Examination of referral source and retention among women in residential substance use disorder treatment: a prospective follow-up study

Substance Abuse Treatment, Prevention, and Policy

Donna Dueker¹  Hortensia Amaro²  Dean Rivera³ 

[1] Department of Health Sciences, California State University, Dominguez Hills, 1000 East Victoria Street, 90747, Carson, CA, USA;Herbert Wertheim College of Medicine and Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC 5, 33199, Miami, FL, USA;Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W. 34th Street, MRF 214, 90089, Los Angeles, CA, USA;

关键词: Substance use disorder;    Mandated residential treatment;    Treatment retention;    Women;    Co-occurring disorder;   

DOI  :  10.1186/s13011-021-00357-y

来源: Springer

【 摘 要 】

BackgroundCourt-mandated substance use disorder (SUD) treatment, as compared to nonmandated treatment, has been associated with increased retention and completion. However, whether child protective services (CPS)-mandated women’s residential SUD treatment leads to improved treatment retention in comparison to criminal justice (CJ)-mandated and nonmandated treatment remains unclear.PurposeThis study compared the number of days retained in residential SUD treatment among three referral sources (CPS, CJ, and nonmandated), while also examining whether having a co-occurring mental health disorder or increased stress, depression, anxiety, and PTSD symptomology contributed to decreased retention. This study tested the hypothesis that women mandated by the CPS and CJ systems would have improved residential SUD treatment retention compared with nonmandated women.MethodsMultiple regression analyses were conducted on data for a diverse sample of 245 women (Hispanic: N = 141, Black: N = 50, White: N = 50) mandated or nonmandated (CJ: N = 114, CPS: N = 82, nonmandated: N = 49) into residential SUD treatment to determine each group’s treatment retention outcomes. Results: Women mandated to SUD residential treatment by the CPS system remained in treatment significantly longer (p = .046), compared to women not mandated, representing a 34.4% increase in retention. Findings further revealed a corresponding 2.3% decrease in retention (p = .048) for each one-unit increase in a patient’s stress score, whereas those with a co-occurring mental health diagnosis had a 43.6% decrease in SUD treatment retention (p < .001).ConclusionsPolicy and clinical considerations include (a) increasing case management support and wraparound services that meet the multiple service needs of women who are nonmandated to residential SUD treatment, and (b) incorporating a more nuanced treatment approach that manages mental health disorders and stress symptomology early in treatment when women are most vulnerable to relapse and treatment dropout.Trial registrationClinicalTrials.gov Identifier: NCT02977988 (first posted November 30, 2016; last update posted October 7, 2019); U.S. NIH Grant/Contract: 5R01DA038648.

【 授权许可】

CC BY