yield. That entry count is found to be in the range of +2 to +3 for a typical 6-deck game, depending on the back-counter's risk profile. If he also adopts an ‘exit’ strategy (abandoning play at a table whose true count has dropped below a lower threshold) and optimises the entry and exit counts simultaneously, he can improve his performance slightly further; the optimal exit count is between ? 2 and ? 3. Because the risk of ruin is very low, he may in addition choose to bet more aggressively than he would if not back-counting—or, conversely, to ‘flat bet’. Criteria are examined for ‘departure’ (abandoning the observation of a table whose true count has yet to reach the entry threshold).     

CAN ENTRY OR EXIT EVENT STUDIES INFORM HORIZONTAL MERGER ANALYSIS? EVIDENCE FROM GROCERY RETAILING

This study estimates how prices change following the entry and exit of grocery retailers. We estimate the effects of entry (exit) by comparing affected markets to a set of unaffected markets using both a difference‐in‐difference estimator and a synthetic control estimator. We find that entry typically results in reduced prices. More surprisingly, we find that exit is frequently associated with falling prices. Our estimated effects of entry on grocery prices are similar in magnitude to estimates of merger price effects in the supermarket industry. This finding suggests that entry event studies may be a useful tool for horizontal merger analysis. (JEL L11, L4, L81)     

Entry and Exit Strategies in Migration Dynamics

In this paper, we use a real option framework in order to study the role of combined entry and exit strategies in migration. The paper’s aim consists in investigating migrants’ behaviour and in particular their duration of stay in the host country. Our framework shows two threshold levels: the first triggers the migration choice, while the second triggers the return to the country of origin. The difference between these two thresholds defines a region of inaction (hysteresis) i.e. the length of the immigrant’s stay in the host country (duration). Our theoretical results show that: (a) the phenomenon of hysteresis is amplified by ethnic communities both in entry and in exit cases; and (b) migration policies that attempt to exacerbate entry could increase duration of immigrants and the migration stock in the host country. Furthermore, the community could reduce the minimum wage level required to trigger both exit and entry. This fact could explain why we sometimes see migration inflows with a low wage differential and also with underemployment.     

Heavy alcohol use compared to alcohol and marijuana use: do college students experience a difference in substance use problems?

This study examines the risk for alcohol and other drug (AOD) problems resulting from alcohol plus marijuana use compared to alcohol-only use. Data are from telephone interviews with 1113 randomly selected college students attending two large urban universities in the southwestern United States. Alcohol and marijuana users (dual users) were more likely to be younger and report a higher mean number of drinks per occasion and experiencing all AOD problems studied compared to alcohol-only users. Multivariate logistic regression analysis findings reveal the relationship between dual-substance use and increased risk for AOD problems remained after controlling for demographics and alcohol use behaviors. Such problems include greater odds of legal problems and riding with or being an intoxicated driver. College students using alcohol and marijuana are at much higher risk for AOD problems than are students who use alcohol only, even when heavy drinking is taken into account.     

Social work students in the aftermath of Hurricanes Katrina and Rita: correlates of post-disaster substance use as a negative coping mechanism

Social work students’ post-disaster coping while in the field is an important workforce issue with ethical implications. The current study utilized secondary data collected in a previous study examining post-disaster alcohol and other drug (AOD) use among social work student volunteers (N = 416) in the wake of Hurricanes Katrina and Rita (HKR). The current sample included participants from the original study who responded to a single-item measure of AOD use as a negative coping mechanism (N = 290). The present study examined potential explanatory variables of AOD use in the aftermath of HKR, including demographic (age, gender, and race) and psychosocial characteristics (hurricane-related stressors, previous traumatic stressors, and post-traumatic stress). The multivariate logistic regression model distinguished between students who never or rarely used AOD and those who used AOD often to cope with HKR, accounting for 24% of model variance. Social work students who report post-disaster AOD use may risk experiencing additional, trauma-related vulnerabilities, should be further assessed, and provided necessary specialized supports to enable their well-being and to prevent impaired practice.     

