President's proposed budget would slash treatment and prevention funding

We had a feeling of déjà vu when the White House sent its proposed budget to Congress last week. Similar to past years, the Office of National Drug Control Policy (ONDCP) would be decimated, moving the $100 million Drug‐Free Communities program to the Center for Substance Abuse Prevention (CSAP) at the Substance Abuse and Mental Health Services Administration (SAMHSA). There's no additional money in the Substance Abuse Prevention and Treatment (SAPT) block grant and cuts to the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, CSAP and SAMHSA's Center for Substance Abuse Treatment.     

Briefly Noted

The National Institutes of Health (NIH) will award 12 grants to form the Justice Community Opioid Innovation Network (JCOIN) to support research on quality addiction treatment for opioid use disorder (OUD) in criminal justice settings nationwide, with a total of $155 million from the National Institute on Drug Abuse. One focus will be on finding new medications. There will be 10 research institutions and two centers. JCOIN is part of the NIH HEAL (Helping to End Addiction Long‐term) initiative launched last year. Funded institutions and the site locations are: the New York State Psychiatric Institute (New York), Baystate Medical Center (Massachusetts), Friends Research Institute Inc. (Maryland), Texas Christian University (Illinois, New Mexico, Texas), the New York University School of Medicine (Connecticut, Delaware, New Hampshire, New York, Oregon), Brown University (North Carolina, Pennsylvania, Rhode Island), the University of Chicago (Illinois), Chestnut Health Systems Inc. (Illinois), the University of Kentucky (Kentucky), and Yale University (Connecticut, Minnesota, New York, North Carolina, Puerto Rico). George Mason University in Fairfax, Virginia, will serve as the JCOIN coordination and translation center. For more information, go to https://www.nih.gov/research‐training/medical‐research‐initiatives/heal‐initiative/justice‐community‐opioid‐innovation‐network .     

Briefly Noted

A conference focusing on “value” — money well spent — in substance use disorder (SUD) treatment featured payment and reimbursement, and, in a refreshing twist, researchers instead of administrators and payers. Led by CHERISH (the Center for Health Economics of Treatment Interventions for Substance Use Disorder, HCV, and HIV, a collaboration of Cornell Weill Medicine, Boston Medical Center, the University of Miami Miller School of Medicine and the University of Pennsylvania, funded by the National Institute on Drug Abuse), the conference, held May 31 at the Leonard David Institute of Health at the University of Pennsylvania, featured speakers from the SUD treatment community who espouse medications. Topics and speakers included: ways to eliminate low‐value care (Joshua Sharfstein, M.D.), what value means (Colleen Barry, Ph.D., Brendan Saloner, Ph.D., and overcoming barriers to effective treatment (Michael Botticelli, Alexis Horan). It did give attendees the opportunity to network and interact directly, as researchers and policymakers, on how to overcome barriers to SUD treatment in communities. The bottom line: What works should be covered; what doesn't shouldn't.     

Family structure,family organization,and quality of family life

This study examines how family organization is associated with the quality of family life for parents in first marriages, remarriages with biological children, and several types of stepfamilies. Data are drawn from the 1987–1988 National Survey of Families and Households; only married couples in which both spouses participated in the survey and who had children under age 19 in the household are considered (N=3,120). Results indicate that respondents in different family structures differ in the perceived quality of parent-child relationships, that differences in family structure are not related to differences in family organization, and that some aspects of family organization are related to marital quality and the quality of parent-chil relationships. Hierarchical multiple regression analyses indicate that family structure and family organization are independently related to the quality of family life. This research was supported by National Institute of Child Health and Human Development Grant R15 HD28198-01. The National Survey of Families and Households was funded by a grant (HD21009) from the Center for Population Research of the National Institute of Child Health and Human Development. The survey was designed and carried out at the Center for Demography and Ecology at the University of Wisconsin-Madison under the direction of Larry Bumpass and James Sweet. The fieldwork was done by the Institute for Survey Research at Temple University. A previous version of this article was presented at the annual meeting of the National Council on Family Relations, Orlando, November 1992. Her research interests include the work/family interface and family policy. She received her Ph.D. from Wayne State University. His research interests include the effects of divorce and remarriage on parents and children. He received his Ph.D. from Ohio State University. Her research interests include adolescents and adoption. She received her Ph.D. from the University of Delaware.     

