Title of ProjectAffiliated Investigator(s)Project DescriptionContact
Family Training for Concerned Significant Others of Adult Drug/Alcohol UsersKimberly Kirby, PhDIn this NIDA-funded study, adults who were concerned about a treatment-resistant adult loved one with a drug or alcohol problem (concerned significant others/CSOs) were randomly assigned to one of three family-oriented treatments. Counselors completed weekly individual sessions with CSOs to help them learn healthier ways of interacting with their substance using loved one and to assist with the treatment referral process when it was requested by the loved one. Data analyses for this study are presently underway and will determine if the treatments varied in their ability to engage the substance user in treatment and to improve the CSOÕs psychological well-being. The Significant Other Survey-SA, a measure of problems experienced by CSOs, was used in this study and may be of interest to researchers and clinicians who work with this population. A similar NIDA-funded study is presently being conducted by Dr. Kirby and her research team. This study, the Family Training Program for Parents of Adolescents, focuses on helping parents and guardians concerned about their adolescent child who is using marijuana, alcohol, or other drugs.Carolyn Carpenedo, X 140
Survey of Counselors' Attitudes toward Incentive ProgramsKimberly Kirby, PhDThe Provider Survey of Incentives (PSI), a 44-item survey, was developed and validated with 383 treatment providers to assess positive and negative beliefs regarding incentive interventions. Twenty-eight of the 44 items assess beliefs about both tangible and social incentives and 22 of the items are used to calculate two summary scores for tangible and social incentives. Both subscales demonstrated good internal consistency. The coefficient alpha estimate for the tangible subscale was .92, and the average item-total correlation was .56 (range = .39 - .75). The coefficient alpha for the social subscale was .90, and the average item-total correlation was .52 (range = .39 Ð .70).Carolyn Carpenedo, X 140
Treatment Administrators' Views of Empirically Supported Drug Abuse TreatmentLois Benishek, PhDFinancial concerns and limited resources for staff training are barriers to introduction of empirically supported drug abuse treatments (ESTs), according to this survey of clinical administrators conducted with funding from the Pennsylvania Department of Health and the National Institute on Drug Abuse. The survey was designed to 1) assess administratorsÕ knowledge of and attitudes toward ESTs versus treatments with little empirical support (ie, 12-step programs), 2) assess change in attitudes and willingness to implement ESTs after introduction of educational material, 3) investigate the extent to which administratorsÕ characteristics are associated with changes in their attitudes and willingness to implement ESTs, and (d) understand perceived barriers to and methods for integrating ESTs into existing outpatient treatment programs. Administrator subjects were surveyed prior to and after reading information about five treatments with varying levels of empirical support: contingency management (CM); relapse prevention, motivational interviewing, 12-step, and verbal confrontation. Results indicate that 1) knowledge of ESTs increased following the readings, 2) changes in the knowledge of ESTs did not translate into changes in beliefs about whether or not the intervention should be routinely used, and 3) financial concerns and limited resources for staff training are frequently reported barriers to implementing ESTs (CM). Carolyn Carpenedo, X 140
Motivational Incentives to Enhance Drug Abuse RecoveryKimberly Kirby, PhDResearch shows that tangible rewards for drug-free urine samples reliably increase treatment retention and drug abstinence, but that applying incentives in practice is often prohibitively expensive for clinics. This study, part of a multisite trial under NIDAÕs Clinical Trials Network, tested a less expensive reward system with cocaine-using patients in drug-free and methadone maintenance clinics. Through lottery drawing patients were given a 1:2 chance to earn low-cost items each time they submitted a cocaine-free urine, with substantially lower chance of earning a larger or a grand prize. In the drug-free outpatient settings, the incentive procedure cost an average of $68/month/participant and was efficacious in improving retention and abstinence outcomes. In the methadone clinics, at an average cost of $40/month/participant, similar improvements in abstinence rates were noted. Attendance rates were unchanged in the methadone group where rates of treatment attendance are typically high.Carolyn Carpenedo, X 140
