Racial/Ethnic Match and Treatment Outcomes for Women with PTSD and Substance Use Disorders Receiving Community-Based Treatment

Introduction. Substance use disorders (SUDs) are commonly associated with a variety of psychiatric disorders. Community-based studies have found a significant association between SUDs and sexual dysfunction in men, with a possible causal relation in the case of nicotine. Methods. The case records of 105 men presenting to a clinic for patients with psychosexual disorders were reviewed. Men with and without comorbid SUDs were compared in terms of demographic, clinical, and familial variables. Results. 25 of the 105 men (23.8%) had a lifetime diagnosis of SUD, and 19 (18.1%) had a current SUD. The commonest substances involved were nicotine (n = 21, 20%) and alcohol (n = 9, 9.5%). Men with comorbid SUDs were more likely to report a family history of substance dependence, particularly alcoholism. Single men with SUDs were more likely to have a comorbid mood disorder. Conclusion. SUDs, particularly nicotine and alcohol use disorders, are common comorbidities in patients with psychosexual disorders. Identifying and treating these disorders in this population are important aspects of management.

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1A Nationwide Analysis of U.S. Racial/Ethnic Disparities in Emergency Department Patients with Mental Health and Substance Use Disorders

10.21203/rs.3.rs-892560/v1 ◽

2021 ◽

Author(s):

Joanne Weinreb ◽

Penina Gavrilova ◽

Jonathan Avery ◽

Sean M. Murphy ◽

Jyotishman Pathak

Keyword(s):

Mental Health ◽

Substance Use ◽

Substance Use Disorders ◽

Wait Time ◽

Wait Times ◽

Hispanic Patients ◽

Racial Ethnic ◽

Triage Level ◽

Hispanic White ◽

White Patients

Abstract BackgroundRacial and ethnic health disparities have been linked with inequalities in access to health care and outcomes. The present study considers whether inequalities persist between racial/ethnic groups among patients with mental health or substance use disorders who visit the emergency department (ED). MethodsWe analyzed data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 2012-2018, assessing health disparities among patients diagnosed with mental health or substance use disorders by observing whether significant differences exist in ED wait time and length of visit (LOV) for patients of different races/ethnicities. Stratified models were performed to further understand the impact of regions across the U.S., year, and triage level on the association analysis. ResultsFrom 2012-2018, non-Hispanic Black and Hispanic patients experienced significantly longer ED wait times and LOV as compared to White patients. Patients with private insurance experienced significantly shorter wait times compared to patients with self-pay, and shorter LOV than those with Medicaid/ Children’s Health Insurance Program, or Medicare. Male patients had significantly longer LOV compared to female patients. We observed year by year differences in wait times of non-Hispanic Black patients with improvement appearing between the years 2013 to 2016, while LOV remained consistently longer. We observed both regional and triage level differences, with the U.S. Northeast presenting with the most disparities. Additionally, we noted a general upward trend of SUD diagnoses. Conclusion Our analysis suggests that while there has been an overall improvement in median ED wait time through the years, non-Hispanic Black and Hispanic patients experience significantly longer ED wait time compared to non-Hispanic White patients. Additionally, non-Hispanic Black and Hispanic patients have a significantly longer ED LOV compared to non-Hispanic White patients.

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Increased Resilience is Associated with Positive Treatment Outcomes for Veterans with Comorbid PTSD and Substance Use Disorders

Journal of Dual Diagnosis ◽

10.1080/15504263.2018.1464237 ◽

2018 ◽

Vol 14 (3) ◽

pp. 181-186 ◽

Cited By ~ 2

Author(s):

Adam P. McGuire ◽

Natalie P. Mota ◽

Lauren M. Sippel ◽

Kevin M. Connolly ◽

Judith A. Lyons

Keyword(s):

Substance Use ◽

Treatment Outcomes ◽

Substance Use Disorders ◽

Positive Treatment

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Psychosocial Treatment Approaches for Substance Use

10.1093/med/9780190275334.003.0013 ◽

2018 ◽

Author(s):