Examination of the Role of Therapeutic Alliance,Treatment Dose,and Treatment Completion in the Effectiveness of The Seven Challenges

Adolescent alcohol and illicit drug (AOD) use is a major public health concern. This longitudinal study examines the effectiveness of The Seven Challenges in reducing adolescent substance use and mental health problems, as well as the process by which it is effective. Participants were 89 adolescents (72 male, 17 female) enrolled in a 3 month intensive outpatient adolescent substance abuse treatment program using The Seven Challenges and who provided self-report data at pre- and post-treatment. Results indicated that The Seven Challenges was effective at increasing the number of days refrained from using AOD, reducing use of tetrahydrocannabinol (THC) and other drugs, and reducing substance use problems and internal mental distress. Results also indicated that The Seven Challenges drug counselors effectively established and maintained therapeutic alliance but this seems to not play a role in the effectiveness of The Seven Challenges. Both treatment dose and completion played a role in the effectiveness of The Seven Challenges; they were both positively related to post-treatment days refrained from AOD use, and negatively related to days of THC use, substance use problems, and internal mental distress. However, the strength of the influence of treatment completion was stronger when treatment dose was low than when it was high. Despite a small sample and other limitations, findings add to existing literature that suggests that The Seven Challenges is an effective substance abuse treatment for adolescents. Furthermore, findings suggest that adolescent substance abuse treatment should focus on clients meeting pre-determined program goals as well as on dose.     

Evaluation of the In Touch training program for the management of alcohol and other drug use issues in schools

In Touch is a professional training program designed to develop staff skills and support structures so as to enable schools to manage alcohol and other drug (AOD) matters in a coordinated manner that maximizes beneficial outcomes for at-risk students, while at the same time maintaining school discipline and community relationships. This study is an evaluation of the impact of the program on alcohol and other drug (AOD) related knowledge, attitudes and activity of participating school staff, and on AOD management practice in their schools. Data from 53 intervention participants and 21 controls were compared at pre- and post-intervention. These data indicated a 46% increase in AOD knowledge among those who participated in In Touch training. Attitudes favorable to integrated, supportive management of AOD issues also increased significantly in this group, as did desirable practice. However, change in school practice was limited. Significantly more schools whose staff participated in In Touch training had a written drug policy at post-intervention, but schools' usual responses to AOD-related incidents were substantially the same. These findings indicate that professional training on the management of AOD matters can change the understanding and practice of individual staff, but if school structures and practice are to be substantially influenced, a broader program is required.     

Social Selection and Social Causation in Marriage and Health: Longitudinal Evidence of Body Weight Change

Social selection proposes that health influences marriage, whereas social causation proposes that marriage influences health. We used biennial 1979 National Longitudinal Survey of Youth data to examine body weight 6 years before and 6 years after entering and exiting first marriages. For marital entry, social selection occurred as lighter women entered marriage. Social causation was not observed because all marital entry groups gained weight at comparable rates. Cohabitation was not associated with weight change after marital entry. For marital exit, short-term social causation occurred as men and women lost weight after marital exit and then regained equivalent weight. Overall, body weight change sometimes followed transitions into and out of marriage, but the associations were few in number, short-lived, and had no long-term impact on body weight.     

Predictors of foster care exits to permanency: A competing risks analysis of reunification, guardianship, and adoption

Although foster care is intended to be temporary, and policy explicitly requires permanency outcomes, many children experience lengthy stays and exit foster care without a permanent family. This study sought to identify which child and placement characteristics were important predictors of exit to three types of permanency outcomes: reunification, guardianship, and adoption. A sample of 3351 children who entered foster care in 2006 was observed for 30 to 42 months. Permanency outcomes were analyzed using competing risks survival analysis. Children exited foster care to different types of permanency at different rates and frequencies. Reunification occurred most quickly and frequently. Guardianship was second in terms of median duration but third in frequency. Adoption was the second most common exit but had the longest median duration. One in four children remained in foster care or exited without permanency. While patterns varied by type of permanency, three major categories of important predictors were identified: 1) demographic characteristics of age at entry and race, 2) clinical needs related to children's disabilities and mental health problems, and 3) continuity and connections represented by kin placements, sibling placements, early stability, and absence of runaway events. Implications for practice, policy, and research are discussed.     