Blending Prevention Models: An Effective Substance Use and HIV Prevention Program for Minority Youth

Illicit drug use and rates of HIV infection among youth have increased over the past decade, indicating the need effective substance use and HIV prevention programs. Particularly at risk are minority youth living in poor urban environments. This study examines effectiveness of an innovative prevention program that blends the “All Star” substance abuse prevention model with the “Popular Opinion Leader” model for HIV prevention. In general, the results indicate non-significant increases in drug and sex risk, behavior and significant positive changes and trends in related areas (i.e., changes in perception, self esteem) thought to be related to drug use and risky sexual behavior.Sally Stevens and Velia Leybas-Amedia are affiliated with the Southwest Institute for Research on Women, University of Arizona. Beth Bourdeau is affiliated with the Pima Prevention Partnership, Tucson, AZ. Lovelle McMichael and Alan Nyitray are affiliated with the Southern Arizona AIDS Foundation, Tucson, AZ. Financial assistance for this project was provided by the Substance Abuse and Mental Health Service Administration, Center for Substance Abuse Prevention Grant# SP08916. The opinions expressed herein are those of the authors and do not reflect official positions of the government. The Southern Arizona AIDS Foundation and the authors would like to acknowledge the staff at the Tucson Urban League Academy Charter School and Luz Social Services Charter School for their assistance and support of the Check Yourself Youth Team prevention project.     

Child day care and the employment of AFDC recipients with preschool children

In the context of recent federal initiatives to increase the affordability, accessibility, and quality of child care for the working poor, this article examines the degree to which expanding the supply of publicly subsidized child care in local communities may promote, through employment, the independence from welfare and economic self-sufficiency of Aid to Families with Dependent Children (AFDC) recipients with preschool-aged children. In a telephone survey of a random sample of 232 AFDC recipients who participated in a larger federally sponsored demonstration project in Mecklenburg County, North Carolina, many respondents reported the lack of available child care as a barrier either to employment or to the attainment of a preferred job. Although it is concluded that increases in the availability of subsidized child care should be a component of any strategy to increase the level of employment participation, continuity, and success for this population, the results underscore the need for a multi-faceted intervention strategy to reduce the welfare dependency and to increase the economic self-sufficiency of these parents. Implications for further research are suggested.The data for this investigation were collected under Authorization No. 89-3-WR-NC-008 to the North Carolina Department of Human Resources from the Division of Program Evaluation, Office of Family Assistance, Family Support Administration, Department of Health and Human Services. Additional support was provided under Grant No. 5-44232 from the University of North Carolina at Chapel Hill, University Research Council, Office of Research Services. The views and conclusions expressed in this article are those of the authors and do not necessarily represent the views or the official position of the U.S. Department of Health and Human Services or the North Carolina Department of Human Resources.He received his Ph.D. in Family Science from the University of North Carolina at Greensboro in 1981. He is a specialist in work and family linkages, policy analysis and evaluation, and survey research methodology. He served as principal investigator on the child care evaluation study that is the basis for this article.He received his Ph.D. in Library Science from the University of Wisconsin in 1982. He is a specialist in evaluation and research methodology, information dissemination and use patterns in public sector agencies, and welfare policy and initiatives. He served as project director for the study described in this article.     

Prevalence studies of problem gambling in the United States

The rapid expansion of legalized gambling in the United States has produced tremendous demands for information about the number and characteristics of problem gamblers in the general population. This paper examines the results of prevalence studies of problem and pathological gambling that have been carried out in the United States. The discussion is largely chronological, with a focus on comparative findings from the 15 United States jurisdictions where prevalence studies have been completed since 1980. The results of diese studies verify findings from clinical and experimental studies as well as suggesting important avenues for future research. The paper concludes with a consideration of the role played by survey research in advancing the field of gambling research.The author would like to acknowledge the Connecticut Division of Special Revenues, the Iowa Department of Human Services, the Montana Department of Corrections and Human Services, the New York State Office of Mental Health, the North Dakota Department of Human Services, the University of South Dakota Business Research Bureau, the Texas Commission on Alcohol and Drug Abuse and the Washington State Lottery for funding several of the gambling surveys discussed here. A substantial proportion of the research reported here was supported by a grant (MH 44295) from the Violence and Traumatic Stress Research Branch of the National Institute of Mental Health.     

Multiple approaches to understanding and preventing elder abuse: Introduction to the cross-disciplinary National Institutes of Health workshop

ABSTRACT

On October 30, 2015, the National Institutes of Health (NIH) convened a workshop, “Multiple Approaches to Understanding and Preventing Elder Abuse,” in Bethesda, Maryland. The workshop brought together experts from across disciplines to discuss research challenges, opportunities, and lessons learned from other fields. Participants included experts in elder abuse, child abuse, intimate partner violence (IPV), emergency medicine, and neuroscience. In this special issue of the Journal of Elder Abuse and Neglect, participants address topics explored before, during, and after the day-long workshop.     