Community Reinforcement through Religious CommunitiesKimberly Kirby, PhDResearch has shown that individuals with influence over drug users can be trained to provide and withdraw rewards for abstinence, with corresponding improvement in patient rates of treatment entry and reduction in drug use. The usefulness of this Community Reinforcement Approach (CRA) is limited because many patients are not willing to involve family members in treatment or are socially isolated from their families, and because it requires considerable training and behavioral change on the part of counselors. This NIDA-funded project evaluated an adaptation of CRA, ÒCRESTÓ or ÒCommunity Reinforcement Employing Spiritual TeamsÓ where members of religious communities act as surrogates when it is not feasible for family members or significant others to assume this role. The initial study involved 18 African-American, cocaine-abusing women in residential treatment randomly assigned to 1) standard, drug-free treatment-as-usual; or 2) standard treatment-as-usual enhanced by pairing with volunteer mentors from the Bridges to the Community (BTC) program. At six months post-assignment, women in the BTC-enhanced group had significantly better treatment retention and less cocaine use than women receiving treatment-as-usual. A subsequent Behavior Therapy Development Grant from NIDA is specifying and enhancing the new CREST intervention using the principles of CRA.Carolyn Carpenedo, X 140
Credentialing Requirements of Substance Abuse and Mental Health CounselorsMaryLouise Kerwin, PhDStates are more likely to require mental health counselors to obtain training through formal education than substance abuse counselors according to this survey of 50 state governments and the District of Columbia. Compared to training and credentialing requirements for mental health counselors, states were more likely to allow substance abuse counselors learn on-the-job through ÒapprenticeÓ programs and less likely to require certification or licensure. States also required fewer hours of formal coursework and practicum courses for substance abuse counselors, more hours of supervised work experience, and lower educational requirements.Carolyn Carpenedo, X 140
A Behavioral Model for Maintenance of Drug AbstinenceKimberly Kirby, PhDThis NIDA-funded study tested the hypothesis that extended periods of abstinence are required before naturally-occurring reinforcers of positive health behavior are sufficiently developed to sustain behavior change. The study involved cocaine abusing subjects from a community methadone maintenance program assigned to 1) a standard schedule of contingency management involving a 12-week escalating schedule of reinforcement (vouchers redeemed for goods and services) for providing cocaine-negative urine specimens followed by a 12-week aftercare phase, or 2) an extended 36-week escalating schedule of reinforcement followed by a 12-week aftercare phase. Analyses indicated that providing a longer duration of voucher reinforcement resulted in longer durations of continuous drug abstinence during the intervention. In addition, longer durations of continuous drug abstinence in the first year of the study predicted better longer-term abstinence outcomes.Carolyn Carpenedo, X 140
An Interview for Family Members of Drug UsersKimberly Kirby, PhDA self-administered instrument, The Significant Others Checklist (SOC) and a structured interview, the Significant Other Survey (SOS) assessing the multiple problems of family members of adult drug users was developed and underwent reliability and validity testing in this NIDA-funded project. The survey is useful in assessing the prevalence and type of problems of family members of drug users, as an assessment tool for researchers and clinicians, and to provide information to healthcare providers and policy makers for making decisions involving drug abuse and families. In addition to the base instrument, one measuring lifetime issues is available as is a self-administered version.Carolyn Carpenedo, X 140
Performance Based Purchasing in the Delaware Treatment SystemDeni Carise, PhDA performance based purchasing system for substance abuse treatment services was developed by the State of Delaware with assistance from TRI investigators. Team members helped State officials and treatment providers introduce a performance-based contracting system rewarding providers able to increase capacity utilization and rates of retention in treatment.Carolyn Carpenedo, X 140
Reducing Paperwork Burdens of Outpatient Treatment Providers in DelawareDeni Carise, PhDAs part of a NIDA-funded grant to expand DelawareÕs performance monitoring/contracting procedures over four phases, TRI completed a systematic evaluation of the multiple data collection demands placed upon state-funded outpatient treatment providers. TRIÕs recommendations were adopted and resulted in decreases in paperwork burden at admission, during ongoing treatment and at discharge.Carolyn Carpenedo, X 140
