Although several long-term studies of alcoholism and drug disorders in the general population exist, the long-term course of substance use disorder in patients with severe mental illness (i.e., dual diagnosis) is largely unknown. We have currently followed 223 adults with dual diagnosis in the New Hampshire Dual Diagnosis Study for 6-7 years with minimal attrition (85 percent with nearly complete data). By extending the study to 10 years of follow-up, the proposed project will yield unique data on the pattern, stability, prediction, timing, and correlates of remissions of substance use disorder in this population. We will also be able to examine treatment costs longitudinally. The 10- year data will allow us to chart the course of abstinence, asymptomatic use, remission, and recovery in dual-diagnosis patients. The study will increase our understanding of the relationships among substance disorder, clinical outcomes, and service costs. Longitudinal data will also allow us to examine several hypotheses from the literature regarding the effects of treatment and non-treatment experiences on the course of substance use disorder in this population. Specifically, we will examine response to new medications (such as olanzapine and naltrexone), prolonged intervals of close supervision (e.g., parole, conditional discharge, or living in a supervised setting), participation in peer support groups (such as dual-diagnosis groups or Alcoholics Anonymous), new sources of hope (like marriage, work, or religion), and medical illnesses related to substance disorder (e.g., gastritis). The results will be of interest to policy makers in many states that are replicating the model of integrated dual-diagnosis services that has been used in New Hampshire since 1988.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH059383-03
Application #
6330317
Study Section
Services Research Review Committee (SER)
Program Officer
Oliver, Karen Anderson
Project Start
1998-12-01
Project End
2002-11-30
Budget Start
2001-01-01
Budget End
2001-11-30
Support Year
3
Fiscal Year
2001
Total Cost
$225,114
Indirect Cost
Name
Dartmouth College
Department
Psychiatry
Type
Schools of Medicine
DUNS #
041027822
City
Hanover
State
NH
Country
United States
Zip Code
03755
Bush, Philip W; Drake, Robert E; Xie, Haiyi et al. (2009) The long-term impact of employment on mental health service use and costs for persons with severe mental illness. Psychiatr Serv 60:1024-31
Xie, Haiyi; McHugo, Gregory J; Drake, Robert E (2009) Subtypes of clients with serious mental illness and co-occurring disorders: latent-class trajectory analysis. Psychiatr Serv 60:804-11
Brunette, Mary F; Drake, Robert E; Xie, Haiyi et al. (2006) Clozapine use and relapses of substance use disorder among patients with co-occurring schizophrenia and substance use disorders. Schizophr Bull 32:637-43
Drake, Robert E; McHugo, Gregory J; Xie, Haiyi et al. (2006) Ten-year recovery outcomes for clients with co-occurring schizophrenia and substance use disorders. Schizophr Bull 32:464-73
Xie, Haiyi; Drake, Robert; McHugo, Gregory (2006) Are there distinctive trajectory groups in substance abuse remission over 10 years? An application of the group-based modeling approach. Adm Policy Ment Health 33:423-32
Drake, Robert E; Wallach, Michael A; Alverson, Hoyt S et al. (2002) Psychosocial aspects of substance abuse by clients with severe mental illness. J Nerv Ment Dis 190:100-6