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Open Access Publications from the University of California

Scholarly Works (92 results)

  • Article
  • Peer Reviewed
UC San Francisco Previously Published Works (2015)
    Cover page: Implications of an Alcohol Addiction RDoC for Delivery Science Research and Clinical Care
    • Article
    • Peer Reviewed
    UC San Francisco Previously Published Works (2006)
    An important question in the alcoholism treatment field is how research findings can be translated into real-world clinical practice. Researchers have developed a new research-practice integration (RPI) model that can both drive the formulation of studies and new research questions and promote improvements in treatment quality. The hallmark of this model is a collaborative relationship between the key stakeholders in both alcohol and other drug (AOD) treatment and research, including health plan administrators and clinicians, treatment program administrators, psychiatry and primary care departments, patients and their families, purchasers, and researchers. The issue of technology transfer is especially relevant in the realm of adolescent AOD treatment. The implementation and feasibility of the RPI model are illustrated by a case study of a managed health care plan's treatment services for adolescents with AOD dependence. In this setting, key research findings are being used to shape the plan's adolescent health services.
      Cover page: Translating research findings into practice: example of treatment services for adolescents in managed care.Creative Commons CC0 public domain dedication, version 1.0.
      • Article
      • Peer Reviewed
      UC San Francisco Previously Published Works (2016)
      Motivational interviewing (MI) has a strong evidence base supporting its clinical efficacy, yet provider fidelity is difficult to maintain over time, may be costly, and the effects of proficiency on client outcomes remain unknown. These issues need further research and may pose significant challenges to MI implementation in health care.
        • Article
        • Peer Reviewed
        UC San Francisco Previously Published Works (2008)

        OBJECTIVE: This study examined the level, changes and predictors of alcohol consumption and binge drinking over a 7-year period among young adults (18-25 years) who met the criteria for problem drinking. METHOD: Interviews with 270 18 to 25 years old problem and dependent drinkers from representative public and private substance use treatment programs and the general population were conducted after 1, 3, 5, and 7 years. Measures included demographic characteristics, severity measures, and both formal and informal influences on drinking. RESULTS: Overall alcohol consumption declined over time but leveled off around 24 years of age. Being male, not attending AA over time, as well as more baseline dependence symptoms and greater ASI alcohol and legal severity were associated with greater consumption and binge drinking. In addition, greater levels of binge drinking were associated with less education, earlier age of first use, and a larger social network of heavy drinkers. In conclusion, more attention should be paid to heavy drinking among young adults and to the factors that influence their drinking patterns.

          Cover page: Alcohol in emerging adulthood: 7-year study of problem and dependent drinkers.
          • Article
          • Peer Reviewed
          UC San Francisco Previously Published Works (2004)

          Objective: This study examined clinical characteristics and treatment outcomes of older alcohol dependent women and men in a mixed-age private outpatient chemical dependency program. Method: The sample included 92 patients aged 55 to 77 (29 women and 63 men). Measures consisted of demographic characteristics, alcohol and drug use and dependence, drinking history, health status, psychiatric symptoms, length of stay in treatment, use of Alcoholics Anonymous and six-month outcomes. Results: Women reported later initiation of heavy drinking than men, but had similar drinking levels at baseline. At six months, 79.3% of women reported abstinence from alcohol and drugs in the prior 30 days, versus 54.0% of men, p = .02. Greater length of stay in treatment predicted abstinence at six months. Among those who were not abstinent, no women reported heavy drinking in 30 days prior to follow-up, while non-abstinent men reported an average of 4.0 heavy drinking days (sd = 9.20), p = .025. Conclusions: Results suggest that alcohol dependent older women may have better drinking outcomes compared with alcohol dependent older men, following outpatient treatment.

            Cover page: Gender differences in treatment outcomes for alcohol dependence among older adults
            • Article
            • Peer Reviewed
            UC San Francisco Previously Published Works (2007)

            Objectives: To examine associations between drinking patterns, medical conditions and behavioral health risks among older adults. Methods: Analyses compared survey participants (health plan members ages 65 to 90, N = 6,662) who drank moderately to those who drank over recommended limits or did not drink. Results: Over-limit drinking was associated with smoking; not trying to eat low fat foods (in men), and lower BMI (in women). Predictors of not drinking during the prior 12 months included ethnicity, lower education, worse self-reported health; diabetes and heart problems. Conclusions: Significant relationships exist between health and alcohol consumption patterns, which vary by gender.

              Cover page: Alcohol consumption, medical conditions and health behavior in older adults
              • Article
              • Peer Reviewed
              UC San Francisco Previously Published Works (2007)

              This prospective study examined the relationship between cigarette smoking and 5-year substance abuse treatment outcomes. Of 749 individuals who began private outpatient treatment, 598 (80%) were re-interviewed by telephone at 5 years. At 5-year follow-up, 53% reported smoking cigarettes in the prior 30 days. Smokers were less likely to be abstinent from alcohol and drugs in the prior 30 days (48.3% vs. 64.0%); had higher Addiction Severity Index (ASI) scores in employment, alcohol, drug, psychiatric, and family/social problems; worse self-reported health; and greater self-reported depression. Findings inform understanding of long-term substance abuse treatment outcomes and potential service needs of smokers.

                Cover page: Cigarette Smoking and Long-Term Alcohol and Drug Treatment Outcomes: A Telephone Follow-Up at Five Years
                • Article
                • Peer Reviewed
                UC San Francisco Previously Published Works (2012)
                This paper used data from a study of pediatric primary care provider (PCP) screening practices to examine barriers to and facilitators of adolescent alcohol and other drug (AOD) screening in pediatric primary care.A web-based survey (N = 437) was used to e
                  • Article
                  • Peer Reviewed
                  UC San Francisco Previously Published Works (2012)
                  Substance use (SU) problems are common among adolescents, a serious health risk for them and a major public health problem, but are inadequately addressed in most pediatric health care settings. Primary care offers an excellent context for SU assessment and treatment for adolescents and their families, offering better access and a less stigmatized environment for receiving treatment than specialty programs. This paper examines the literature on the integration of substance use treatment with adolescent health care, focusing on 2 areas: Screening, Brief Intervention, and Referral to Treatment (SBIRT) in Emergency Departments and Primary Care, and School- and College-Based Health Centers.
                    • Article
                    • Peer Reviewed
                    UC San Francisco Previously Published Works (2012)

                    Background

                    The treatment of alcohol and other drugs is now more commonly framed in terms of a chronic condition which requires ongoing monitoring. A model which includes continuing access to health care may optimize outcomes. Most studies of chronic care models have not included health care and have only examined short term effects.

                    Methods

                    The sample (n = 783) included consecutive admissions in ten public and private alcohol and other drug (AOD) treatment programs followed over seven years. The outcome was remission which was defined as alcohol and drug abstinence or non-problem use.

                    Results

                    In the private sample, receiving health care services predicted remission across the seven years; however this did not occur in the public sample. More patients in the public treatment sample received AOD treatment readmissions each year, while more of those in the private sector received psychiatric and general health visits. Except for drug problem severity, there were no other clinical differences between the samples. There were no differences in the proportions of patients in the two sectors who received the full spectrum of chronic care services. In the final models, 12-step participation was markedly significant for both samples.

                    Conclusions

                    Models of chronic care for substance use need to consider differences between private and public treatment and should take into account that individuals may not always have access, or avail themselves of services that may optimize long-term outcomes.
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