Concurrent Recovery Monitoring in DelawareDeni Carise, PhDIn this NIDA R21 Exploratory Grant, Dr. Carise collaborated with Delaware agency staff and outpatient treatment providers to extend the performance-based contracting system already in place. During the two-year pilot project the team: 1) completed a systematic evaluation of the Òpaperwork burdenÓ in each treatment program with the goal of removing unnecessary and burdensome requirements and consolidating others; 2) selected a small number of additional performance indicators for regular collection within the existing outpatient performance monitoring/contracting system; 3) pilot tested the data collection, recording and reporting procedures for these additional CRM measures to assess feasibility and usefulness to the treatment programs; and 4) used the results of this work to submit further proposals to evaluate evidence-based practices and to further develop the statewide CRM system.Carolyn Carpenedo, X 140
Betty Ford Center: Focused Continuing CareDeni Carise, PhDAn existing extended care model, ÒFocused Continuing CareÓ or ÒFCCÓ was standardized to simplify training and improve client engagement. The frequency of post-discharge telephone contact was increased with more emphasis on follow-up contact rates. Other changes engage clients and their families in the recovery process by providing graphic reports illustrating clinical progress and Ònext stepsÓ toward recovery. Development of a data collection/reporting infrastructure allowing Betty Ford counselors to assess results of future FCC changes is underway.Carolyn Carpenedo, X 140
NIDA/SAMHSA-ATTC Blending Initiative: ASI Based Treatment PlanningDeni Carise, PhDWith A. Thomas McLellan, Ph.D. and Senior Products Manager Meghan Love, Dr. Carise led a NIDA research team in collaboration with SAMHSA/CSAT and the Mid-Atlantic, Mountain West and Gulf Coast ATTCs to develop a comprehensive training package on treatment planning. The training teaches counselors and clinical managers to transform the ASI assessment process into a clinically useful exercise by using results to identify client problems, develop individual treatment plans, make referrals matched to client needs, and monitor treatment outcomes ad/or client retention. The package includes a face-to-face and online training curriculum, accompanying instructional CD, and electronic reference and resource kit.Carolyn Carpenedo, X 140
DENSTM: Drug Evaluation Network SystemDeni Carise, PhDAn ASI-based, computerized patient assessment system linking client assessment with treatment planning was developed with partial funding from the White House Office on National Drug Control Policy and is now installed in numerous state- and agency-based systems and Veterans Administration programs, as well as in several international sites including Ireland, Thailand, Scotland, Sweden and others.Carolyn Carpenedo, X 140
United Nations Office on Drugs & Crime TreatNet Project Ð An International Network of Drug Dependence Treatment and Rehabilitation CentersDeni Carise, PhD; Mady Chalk, PhDTRIÕs Deni Carise and Mady Chalk worked to build capacity among the twentyTreatment and Rehabilitation Resource Centers established by the United Nations as repositories for the exchange of knowledge about drugs, treatment methods and organizational development. Primary targets were the service providers (physicians, psychiatrists, psychologists, counselors, social workers, case workers, etc.), service managers, planners, and trainers working at the Centers. TRIÕs work focused on the twelve centers in disadvantaged regions (Brazil, Colombia, China, Egypt, India, Indonesia, Iran, Kazakhstan, Kenya, Mexico, Nigeria, and Russia) where Carise and Chalk led development of training packages for Screening, Assessment and Treatment Planning and training of 40 trainers from the national sites. Carise was also responsible for leading translations and cultural adaptations of assessment and treatment planning instruments.Carolyn Carpenedo, X 140
Role of Judicial Status Hearings in Drug CourtDoug Marlowe, JD, PhDIn this groundbreaking study funded by NIDA and CSAT, drug court defendants were randomly assigned to attend court hearings either biweekly or as needed when they encounter problems in the program. Otherwise, all participants received the same treatment, urinalyses, rewards and sanctions. Findings indicated that Òhigh-riskÓ clients (i.e., antisocial personality disorder [APD] or previous failure in drug abuse treatment) had substantially better outcomes when required to attend more frequent status hearings. In contrast, Òlow-riskÓ clients performed equally well or better when they were required to only attend hearings as needed. The findings were reproduced in several adult felony and misdemeanor drug courts located in both urban and rural communities and further supported in a prospective study in which clients were matched to dosage of judicial status hearings based on their risk status.Thea Musselman, X 148