The Extent and Nature of Practitioners,Encounters with Alcohol and Other Drug Use in Social Work and Social Care Practice

This article considers the extent and nature of social work and social care practitioners' experience of working with service users whose lives are affected by the problematic use of alcohol or other drugs (AOD). It draws on the findings of a national study of ‘working with alcohol and drug use’ which was conducted in England in 2010–2011. The study reported here comprised an online survey of front-line practitioners (n = 597), complemented by 12 practitioner focus groups and interviews with 21 key informants from participating local authorities and substance use treatment services. This paper focuses primarily on data from one element of the survey. Findings indicate that the great majority of staff encountered service users who are affected by AOD problems at some level, although there were differences between groups of practitioners in the extent and nature of AOD problems for different groups of service users. The differential experiences of staff according to their client groups underlines the need for education and professional development not only to provide training on working with AOD but to ensure that training is contextualised and relevant to practitioners across the range of social work and social care services.     

Urban poverty and labor market dynamics in five Latin American countries: 2003–2008

Latin America experienced a long period of sustained growth since 2003 that positively impacted social and labor market indicators, including poverty. This paper contributes to the understanding of this process as it carries out a comparative study of poverty dynamics in five Latin American countries during 2003–2008. It analyzes the extent to which countries with different levels of poverty incidence diverge in terms of poverty exit and entry rates, identifies the relative importance of the frequency and impact of events associated to poverty transitions and examines how these events affect households with different characteristics. For this, a dynamic analysis of panel data is carried out using regular household surveys. Sizeable rates of poverty movements were observed in all five countries and it was found that a large proportion of household experienced positive events, mainly related to the labor market; however, only a small fraction of them actually exited poverty. Demographic events and public cash transfers proved to be of little relevance; in particular, the latter did not contribute much either to intensify poverty exits or to prevent poverty entries. Households with children experienced more (less) negative (positive) events than those without children. It appeared therefore that even when the economy behaved reasonably well at the aggregate level, high levels of labor turnover and income mobility (even of a negative nature) still prevail, mainly associated to the high level of precariousness and the undeveloped system of social protection that characterize the studied countries.     

News coverage of alcohol and other drugs in U.S. college newspapers

This study investigated the substance use-related content of a sample of student-run college newspapers. Two independent coders examined 157 news stories, features, editorials, commentaries, letters, photographs, and cartoons. Items about alcohol appeared in one out of every two issues, while items about other drugs appeared in one out of every five issues. Basic information about alcohol and other drug (AOD) use was reported in about one-fifth of the items, while three-fourths dealt with social, legal, safety, or health problems associated with AOD use, especially alcohol consumption. Just over half referred to some type of control policy, most often an enforcement action. Around one-fourth mentioned educational efforts to promote AOD prevention. Very few dealt with detection, intervention, or treatment. Most college newspapers are missing good opportunities for more extensive coverage of AOD issues that would better inform their readers, especially about factors contributing to campus AOD problems and specific program and policy options.     

A Survey of 100 Community Colleges on Student Substance Use,Programming, and Collaborations

Abstract

Objective: The objective was to survey community college personnel about student substance use, and infrastructure (staff and funding), programs, and collaborations dedicated to substance use prevention. Participants: The sample included 100 administrators, faculty, and health services staff at 100 community colleges. Methods: Participants completed a Web-based survey. Results: Participants reported a number of alcohol and other drug (AOD) related concerns. Despite limited staff and funding dedicated to AOD, institutions are implementing a number of programs, although many are not implementing some of the programs popular at traditional 4-year colleges. They are also collaborating with a number of on- and off-campus groups. The availability of staff and funding dedicated to AOD, and the presence of residence halls, is associated with health programming and substance abuse collaborations. Conclusions: Results suggest that there is a need for increased research to understand the most effective AOD prevention strategies for community colleges.     

Caregiver AOD use, case substantiation, and AOD treatment: studies based on two southwestern counties

This article includes two separate studies: the first explores the impact of caregiver AOD use on CPS case substantiation; the second compares CPS-involved and CPS-noninvolved females in AOD treatment systems. Results suggest that cases with indications of AOD use are more likely to be substantiated than cases without; and increasing numbers of children and younger maternal ages are risk factors for CPS involvement among AOD-using women. Related findings are also presented, followed by implications for practice and research.     

