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Treating Drug Problems Volume 1 (1990) / Chapter Skim
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Index
Pages 321-332

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From page 321...
... , 198, 268 Alabama, state drug coverage mandates, 292 321 Alcohol and alcoholism Addiction Severity Index, 110 chemical dependency programs, 16, 275 cost-effectiveness of treatment, 28~285 employee assistance programs, 121, 288 employers and private coverage decisions, 282-283 extension of treatment capacity to drug treatment, 218 partial legality, 62 pregnant women, 85 private insurance coverage, 278 recovery and relapse compared to heroin, 73 state mandates regarding treatment coverage, 289 n.5 therapeutic communities, 162 trends in provider characteristics, 208-209 Alcohol, Drug Abuse, and Mental Health Administration (ADAM HA) block grant administration, 241 emergency appropriation for F Y 1990, 216 health services research programs, 195 strategic planning for drug treatment, 235 trends in federal funding, 214 Alcoholics Anonymous chemical dependency programs, 16, 53, 170, 171, 190 drug treatment programs, 135 Amantadine, 175 Ambivalence, client incentives and motivation, 224 spectrum of recovery, 12~130 Anslinger, Harry, 48Anti-Drug Abuse Act of 1986 call for independent study of substance abuse treatment coverage, 1, 33 emphasis on enforcement and interdiction, 55 federal support of research, 192 federal support of treatment, 104, 202 n.1, 216, 244 TASC programs, 116 Anti-Drug Abuse Act of 1988 federal policy and treatment, 55, 216, 245 federal support of research, 192 ARC programs, 116 waiting list reduction, 232 Arkansas, state drug coverage mandates, 292
From page 322...
... , 164, 240 Clients, drug treatment chemical dependency programs and therapeutic communities compared, 172 individual goals, 12~130 parties involved in treatment, 107 public and private tiers, 205-206 trends in numbers and provider characteristics, 206 210 Clinical trials, research on major modalities of drug treatment, 18 n.2 detoxification, 175-176 methadone maintenance, 142-145,149 therapeutic communities, 158-160 Cocaine detoxification, 175, 176 drug sequencing, 69 emergency room and medical examiner cases, 77 employee assistance programs, 122 federal policy emphasis on enforcement, 55 history of use, 66-67 improvement of public coverage, 233 methadone programs, 14 need for expansion of public tier, 219 normative attitudes, 62 patterns of drug consumption, 5 patterns of drug treatment motivation, 111 n.2 positive tests among arresters, 100
From page 323...
... Addiction Severity Index, 110 additional policy questions, 38 agencies as parties in drug treatment, 108 comprehensive strategy option, 238 239 estimating extent of need for treatment, 81 84, 88 estimating need for treatment among arresters, 9~102 federal drug policy, 215 goals of drug treatment, 10-11, 106, 113-114, 116-120, 131 health services research, 196 implications of involvement in admissions to drug programs, 11~113 inducing more clients to accept treatment, 235 reasons for seeking treatment, 112
From page 324...
... cocaine consumption, 67 data systems and research, 196 Drug consumption estimation of need for treatment, 9~91 goals of drug treatment, 129 individual drug history, 60-61 level of use and criminality, 119 methadone dosage levels, 150 patterns and need for drug treatment, 4-5, 59 use, abuse, and dependence stages, 61-62 "Drug czar," 55 Drug dependence (see Drug abuse and dependence) Drug-Free Workplace Act of 1988, 123 Drug history, individual age of onset and drug sequencing, 6~69 learning and drug experience, 64~6 model and overview of individual, 59-62 social environment, 66 67 Drug screening programs availability to workers, 121 n.4 employers and goals of treatment, 123, 124 Drug sequencing, individual drug history, 6~69 Drug testing, employee libertarian ideas, 45 private treatment programs and goals of drug treatment, 108~109 Drug trade crime control resources, 102103 homicide, 102 Drug treatment (see also Chemical dependency programs, Correctional treatment programs, Detoxification, Methadone maintenance, Private tier, Public tier, Therapeutic communities)
From page 325...