Role of Judicial Status Hearings in Drug Court (October 2009 Update)Douglas Marlowe, JD, PhDTRI prospectively matched misdemeanor drug court clients to the optimal schedule of status hearings based on risk status, and compared outcomes to treatment as usual. Results confirmed that participants who were high risk and matched to biweekly hearings had better during-treatment outcomes than participants assigned to status hearings as usual. High-risk participants graduated at a higher rate, provided more drug-negative urine specimens at 6 months post-admission, and reported significantly less drug use and alcohol intoxication at 6 months post-admission when they were matched to bi-weekly hearings as compared to the usual schedule of hearings. These findings provide confirmation of the risk principle in drug courts and yield practical information for enhancing the efficacy and cost-efficiency of drug courts. Following this line of research, an ongoing study (see Adaptive Services in Drug Court) is examining the incremental utility gained by re-adjusting the dosage of both court hearings and clinical case-management sessions in response to participantsÕ on-going performance in the program.Thea Musselman, X 148
Detection, Advice, Referral to Treatment ("DARTS")Amy Mericle, PhD; David Festinger, PhD; Steven Belenko, PhDThe goal of this pilot project funded by the Robert Wood Johnson Foundation was to improve access to health and social services among vulnerable populations by training Public Defenders (PDs) in Pennsylvania to identify clients with substance abuse or dependence and link them to appropriate substance abuse, health, legal, and other social services. Among the many things accomplished was development and evaluation of PD procedures (based on a regional PD survey and a drug use screening developed by the World Health Organization); and production of a DARTS manual (A Guide for Public Defenders to Assist Clients With Alcohol and Drug Problems) and a PD training curriculum. Researchers used the CASPAR Resource Guide that TRI developed as part of prior research efforts under the direction of Deni Carise, Ph.D.Thea Musselman, X 148
Impact of Proposition 36-Like Diversion ProgramsDoug Marlowe, JD, PhDMarlowe and NADCP colleagues submitted briefings to California policy makers citing empirical evidence of higher recidivism rates and return to drug use for some offenders diverted into treatment programs with minimal judicial supervision. California Governor SchwarzeneggerÕs FY 2006 budget and message embraced the recommendations, proposing a series of reforms to the Proposition 36 program, including mandatory drug testing, use of Òdrug court modelsÓ and judicial authority to impose jail sentences.Thea Musselman, X 148
Conference on Evidence-Based Interventions for Crime & AddictionsSteven Belenko, PhD; Harry Wexler, PhDWith funding from the Robert Wood Johnson Foundation, Drs. Belenko and Wexler hosted a multidisciplinary conference of practitioners, researchers and policy makers to discuss treatment interventions for substance-abusing offenders, emphasizing feasibility, sustainability, dissemination and policy development. Read Conference Report. The goal of CEICA was to place equal emphasis on research and practice, explicitly focus on implementation and sustainability of evidence based practices in criminal justice treatment, and be sufficiently balanced in representing the views of researchers, practitioners, policy makers, and clients.Thea Musselman, X 148
Legality of Court-Imposed Sanctions in Family Dependency HearingsDoug Marlowe, JD, PhDAn Amicus Curiae brief authored by Marlowe and colleagues on behalf of NADCP and its California Chapter cites research findings suggesting that graduated sanctions, including the threat of jail detention, are necessary to the success of family dependency courts. Reunification models with minimal judicial intervention fail to improve patient outcomes or enhance exposure to treatment according to the brief filed before the California Supreme Court in re Olivia J. and Otis J. v. San Diego County Health & Human Services Agency, objecting to the brief imposition of jail sanctions in dependency proceedings. Download Brief.Thea Musselman, X 148
Ethics of Participant Payment in Substance Abuse ResearchDavid Festinger, PhDOutpatient substance abuse clients were randomly assigned to receive cash payments of $10, $40, or $70, or the equivalent in gift certificates. Results indicated that neither mode nor magnitude of payment differentially affected rates of new drug use or participantsÕ perceptions of coercion, but that larger-magnitude cash payments were associated with higher follow-up rates and reduced tracking efforts. A subsequent NIDA-funded study examined these effects with even higher magnitude research payments ($100, $130, and $160) in either cash or gift certificates. Findings revealed that neither the magnitude nor mode of payment had a significant effect on new drug use or perceived coercion. Consistent with previous findings, higher payments and cash payments resulted in significantly higher follow-up rates and fewer tracking calls. In addition, participants receiving cash vs. gift cards were more likely to use their payments for essential, non-luxury purchases. Follow-up rates for participants receiving cash payments of $100, $130, and $160 approached or exceeded the FDA required minimum of 70% for studies to be considered in evaluations of new medications. This suggests that the use of higher magnitude payments and cash payments may be effective strategies for obtaining more representative follow-up samples without increasing new drug use or perceptions of coercion.Thea Musselman, X 148
