This a competing continuation for the grant, """"""""Service Outreach to Homeless Drug Users at HIV Risk."""""""" The parent grant surveyed soup kitchen guests, finding very high rates of cocaine/crack (75%) and substantial rates of heroin/opiate use (20%). However, drug treatment utilization was low; in particular, very few (10% of the primary cocaine/crack users were in treatment or attending 12-step groups. An efficacy trial of an enhanced case management model successfully delivered a variety of entitlements, health and social services to subjects, but resistance to drug treatment was high. To respond to this situation, this application proposes: 1) To implement a Motivation Enhancement for Recovery (MER) group intervention as a means to increase participation of street cocaine/crack users in formal treatment and other credible interventions for drug addiction. 2) To conduct an efficacy trial of a comprehensive model (Service Outreach and Recovery-SOAR) designed to increase participation of street cocaine crack users in treatment and other credible interventions for drug addiction. Subjects will be randomized voluntary into two conditions: 1. SOAR Model-Case Management Team (CMT), Motivational Enhancement for Recovery (MER), and Incentivized Options for Recovery (IOR) (n=120). 2. Case Management Team (CMT) only (n=120). The options for Recovery will be traditional formal treatment modalities (outpatient, residential/TC, inpatient rehabilitation, detoxification); traditional 12-step meetings (Narcotics Anonymous [NA]), alternative 12 step meetings (Recoveries Anonymous [RA]), and a low threshold, harm reduction group therapy (Education and Skills for Recovery); the latter two options will be offered directly by the study. Subjects will receive accelerated incentives of modest amounts to participate in their selected Option for Recovery for us to three months. The primary outcome variables are entry into treatment or other intervention for drug addiction; length of retention in treatment or other intervention; and substance use at 6 and 12 month follow-ups. 3) To determine the client characteristics and service process variables which predict entry to and retention in treatment/interventions for drug addiction, as well as other differences in outcomes.
| Rosenblum, Andrew; Magura, Stephen; Kayman, Deborah J et al. (2005) Motivationally enhanced group counseling for substance users in a soup kitchen: a randomized clinical trial. Drug Alcohol Depend 80:91-103 |
| Nwakeze, Peter C; Magura, Stephen; Rosenblum, Andrew et al. (2003) Homelessness, substance misuse, and access to public entitlements in a soup kitchen population. Subst Use Misuse 38:645-68 |
| Nwakeze, Peter C; Magura, Stephen; Rosenblum, Andrew (2002) Drug problem recognition, desire for help, and treatment readiness in a soup kitchen population. Subst Use Misuse 37:291-312 |
| Magura, S; Nwakeze, P C; Rosenblum, A et al. (2000) Substance misuse and related infectious diseases in a soup kitchen population. Subst Use Misuse 35:551-83 |