Perceptions of drinking and related findings from the Nationwide Campuses Study

Proponents of social norms approaches maintain that correcting misperceptions of alcohol use among college students may reduce drinking and its consequences. The author used aggregate campus-level data from the Nationwide Campuses Study to test this hypothesis. He defined the misperceptions ratio as the ratio of the frequency of the "average student's" perceived alcohol use to the frequency of self-use at each campus. Each of the 57 colleges reported misperceptions ratios greater than unity. At campuses where students had more accurate perceptions of alcohol use, students were more likely to desire alcohol availability at campus events and to drink on more days throughout the year than at campuses where students had greater misperceptions of alcohol use. The author found no data to support the preferential use of social norms programming on campuses with high levels of self-reported alcohol use or binge drinking. These findings raise questions about potentially unexpected and unintended effects of social norms approaches.     

Gender differences in psychosocial complexity for a cohort of adolescents attending youth-specific substance abuse services

This study examines gender differences in the characteristics of young people (N = 1000) attending alcohol and other drug (AOD) services in the state of Victoria, Australia. Females demonstrate levels of substance use that are at least as high, and perhaps more harmful than that of males. Our data add to a growing base of evidence that young women attending youth AOD services experience additional psychosocial problems at higher rates than their male counterparts. This evidence is now fairly consistent in regard to mental health problems, self-injury, suicide attempts, and homelessness. Findings from this study further suggest that the gender imbalance may extend to child protection involvement, family conflict and disconnection, access to social support, and exposure to neglect and abuse.     

Developing a screening questionnaire for problem drinking in college students.

The CAGE questionnaire is one of several brief screening instruments that has been successful in detecting alcoholism in a general population. There is evidence, however, indicating that none of these instruments has sufficient validity for detecting the less severe pattern of problem drinking that is more typical of college students. This study analyzed survey data, including CAGE questions, to identify items that would have sufficient test operating characteristics more valid for screening problem drinkers. Problem and normal drinking patterns were defined by combining certain categories of quantity-frequency data with categories of alcohol-related problems. Problem and normal drinkers were identified as those students at the ends of the quantity-frequency/alcohol-problems continuum. Differences between the two groups in response frequencies to a 17-item alcohol-use survey were examined using chi-square analyses. Five items showing highly significant differences were identified, and sensitivity, specificity, and positive predictive values were calculated at possible cutoff points. These items were (1) a positive response to any 2 of the 4 CAGE items, (2) reporting rarely or never choosing nonalcoholic beverages at social events, (3) driving under the influence at least 6 to 10 times or more in the last year, and (4) having started regular use of alcohol before the college years. At the recommended cutoff score for a positive test, the items have a sensitivity of 88%, specificity of 87%, and positive predictive value of 52%. When used for screening in a population similar to this, it will fail to identify 12% of the problem drinkers and will falsely classify 13% of all normal drinkers as problem drinkers.(ABSTRACT TRUNCATED AT 250 WORDS)     

THE IMPACT OF TRADE COSTS ON FIRM ENTRY,EXPORTING, AND SURVIVAL IN KOREA

This study examines how changes in trade costs have affected entry, exit, productivity, and exporting in the Korean manufacturing sector. We verify several predictions of heterogeneous‐firm models of international trade. For example, falling import‐trade costs are associated with less entry and lower market shares among existing domestic firms, and higher total factor productivity for Korean manufacturing as a whole. The size of firms plays an important role in many of our results. New domestic firms are more likely to be small, but large firms are less likely to exit and more likely to have an increase in total factor productivity. (JEL F10, D24)     

Poverty Dynamics among Recent Immigrants to Canada1

This paper examines two issues: (1) poverty dynamics among successive cohorts of entering immigrants to Canada, and (2) whether rising educational attainment and increasing share in the “skilled” class since the early 1990s has resulted in improvements in poverty entry, exit, and chronic poverty. The entry to poverty is very high during the first year in Canada, but low in subsequent years. The dramatic move toward more labor‐market friendly characteristics of entering immigrants had only a very small effect on poverty outcomes, in part because the relative advantage of holding a degree diminished, and “skilled economic” class immigrants were more likely to enter poverty than their “family” class counterparts.