Economic Benefits of Substance Abuse TreatmentSteven Belenko, PhD In a comprehensive empirical review, Belenko and others found that substance abuse treatment, especially when evidence-based, results in clinically significant reductions in alcohol and drug use and criminal activity. Economic studies consistently show positive economic benefits of treatment, including reduced crime and associated incarceration savings and lower victimization rates.Thea Musselman, X 148
Improving the Ethics of Consent in Drug Abuse ResearchDavid Festinger, PhDThis randomized study examined the effectiveness of two novel informed consent procedures to improve comprehension and information retention among criminally involved, substance-abusing research subjects. In the corrected feedback procedure, participantsÕ recall of consent information at various intervals was tested and erroneous responses corrected. In the research intermediary procedure, a neutral third party intervened on behalf of participants. Findings revealed that corrected feedback led to significant increases in recall of consent information. The intermediary procedure led to reductions in perceived coercion but had no effect on understanding or recall. Despite the significant effects of corrected feedback, participants receiving this intervention recalled an average of only 65% of the consent information with cognitive and intellectual factors explaining only a portion of the variance in consent recall. This suggests that remedial interventions alone may be insufficient to facilitate adequate learning and recall of consent information.Thea Musselman, X 148
Services Research on Sanctions & Reward in Drug CourtDoug Marlowe, JD, PhDThis study experimentally examined the effects of adapting a tangible incentive program for use within a felony pre-adjudication drug court. Participants earned gift certificates at each court hearing where staff determined they were compliant in the program. Participants in one condition earned gift certificates gradually escalating by $5.00 increments. In a second condition they began by earning higher magnitude gift certificates on a continuous schedule, tapering to intermittent schedules over time. In a randomized comparison against drug court as usual, no main effects were detected. This appears to have been attributable to a ceiling effect from the programmatic contingencies and intensive monitoring and treatment already delivered in the drug court, and possibly also to the low density of reinforcement in the experimental interventions. However, pre-planned interaction analyses suggested high-risk participants who had more serious criminal backgrounds or were younger may have performed better in the incentive conditions. Although the magnitude of the effects were small, if these preliminary findings are replicated this could suggest that tangible incentive programs may be best suited for incorrigible drug offenders not predisposed to respond adequately in traditional court-monitored programs.Thea Musselman, X 148
Narcotics on the InternetDavid Festinger, PhDThis NIDA-funded study expanded upon TRIÕs original Internet pharmacies project. In this study, the team tested a wider variety of search terms to assess the prevalence of websites where controlled substances may be purchased without a prescription. A database with descriptive information for all ÒOpioid No Prescription DrugsÓ was developed.Thea Musselman, X 148
STI/HIV Risk, Services, Drug Use for Young ArresteesSteven Belenko, PhDThis project implemented an assessment and urine screening protocol for the Sexually Transmitted Infections (STI) chlamydia and gonorrhea in the Hillsborough County (FL) Juvenile Assessment Center (JAC); analyzing relationships among drug use, sex risk behaviors and STI infection rates; and identifying STI-related service needs and impediments to expanding STI testing and treatment services. Data from an Intake Assessment and STI urine tests were collected from a sample of 900 eligible delinquent youth consecutively admitted to the JAC (stratified to yield 450 females). Organizational data was drawn from juvenile justice and service provider records, geocoded data on infections and health service locations, and 40 staff interviews. Follow-up data on STI treatment and retesting was collected from the Hillsborough County Health Department for STI-positive participants.Thea Musselman, X 148