... , 289-290 Employers drug screening programs, 123 extent and nature of insurance coverage for drug treatment, 273, 282-283 federal government and drug treatment coverage, 281-282 goals of drug treatment, 120125, 131 325 parties involved in drug treatment, 108 private companies and drug treatment coverage, 278-279 reasons for seeking treatment, 112 state and local government and drug treatment coverage, 279-280 Employment Addiction Severity Index, 110 aggregate need for drug treatment, 8 oost/benefit ratio of methadone maintenance, 153 cost/benefit ratio of outpatient nonmethadone programs, 170 goals of drug treatment, 10, 129 therapeutic communities and treatment retention, 162 F Facilities, improvement of public coverage, 233 Families Addiction Severity Index, 110 chemical dependency programs, 171 criminal view of drug problem, 47~8 goals of drug treatment, 129 parties involved in drug treatment, 107, 108 n.1 reasons for seeking treatment, 112 therapeutic communities, 156 Federal Employee Benefits Health Plan, 281 Financing amounts needed to meet priority objectives, 255 differences between private and public tiers, 202-204 private coverage, 29-32, 273-300 public care, 21-29, 22~272 sources of treatment dollars, 211-214 trends in federal funding, 214-216 trends in funding base, 21~211 Flupenthixol decanoate, 175 Food and Drug Administration Dole-Nyswander model of methadone maintenance, 51 LOAM, 139 n.6 Function impairments, recovery process, 6 G Gatekeepers employee assistance program staff, 288 utilization management, 27, 28, 250 Gaudenzia House, 166
From page 326...
... , 281-282, 290 n.6 Health services cost offsets, 283 research and treatment systems, 19-20 research recommendations, 195-197 Heart infections, transmission by injection, 68 n.2 Hepatitis, transmission by injection, 68 n.2 Heroin detoxification and relapse, 13~139, 176 Dole-Nyswander research on methadone maintenance, 50-51 effects compared to methadone, 140 emergency room and medical examiner cases, 77 literature on dependence and recovery, 73-74 literature on patterns of drug treatment motivation, 111 n.2 Nixon administration "War on Drugs," 53-54 research and problem of noncompliance, 157-158 n.14 state prison inmates, 82-83 therapeutic communities, 14, 154, 162 Homeless, estimating extent of need for treatment, 8~85, 88 Homicide, drug trafficking, 102 Hong Kong, study of methadone maintenance, 144 n.8 Hospitals chemical dependency programs, 16,190 committee recommendations on optimal private coverage provisions, 3~31 cost control and utilization management, 28 drug detoxification, 16, 175, 19~191 optimal private coverage provisions, 294-295 prescription of methadone, 141 trends in drug treatment client numbed, 207-208 utilization management and public tier, 251-252 Household population, estimating extent of need for treatment, 77-80, 92-94, 9~99 Human immunodeficiency virus (HIV) (see also Acquired immune deficiency syndrome)
From page 327...
... , 139 n.6, 158 n.14 Libertarian ideas drug policy, 3, 11 46, 56, 57 influence on nation's collective thinking, 223 M Managed care employee assistance program personnel, 288 health insurance and cost containment, 286-287 Marijuana drug sequencing, 69 emergency room reports, 77 employee assistance programs, 122 normative attitutes, 62 patterns of drug consumption, 5 positive tests among arresters, 100 state prison inmates, 82, 83 urinalysis, 99 100 Marketing, chemical dependency programs, 20, 197 Maryland, state-mandated drug treatment coverage, 290 Medicaid federal contribution, 212 federal legislation and drug treatment needs, 248 250 public tier funding of treatment services, 26-27, 256, 265-272 transitional steps toward the year 2000, 249 Medical idea classic era of narcotics control, 48
From page 328...
... , 232 National Drug and Alcoholism Treatment Utilization Survey (NDATUS) baseline comparison values, 256-257 data on client numbers and provider characteristics, 206 data on provider insurance receipts, 274 health insurance and cost of drug treatment, 283-284 public and private tiers, 202, 216-219 women and special services, 198 National Drug Control Strategy (September 1988)
From page 329...
... cost/benefit ratio, 18,170 cost effectiveness compared to therapeutic communities, 166 description of modality, 167-168 effectiveness of chug treatment, 15, 168-169 prison treatment programs, 17 private coverage and effectiveness data, 275 research on treatment effectiveness, 18-19, 185-186 rise in modern treatment, 52,133 summary of committee finding, 189-190 trends in client numbers, 206 variations in effectiveness, 169 Oxford House, 135 p Parole (see also Civil Addict Program, Criminal justice system) community-based treatment programs, 10 estimating extent of need for treatment, 84 implications of criminal justice involvement in admissions to drug treatment, 113 reasons for seeking treatment, 112 state prison inmates and revocation, 82 n.6 Pennsylvania, Medicaid and drug treatment, 267, 271 Performance certification and public support, 29 committee recommendations on optimal private coverage provsions, 31, 296 297 states and data systems, 247 utilization management, 250 Phillips, Mary Dana, 35 Phoenix House, 161 Pleasure seeking, methadone as effective analgesic, 140 Polipy, national drug effect of alternative scenarios on need for treatment, 265-266 fundamental questions, 220-221
From page 330...
