The proposed study has two overall goals. First, it will monitor changes in treatment practices in the nation's outpatient drug abuse treatment units to determine the extent to which they are meeting known or desired standards of care. Information will be gathered on several important treatment practices, including: treatment duration and intensity; clients' use of primary health care, mental health care, and social services; HIV prevention practices; availability of special services for women and ethnic minorities; and methadone dose levels. Second, this study will examine how key organizational and community factors (e.g., unit ownership) account for change and variation in treatment practices. For example, how are various managed care arrangements affecting treatment duration and intensity, and clients access to social and health services? To achieve these goals, the National Drug Abuse Treatment System Survey (NDATSS) will be continued in 1999. The 1999 data will give us a current picture of treatment practices across the nation (n=600 treatment units). Further, with the addition of the 1999 survey, we will have data from a representative national sample of outpatient nonmethadone and methadone units for 1988, 1990, 1995, and 1999. The majority of treatment units to be included in the 1999 sample (n=387) have already participated in NDATSS in 1988, 1990, and 1995. Thus, we will be in a strong position to monitor changes in treatment practices over a decade (1988-1999), and to make causal inferences about these changes that can inform both policy and practice.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
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Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Hilton, Thomas
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University of Chicago
Schools of Social Work
United States
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Chuang, Emmeline; Wells, Rebecca; Alexander, Jeffrey et al. (2013) How outpatient substance abuse treatment unit director activities may affect provision of community outreach services. Drugs (Abingdon Engl) 20:149-159
Chuang, Emmeline; Wells, Rebecca; Alexander, Jeffrey A (2011) Public managed care and service access in outpatient substance abuse treatment units. J Behav Health Serv Res 38:444-63
Friedmann, Peter D; Jiang, Lan; Alexander, Jeffrey A (2010) Top manager effects on buprenorphine adoption in outpatient substance abuse treatment programs. J Behav Health Serv Res 37:322-37
Campbell, Cynthia I; Alexander, Jeffrey A; Lemak, Christy Harris (2009) Organizational determinants of outpatient substance abuse treatment duration in women. J Subst Abuse Treat 37:64-72
Chuang, Emmeline; Wells, Rebecca; Alexander, Jeffrey A et al. (2009) Factors Associated With Use of ASAM Criteria and Service Provision in a National Sample of Outpatient Substance Abuse Treatment Units. J Addict Med 3:139-50
Nahra, Tammie A; Alexander, Jeffrey; Pollack, Harold (2009) Influence of ownership on access in outpatient substance abuse treatment. J Subst Abuse Treat 36:355-65
Alexander, Jeffrey A; Wells, Rebecca (2008) How do resource dependencies affect treatment practices? The case of outpatient substance abuse treatment programs. Med Care Res Rev 65:729-47
Pollack, Harold A; D'Aunno, Thomas (2008) Dosage patterns in methadone treatment: results from a national survey, 1988-2005. Health Serv Res 43:2143-63
Basu, Anirban; Paltiel, A David; Pollack, Harold A (2008) Social costs of robbery and the cost-effectiveness of substance abuse treatment. Health Econ 17:927-46
Alexander, Jeffrey A; Wells, Rebecca; Jiang, Lan et al. (2008) Organizational determinants of boundary spanning activity in outpatient substance abuse treatment programmes. Health Serv Manage Res 21:168-77

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