Table of Contents

Addiction Treatment Provider Continues Expansion into Mental Health Seabrook Positions for Changes with Renewed Outpatient Emphasis NIH Responds to Nature Article on Duplicative Grants CSAT's Reuter Retires, Leaving a Legacy for OTPs Colo. Officials Worried about Child Welfare and Substance Abuse ADAW Editor Awarded CADCA ‘National Newsmaker’ Briefly Noted State News Correction Coming up     

Structuring a multi-site evaluation for youth mentoring programs to prevent teen alcohol and drug use

Despite mentoring's rapidly increasing popularity as an intervention for the prevention of teen alcohol and drug abuse and associated problems, there is little research consensus on its overall effectiveness or on the core principles and components that define effective mentoring. To advance knowledge concerning this important prevention intervention, the Center for Substance Abuse Prevention has designed and funded a multi-site cooperative agreement involving seven mentoring programs. The programs are designed to provide a rigorous outcome evaluation that allows comparisons of differing approaches to organizing and delivering mentoring services to adolescents at high risk for substance abuse. The cooperative agreement guidelines set service parameters and options that focus on issues that are grounded in past research on mentoring prevention interventions. The cooperative agreement includes a quasi-experimental, longitudinal multi-site evaluation that provides evidence-based recommendations to advance the effective use of mentoring as a prevention strategy.     

CMHS/CSAT Collaborative Demonstration Program for Homeless Individuals1

The Collaborative Demonstration Program for Homeless Individuals is providing an opportunity for several community agencies in the United States to explore innovative intervention and treatment strategies to address the needs of homeless people with co-occurring (mental illness and substance abuse) disorders. This cooperative agreement, funded jointly by the Center for Mental Health Services (CMHS) and the Center for Substance Abuse Treatment (CSAT), is a $3 million project supporting programs in various community     

NASADAD to NIDA: Connect research to practice

When the National Institute on Drug Abuse (NIDA) sought input on its five‐year plan, the people responsible for publicly funded prevention, treatment and recovery — state directors — called for returning to the days of communication between federal agencies like the Substance Abuse and Mental Health Services Administration (SAMHSA) and between NIDA researchers and the service delivery system. In an Aug. 7 letter to NIDA's strategic planning team, Robert I.L. Morrison, executive director of the National Association of State Alcohol and Drug Abuse Directors (NASADAD), noted that each state alcohol and drug agency has a critical role to play in NIDA initiatives. This role includes.     

A Noncausal Relation Between Casual Sex in Adolescence and Early Adult Depression and Suicidal Ideation: A Longitudinal Discordant Twin Study

Research on relations between casual sex and mental health is inconclusive; while some studies indicate casual sex may lead to more negative mental health (e.g., depression), other studies report no such relationship. Using a genetically informed approach, this study examined whether earlier casual sex (i.e., ever engaging in casual sex and number of casual sex partners) in adolescence has a causal influence on later mental health in young adulthood (i.e., depressive symptoms and suicidal ideation), as well as the reverse relationship (adolescent negative mental health on young adult casual sex) by exploiting the quasi-experimental nature of discordant-twin models. Multilevel models that measured within-twin and between-twin pair effects of adolescent casual sex were estimated, using 714 twins (357 twin pairs) from the sibling subsample of the National Longitudinal Study of Adolescent Health (Add Health). Results indicated that there was no causal relationship between casual sex in adolescence and higher levels of depressive symptoms or suicidal ideation in young adulthood, and these effects did not differ by gender. There were also no causal relations between adolescent depressive symptoms or suicidal ideation and casual sexual experience in young adulthood. Implications for ways to increase scientific rigor by using different methods (e.g., genetically informed analyses) are discussed.     

Table of Contents

Once‐a‐Week Buprenorphine in Physician's Office Found Effective Drug Court Audit Finds Lack of Data on Outcomes Buprenorphine in a Therapeutic Community Senate Committee Votes to Add $30 Million to Block Grant Senate Appropriations for Block Grant and Other Substance Abuse Funding Letter to the Editor Illegal Activity at Maine Clinic Puts Methadone in Spotlight NAADAC 2006 Award Recipients Announced Briefly Noted Resources Names in the News Business Obituaries Coming Up     

