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Addiction Severity (addiction + severity)

Distribution by Scientific Domains
Medical Sciences80%

Terms modified by Addiction Severity

  • addiction severity index
    		•

    Selected Abstracts

    Primary Care Quality and Addiction Severity: A Prospective Cohort Study

    HEALTH SERVICES RESEARCH, Issue 2 2007
    Theresa W. Kim
    Background. Alcohol and drug use disorders are chronic diseases that require ongoing management of physical, psychiatric, and social consequences. While specific addiction-focused interventions in primary care are efficacious, the influence of overall primary care quality (PCQ) on addiction outcomes has not been studied. The aim of this study was to prospectively examine if higher PCQ is associated with lower addiction severity among patients with substance use disorders. Study Population. Subjects with alcohol, cocaine, and/or heroin use disorders who initiated primary care after being discharged from an urban residential detoxification program. Measurements. We used the Primary Care Assessment Survey (PCAS), a well-validated, patient-completed survey that measures defining attributes of primary care named by the Institute of Medicine. Nine summary scales cover two broad areas of PCQ: the patient,physician relationship (communication, interpersonal treatment, thoroughness of the physical exam, whole-person knowledge, preventive counseling, and trust) and structural/organizational features of care (organizational access, financial access, and visit-based continuity). Each of the three addiction outcomes (alcohol addiction severity (ASI-alc), drug addiction severity (ASI-drug), and any drug or heavy alcohol use) were derived from the Addiction Severity Index and assessed 6,18 months after PCAS administration. Separate longitudinal regression models included a single PCAS scale as the main predictor variable as well as variables known to be associated with addiction outcomes. Main Results. Eight of the nine PCAS scales were associated with lower alcohol addiction severity at follow-up (p,.05). Two measures of relationship quality (communication and whole- person knowledge of the patient) were associated with the largest decreases in ASI-alc (,0.06). More whole-person knowledge, organizational access, and visit-based continuity predicted lower drug addiction severity (ASI-drug: ,0.02). Two PCAS scales (trust and whole-person knowledge of the patient) were associated with lower likelihood of subsequent substance use (adjusted odds ratio, [AOR]=0.76, 95 percent confidence interval [95% CI]=0.60, 0.96 and AOR=0.66, 95 percent CI=0.52, 0.85, respectively). Conclusion. Core features of PCQ, particularly those reflecting the quality of the physician,patient relationship, were associated with positive addiction outcomes. Our findings suggest that the provision of patient-centered, comprehensive care from a primary care clinician may be an important treatment component for substance use disorders. [source]

    Coping style of substance-abuse patients: Effects of anxiety and mood disorders on coping change

    JOURNAL OF CLINICAL PSYCHOLOGY, Issue 3 2001
    Ingmar H.A. Franken
    The authors studied the coping style of substance-abuse patients during clinical cognitive-behavioral group therapy, and the effects of mood and anxiety disorders on changes in coping style. Change in coping style was studied prospectively in a cohort of 132 residential-drug-abuse patients. In addition to pretreatment assessments, which included diagnosis of mood and anxiety disorders and addiction severity, repeated measurements of coping style were performed at predetoxification, pretreatment, and after three and six months of treatment. Considerable change in coping style between predetoxification and pretreatment was found, suggesting that coping assessment in a predetoxification phase is confounded by state factors surrounding treatment entry. Coping style of detoxified substance abusers is related to the presence of mood and anxiety disorders. Coping style was not found to be related to the severity of drug abuse. Furthermore, maladaptive coping styles decreased after three months of inpatient-substance-abuse treatment, and more-adaptive coping styles remained stable for another three months of inpatient treatment. Patients with an anxiety disorder improved less on coping style when compared to non-anxiety patients. Presence of a mood disorder had no impact on coping-style improvement. The results indicate that more attention should be focused on anxiety disorders during substance-abuse treatment in order to improve coping style. Furthermore, more studies are needed on the relation between substance abuse, coping style, and psychopathology. © 2001 John Wiley & Sons, Inc. J Clin Psychol 57: 299,306, 2001. [source]

    Polymorphisms of the IL-1 Gene Complex Are Associated With Alcohol Dependence in Spanish Caucasians: Data From an Association Study

    ALCOHOLISM, Issue 12 2009
    Pilar A. Saiz
    Background:, There is growing evidence for involvement of pro-inflammatory cytokines in alcohol dependence. The aim of this study was to investigate whether 4 functionally relevant polymorphisms of the interleukin-1 (IL-1) and tumor necrosis factor-alpha genes were associated with alcohol dependence and with measures of clinical severity and treatment outcome. Methods:, Two hundred alcohol-dependent (AD) patients and 420 healthy controls from the same Spanish Caucasian population were genotyped using standard methods. Baseline and 6-month assessments included alcohol intake, addiction severity, and biomarkers of alcohol intake. Results:, Alcohol-dependent patients showed an excess of IL-1,,889 C/T [50.8% vs. 39.3%, ,2 (df) = 7.30 (2), uncorrected p = 0.026, corrected p = 0.104] and IL-1RA (86 bp)n A1/A1 genotypes [64.8% vs. 50.8%, ,2 (df) = 12.65 (3), corrected p = 0.020]. The A1/A1 excess was associated with alcohol dependence only in men [69.9% vs. 49.5%, ,2 (df) = 15.72 (2), corrected p < 0.001]. Six-month clinical and hematological outcome measures did not vary by genotype of the 4 polymorphisms. Haplotype analysis revealed an excess of the IL-1,,889 C/IL-1, +3953 C/IL-1RA A2 haplotype in the control group compared with AD patients [20.0% vs. 14.1%, ,2 (df) = 7.25 (1), p = 0.007; odds ratio (OR) = 0.64, 95% confidence interval (CI) = 0.46,0.89] and in the abstainers after 6 months of treatment compared with nonabstinent patients [14.7% vs. 6.2%, ,2 (df) = 5.65 (1), p = 0.017; OR = 2.56, 95% CI = 1.15,5.62]. Conclusions:, Our findings provide further tentative evidence of the role of IL-1 in alcohol dependence as well as evidence that the nature of the associations may be direct, gender-specific, or involve haplotype effects. However, findings from single association studies constitute tentative knowledge and must be interpreted carefully and precise replication is required. [source]

    The Addiction Severity Index at 25: Origins, Contributions and Transitions

    THE AMERICAN JOURNAL ON ADDICTIONS, Issue 2 2006
    A. Thomas McLellan PhD
    The Addiction Severity Index (ASI) is a multidimensional interview used to measure the substance use, health, and social problems of those with alcohol and other drug problems, both at admission to treatment and subsequently at follow-up contacts. This article first discusses the conceptual and practical importance of the ASI's multi-dimensional approach to measuring addiction severity, as illustrated by two case presentations. The second section of the paper reviews how this measurement approach has led to some important findings regarding the prediction and measurement of addiction treatment effectiveness. The third section describes the historical and practical considerations that have changed the instrument over time, details the problems with the instrument, and describes our efforts to correct those problems with the ASI-6. Finally, some recent ASI data collected from over 8,400 patients admitted to a nationally representative sample of U.S. addiction treatment programs are presented. [source]