Services Research on Sanctions & Rewards in Drug CourtDoug Marlowe, JD, PhDDrug court clients were randomly assigned to receive sanctions for infractions, rewards for accomplishments, or both. The study isolated the operative effects of each by examining participantsÕ drug and alcohol use, criminal recidivism, and psychosocial functioning monthly during treatment and at six and 12 months post-admission to drug court. Preliminary findings suggested that augmented positive rewards may help clients achieve treatment goals more quickly, and that clients with specific risk factors (i.e., younger age, criminal history, psychopathy) achieved better outcomes when assigned to the enhanced rewards conditions.Thea Musselman, X 148
Effects of Youth Exposure to Drug-Related WebsitesSteven Belenko, PhDSecondary examination of the dataset for the National Survey of Parents and Youth enabled comparisons of the characteristics and correlates of youth who view anti-drug and pro-drug websites, and guide future research about how internet experiences affect initiation into and desistance from marijuana use. The study addressed two exploratory hypotheses: 1) youth who view anti-drug, pro-drug, and neither type of website will be distinguished by significant differences in level of risk, peer norms, parental behaviors, prior drug use, and exposure to other types of media messages, and 2) exposure to internet drug websites affects initiation of and desistance from marijuana use.Thea Musselman, X 148
e-Court: Technology Transfer and Integrated Systems in Drug CourtsSteven Belenko, PhDSince the inception of the drug court concept, advocates have promoted the use of offender-level information as a means to adjust treatment and accountability requirements. The Department of JusticeÕs Office of Justice Programs (OJP) provided supplemental funding to the NIDA CJ-DATS project to examine issues related to development and implementation of a web-based MIS that facilitates data collection, information sharing, and performance monitoring by judges, prosecutors, defenders, case managers, treatment providers, and others. NIDAÕs goal, consistent with the vision for CJ-DATS, is to improve understanding of how systematic information on offender needs impacts outcomes. OJP and NIDA have agreed that the availability of a performance-focused MIS is one step in the process. More important from NIDAÕs perspective is the ability to understand how drug court programs (and systems) use MIS not just to monitor offender compliance but also in integrating drug court and drug treatment services. This study provided a platform to test technology transfer approaches for implementing and using a comprehensive and well-designed web-based management information system in OJP-funded drug courts.Thea Musselman, X 148
Monitoring & Feedback in Substance Abuse TreatmentJohn Cacciola, PhDIn substance abuse treatment, although monitoring and feedback approaches have been recommended and many lines of evidence support their potential value, none has been formally evaluated in standard outpatient treatment. The specific aims of this three-year NIDA grant are to conduct a three-staged study to develop and evaluate a monitoring instrument and associated intervention, using a web-based recovery system, as follows: Stage 1 - Develop and determine the reliability, validity, and sensitivity to change of a brief Multidimensional Monitoring Instrument (MMI) for clients in substance abuse treatment; Stage 2 - Develop a Monitoring and Feedback Intervention (MFI) and treatment manual/training materials that use the MMI, and conduct a feasibility study to refine the intervention; Stage 3 - Conduct a randomized clinical trial to determine the preliminary efficacy of the MFI compared to treatment as usual (TAU). The intervention (MFI) is an approach that counselors can easily incorporate into their usual practice with minimal training. The MFI has the potential to be portable, practical and sustainable. Future work could establish benchmarks and data could be fed back to supervisory personnel as well as to the treating clinician, and quality improvement efforts could be initiated and evaluated. Finally, the monitoring instrument (MMI) could aid evaluators and researchers in evaluating the course of clients' change during treatment and their discharge status across treatment organizations or experimental conditions.Graham DiGuiseppi, X 133