Lynn McFarr ◽

Julie Snyder ◽

Lisa Benson ◽

Rachel Higier

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Meta Analysis ◽

Contingency Management ◽

Psychosocial Interventions ◽

Psychosocial Treatment ◽

Community Based ◽

Theoretical Orientations ◽

Psychosocial Treatments ◽

Community Based Programs

Multiple psychosocial treatments for substance-use disorders have been studied for efficacy. A recent meta-analysis indicates that psychosocial interventions are effective across multiple types of substances used. In the case of opiates, psychosocial interventions combined with medication appear to be the most effective. Many studies further agree that psychosocial interventions are an integral and necessary part of treating substance-use disorders. Although theoretical orientations may differ across psychosocial treatments, they have several principles and practices in common. All involve talk therapy or talk in communities as a way to clarify triggers, build commitment, and improve accountability. Many also target addiction behaviors and work to develop alternative contingencies to reduce or eliminate use. Finally, targeting repeated performance (or building “chains of committed behavior”) decreases the likelihood of relapse. This chapter discusses the most frequently studied and employed psychosocial treatments for substance use including CBT, motivational interviewing, contingency management, mindfulness, and community-based programs.

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Group therapy for women with substance use disorders: In-session affiliation predicts women's substance use treatment outcomes

Journal of Substance Abuse Treatment ◽

10.1016/j.jsat.2018.08.008 ◽

2018 ◽

Vol 94 ◽

pp. 60-68 ◽

Cited By ~ 4

Author(s):

Linda Valeri ◽

Dawn E. Sugarman ◽

Meghan E. Reilly ◽

R. Kathryn McHugh ◽

Garrett M. Fitzmaurice ◽

...

Keyword(s):

Substance Use ◽

Group Therapy ◽

Treatment Outcomes ◽

Substance Use Disorders ◽

Substance Use Treatment

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The influence of family and social problems on treatment outcomes of persons with co-occurring substance use disorders and PTSD

Journal of Substance Use ◽

10.3109/14659891.2015.1005184 ◽

2015 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Elizabeth C. Saunders ◽

Bethany M. McLeman ◽

Mark P. McGovern ◽

Haiyi Xie ◽

Chantal Lambert-Harris ◽

...

Keyword(s):

Substance Use ◽

Treatment Outcomes ◽

Substance Use Disorders ◽

Social Problems

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Life events and treatment outcomes among individuals with substance use disorders: A narrative review

Clinical Psychology Review ◽

10.1016/j.cpr.2013.01.012 ◽

2013 ◽

Vol 33 (3) ◽

pp. 470-483 ◽

Cited By ~ 10

Author(s):

Marketa Krenek ◽

Stephen A. Maisto

Keyword(s):

Substance Use ◽

Treatment Outcomes ◽

Life Events ◽

Substance Use Disorders ◽

Narrative Review

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Comparative analysis of treatment conditions upon psychiatric severity levels at two years among justice involved persons

Advances in Dual Diagnosis ◽

10.1108/add-07-2015-0015 ◽

2016 ◽

Vol 9 (1) ◽

pp. 38-47 ◽

Cited By ~ 1

Author(s):

John M Majer ◽

Hannah M Chapman ◽

Leonard A Jason

Keyword(s):

Substance Use ◽

Residential Treatment ◽

Substance Use Disorders ◽

Community Based ◽

Content Type ◽

Oxford House ◽

Treatment Conditions ◽

Psychiatric Severity ◽

Dual Diagnoses ◽

Severity Levels

Purpose – The purpose of this paper is to compare the effects of two types of community-based, residential treatment programs among justice involved persons with dual diagnoses. Design/methodology/approach – A randomized clinical trial examined treatment conditions among justice involved persons with substance use disorders who reported high baseline levels of psychiatric severity indicative of diagnosable psychiatric comorbidity. Participants (n=39) were randomly assigned to one of three treatment conditions upon discharge from inpatient treatment for substance use disorders: a professionally staffed, integrated residential treatment setting (therapeutic community), a self-run residential setting (Oxford House), or a treatment-specific aftercare referral (usual care). Levels of psychiatric severity, a global estimate of current psychopathological problem severity, were measured at two years as the outcome. Findings – Participants randomly assigned to residential conditions reported significant reductions in psychiatric severity whereas those assigned to the usual care condition reported significant increases. There were no significant differences in psychiatric severity levels between residential conditions. Research limitations/implications – Findings suggest that cost-effective, self-run residential settings such as Oxford Houses provide benefits comparable to professionally run residential integrated treatments for justice involved persons who have dual diagnoses. Social implications – Results support the utilization of low-cost, community-based treatments for a highly marginalized population. Originality/value – Little is known about residential treatments that reduce psychiatric severity for this population. Results extend the body of knowledge regarding the effects of community-based, residential integrated treatment and the Oxford House model.

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