Heroin use and criminal careers

The relationship between heroin use and crime has been the subject of continuing debate. While the principle focus of this debate has been the causal nexus between heroin and crime, a related controversy exists regarding the nature of addict criminality. Some have argued that heroin addicts are impulsive and opportunistic criminals, while others maintain that addicts are sophisticated criminal entrepreneurs. The present study based on career history interviews with 30 hard core street addicts, suggests that both positions may be relevant at different times in the addict's career. These addicts clearly identified a preferred main hustle, but did find it necessary to deviate from their main hustle at various times in their careers. This paper seeks to identify those conditions under which addicts are likely to maintain and, conversely, deviate from established patterns of criminality.This research was supported in part by DHEW Grant No. 1 R01 DA01827 from the Division of Research, National Institute on Drug Abuse. Views expressed are those of the author and do not necessarily reflect the position of the National Institute on Drug Abuse. I would like to thank Carl Klockars for his meticulous guidance through various drafts of this paper.     

NIDA: How parents can talk to children about opioids

The National Institute on Drug Abuse (NIDA), part of the federal National Institutes of Health, has advice for parents in the midst of the opioid epidemic: “[T]alk openly about the effects of opioids and other drugs with your children and stay actively engaged in their lives.”     

Individual vs. household determinants of the demand for medical care: A study of rural families

This article investigates, from a household perspective, the demand for medical care. Earlier (economic) studies have typically focused on individual utilization patterns; however, the data set employed here allows for an investigation of the role of other family members on individual demand. The theoretical results suggest that the labor force status (via the wage rate) of one family member may, in addition to influencing that person's rate of medical care use, effect the utilization of other household members. Separate physician visit demand equations are estimated for husbands, wives, and the household unit. The empirical results indicate that the wife's (full) cost of receiving medical care is a significant determinant of utilization by both the husband and other family members. Overall, the findings suggest that demand studies should take the presence of other household members and family structure into consideration when analyzing the determinants of individual medical care utilization.This study was supported in part by grant no. 1R03 HSO 2417-01 from the National Center for Health Services Research, HHS.Laurence Miners received his Ph.D. in economics from the University of North Carolina at Chapel Hill. He is currently an Associate Professor at Fairfield University and his research interests are focused mainly in the areas of health and labor economics. Correspondence concerning this article should be addressed to Laurence Miners, Department of Economics, Fairfield University, Fairfield, CT 06430.     

Toward an effective treatment system for adolescents with substance use disorders: The role of the states

A 2002 national expert panel found that the treatment system for adolescents with substance use disorders was inadequate and underdeveloped. The panel recommended immediate improvement in five areas: youth-serving agency collaboration, treatment system financing, workforce development, the implementation of evidence-based practices, and family involvement in all aspects of treatment. In 2004, the Center for Substance Abuse Treatment (CSAT), part of the Substance Abuse and Mental Health Services Administration (SAMHSA), designed the State Adolescent Substance Abuse Treatment Coordination Grant program (SAC) and implemented it in 2005 to address the critical need in the field. This paper reviews the adolescent substance use disorders treatment system, discusses selected drivers for change and the design of the SAC grant program, and summarizes some of the program's results. Both quantitative and qualitative data analysis document that substantive systems development occurred within each of the sixteen grantees and that federal–state partnerships are useful in creating systemic change.     

The Value of Cultural Adaptation Processes: Older Youth Participants as Substance Abuse Preventionists

This National Institutes of Health (National Institute on Drug Abuse) funded study employed focus groups to explore the value of: (a) engaging youth as experts in their own drug culture to engage them in open, honest discussion around substance use in their communities; and (b) allowing youth within a range of settings to systematically recreate unique workbook and video scenarios while maintaining the core components of an evidence-based substance abuse prevention program. Researchers collaborated with community based agencies that serve high risk youth, including youth who were incarcerated, homeless, in alternative high schools, in low-income housing programs, and on the US-Mexico border. The research indicates that high-risk youth in community settings can be actively engaged in adapting evidence-based prevention curricula. Youth emphasized their reasons for using drugs, as well as the salient consequences, and the value of tailored scenarios that incorporate their life experiences, language, drugs of choice, and relevant motivators. Serendipitous findings noted attitude changes related to dissonance between the adaptation component participants’ behaviors and their input as “Preventionists.” Findings have implications for developing prevention strategies that may be helpful for older, high-risk youth.     

ATOD-TV: A Case Study on Developing Interactive Multimedia

ABSTRACT

ATOD-TV (Alcohol, Tobacco, and Other Drugs-TV), an interactive multimedia program funded by the National Institute on Drug Abuse, was designed to teach the general public about the importance of substance abuse research and treatment. This article examines the process used to develop the program and argues that its success is due more to careful planning and formative evaluation than the use of sophisticated tools and techniques.