Concurrent Recovery Monitoring, State of DelawareDeni Carise, PhD; Adam Brooks, PhD; Amy Mericle, PhD; Meghan LoveAn exploratory NIDA-funded R21 grant aimed to develop, pilot, and disseminate a series of clinical questions useful for counselors, treatment providers, and payers to monitor the recovery process in the state of Delaware. The Department of Substance Abuse and Mental Health (DSAMH), TRI, and state-funded outpatient substance abuse treatment providers collaborated to complete a systematic evaluation of the Òpaperwork burdenÓ in each treatment program. Multiple, competing data collection demands were examined with the goal of removing unnecessary and burdensome requirements and consolidating others; a small number of additional performance indicators were selected for regular collection within the existing outpatient performance monitoring/contracting system; data collection, recording, and reporting procedures were pilot tested for these additional concurrent recovery monitoring (CRM) measures to assess their feasibility and their usefulness to the treatment programs. The results of this work have been utilized to submit further proposals (to DSAMH and NIDA) to evaluate evidence-based practices and to further develop the statewide CRM system.Graham DiGuiseppi, X 133
NQF Treatment StandardsMady Chalk, PhD; Richard Rawson, PhD; Jack KempTRI and the University of CaliforniaÐLos Angeles convened stakeholder workshops to disseminate information about the National Quality Forum standards for treatment of substance use disorders and explore implementation issues in public and private sector treatment systems. The project was funded by grant from the Open Society Institute. A workshop for states was hosted by TRI in September 2010 and attended by representatives of 25 states.Kelly Alanis-Hirsch, X 180
Program to Integrate Substance Use Issues into Mainstream Health Care ("PRISM")A. Thomas McLellan, PhD; Barbara Turner, MDLaunched in 2002 by TRI and the University of Pennsylvania School of Medicine, this groundbreaking project sought to engage doctors and other primary care specialists in patient substance use issues by demonstrating that the course, treatment and outcomes of many common medical conditions could be affected by drinking and drug taking, even at levels below the threshold for addiction. In 2006, persuaded by still-emerging findings, four of the nationÕs most respected medical societies joined the project. By 2008, final project results were replete with evidence of the effects of alcohol and other drug use on chronic medical conditions.Kelly Alanis-Hirsch, X 180
Advancing RecoveryMady Chalk, PhD Under a grant from the Robert Wood Johnson Foundation, TRI and the Network for Improvement of Addiction Treatment (NIATx) co-directed ÒAdvancing Recovery: State Provider Partnerships for Quality Addiction Care.Ó The project provided technical assistance and coaching to competitively selected partnerships of state agencies and treatment providers to increase the use of evidence-based administrative and clinical practices in addiction treatment.Kelly Alanis-Hirsch, X 180
Educating State Legislators on the Outcomes of Addiction Treatment and Approaches to Measuring PerformanceA. Thomas McLellan, PhD; Mady Chalk, PhD; Deni Carise, PhD; Doug Marlowe, JD, PhDIn 2009 this SAMHSA-funded project ended its final phase of bringing scientists to State capitols to discuss ways the quality of addiction treatment can be improved through performance measurement. The many topics covered at these locally-designed briefings included monitoring outcomes of expenditures, tracking return on investment, re-directing savings through cost-offset studies, developing performance-based contracting systems, and improving purchasing practices. Funded under Partners for Recovery through Abt Associates, the project was led by the State Associations of Addictions Services with TRI and NCSL.Kelly Alanis-Hirsch, X 180
COMAT (Center on the Organization and Management of Addiction Treatment)A. Thomas McLellan, PhD; Constance Pechura, PhD; John Kimberly, PhD (Wharton at Upenn); Mady Chalk, PhDMulti-year, collaborative project between TRI and the Wharton School at the University of Pennsylvania sponsored conferences, policy maker meetings, and publications examining the ÒbusinessÓ of addiction treatment in the U.S.
Adolescent Brain DevelopmentKen Winters, PhDScience shows that brain development is still in progress during adolescence, and that immature brain structures may place teenagers at elevated risk of substance abuse and arrested brain development.Bonnie Catone, X 100
Keep Internet Neighborhoods Safe: Preventing Internet Sales of Controlled Substances to YouthA. Thomas McLellan, PhDJoining the Harvard Law SchoolÕs Center for International Criminal Justice; Drug Strategies; OpenAir; and the Weill Medical Center of Cornell University, TRI helped lead a public/private sector consortium of more than fifty organizations dedicated to developing new strategies to curtail Internet drug trafficking. Work of the coalition was based on TRI research in 2004 demonstrating the ease with which cyber-savvy teenagers could purchase drugs from rogue Internet pharmacies. A. Thomas McLellan subsequently testified on the subject before Congress (in 2007).Bonnie Catone, X 100