... , 76 Price, sensitivity of drug abusers to cost of treatment, 276, 277 Prison-hospitals classic era of narcotics control, 48 rise of modern treatment, 49-50 Prisons compared to jails, 82 n.5 effectiveness of drug treatment, 17, 176-185, 191 external costs and public intervention, 223 motivations for treatment, 127 overcrowding and criminal justice referrals to treatment, 10, 120 populations and estimating extent of need for treatment, 81-84 referrals to treatment, 117-119 Private coverage committee recommendations, 293-297 cost containment of health benefits, 283-288, 291-292 extent, 277-283 logic of mandating coverage of drug treatment, 276-277 state mandates, 28~293 Private tier clients compared to public tier, 205, 206 defined, 201-202 drug treatment coverage, 29-32, 277-283 drug treatment supply system, 216-217, 217-218 excess capacity, 206, 218-219 expansion in 1980s, 215, 218 INDEX financing, 21-22, 202-203 goals of drug treatment, 10~109 overview, 273-276 ownership of programs, 209 ratio of drug treatment expenditures, 203-204 referrals from criminal justice system, 112 sources of treatment dollars, 21 Probation (see also Criminal justice system) community-based treatment programs, 10 estimating extent of need for treatment, 84 implications of criminal justice involvement in admissions to drug treatment, 113 outpatient nonmethadone treatment, 167 prisons and criminological thought, 49 reasons for seeking treatment, 112 Productivity employers and drug treatment, 124, 282 estimating costs of drug problems, 103-104 goals of drug treatment, 106 societal costs of drug abuse, 89 Profit, growth of drug treatment industry in 1980s, 277 Psychoactive drugs (see also Heroin; Methadone; Opiates)
From page 331...
... , effectiveness of correctional treatment programs, 17, 183-184 Social change, fundamental ideas about drugs, 40 Social services improvement of public coverage, 233 outpatient nonmethadone programs, 167-168 Society ethical position on income constraints, 225 external costs and private coverage, 276 external costs and public intervention, 223 Socioeconomic environment additional policy questions, 3~39 drug dependence, 5 individual drug history, 66~7 recovery and relapse, 6, 75 Special Action Office for Drug Abuse Prevention (SAODAP) , 54, 240-241, 250 Staff chemical dependency programs and therapeutic communities compared, 172 composition of in 1982 NDATUS, 210 n.1 differential effectiveness of treatment programs, 24 improvement of public coverage, 233 requirements of public tier programs, 206 variations in treatment effectiveness, 150, 164, 185
From page 332...
... , 114, 116-117, 157 Treatment Outcome Prospective Study (TOPS) cost/benefit analyses, 152 effectiveness of drug treatment, 12, 35, 1 134, 196 electiveness of OPNMs, 168-169, 170 INDEX effectiveness of therapeutic communities, 160, 162-163, 166 veterans as clients, 253 TASC referrals, 116 variations in effectiveness of methadone maintenance programs, 148-149 veterans and drug treatment programs, 253 U Unemployment aggregate need for drug treatment, 8 estimating extent of need for drug treatment, 80 goals of drug treatment, 10 Unions, employer-sponsored health insurance, 273 Urban neighborhoods, goals of drug treatment, 108 Urinalysis clinical rigor, 125-126 estimating need for treatment among arresters, 99-100 Utilization management optimal private coverage provisions, 31 public financing of drug treatment, 27-29 public intervention in the 1990s, 25~252 V Veterans, as special case of public coverage, 25, 252-254, 256 Veterans Affairs, Department of, 252-254, 266 n.5 Vietnam War, 253 W Waiting lists elimination as priority of public coverage, 232 reduction and core strategy option, 238 Wlllmar State Hospital, 53 Withdrawal, methadone and symptoms of heroin, 140 Women (see also Mothers; Pregnant women)


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