Showing papers in "Journal of Social Work Practice in The Addictions in 2005"

Acculturation Status and Substance Use Prevention with Mexican and Mexican-American Youth.

Abstract: SUMMARY This study examined whether language preference, as an indicator of acculturation, moderated the effects of a culturally grounded substance use prevention intervention for Mexican and Mexican American middle school students (N = 2,146) in Phoenix, Arizona. The main hypothesis was that levels of program effectiveness would vary based on the language preference of the students and the specific culturally grounded version of the intervention they were assigned. Findings show that matching language preference to particular versions of the intervention did not influence substance use related program outcomes, but that overall program effects (intervention versus control) did vary by language preference. English-language dominant participants, the most at risk sub-group, responded more positively to the intervention, while Spanish dominant, who had low substance use rates at baseline, and bilingual participants did not demonstrate significant differences between the intervention and control groups. Impl...

Substance Abuse Among U.S. Latinos: A Review of the Literature

Abstract: SUMMARY Latinos have recently become the largest minority in the United States. High fertility and high immigration rates suggest continued high rate of growth. Alcohol and illicit drug use within this population give reason for concern. Beginning in early adolescence, Latinos and Native Americans lead the nation in alcohol and illicit drug use. They also have a high need for alcohol and illicit drug treatment compared to Whites and African-Americans. Research concerning ethnic differences is reviewed in order to gain an understanding of the patterns and trajectories of substance use within the Latino community. Prevention and treatment interventions specific to Latinos are described, and gaps in the literature are noted. Finally, implications of the current research findings for social workers and recommendations for future research are discussed.

Development of an Objective Structured Clinical Examination (OSCE) for Practicing Substance Abuse Intervention Competencies: An Application in Social Work Education

Abstract: The substance abuse skills OSCE (Objective Structured Clinical Examination) was developed by an interdisciplinary faculty team at New York University from 2001 to 2003. The aims of the project were to teach medical, nursing, and social work students screening and brief intervention skills, provide a practice opportunity and feedback to students on their ability to demonstrate substance abuse skills, and to expose students to interdisciplinary collaboration. After students were educated and participated in the OSCE, the mean score on their substance abuse knowledge questionnaires increased from 6.24 (SD = 1.522) at pretest to 8.06 (SD = 1.600) at post test (t (16) = −6.080, p <.002). According to the faculty observer performance checklists, students manifested the fifteen competencies on the checklist at an average rate of 79.0%. Students rated the overall experience of participating in the OSCE highly favorably, at 4.9 on a five-point scale. While the OSCE proved to be highly compatible with the ...

Spiritual Mechanisms Underlying Substance Abuse Behavior Change in Faith-Based Substance Abuse Treatment

Abstract: Despite increasing interest in “faith-based” substance abuse treatment and HIV risk reduction interventions, there is little systematic evidence of the efficacy of explicitly spiritual interventions. However, fundamental to effective interventions is an explicit conceptualization of mechanisms underlying behavior change. This paper discusses the definition of faith-based organizations, specifically as they relate to substance abuse treatment programs, briefly reviews relevant behavior change theories to identify key variables underlying change, presents an integrative conceptual framework articulating linkages between spiritual intervention components, behavior change processes and substance abuse outcomes, and discusses how the mechanisms identified in our model can be seen in commonly used substance abuse interventions. Overall, the paper suggests that what happens in “faith-based” programs may not be so different from processes taking place in good social work practice in the addictions field.

Beyond “Dry Drunkenness”: Facilitating Second Stage Recovery Using Wilber’s “Spectrum of Consciousness” Developmental Model

Abstract: Article copies available from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: ; The Haworth Press, Inc. .

Drug Use, Self-Efficacy, and Coping Skills Among People with Concurrent Substance Abuse and Personality Disorders: Implications for Relapse Prevention

Abstract: This study investigated drug use antecedents, abstinence self-efficacy and coping skills among people with concurrent substance abuse and personality disorders. Fifty inpatients with recent polydrug abuse were divided into two groups based upon the presence (PD) or absence (NPD) of a personality disorder. The PD group reported more often using drugs when experiencing unpleasant emotions, physical discomfort, and conflict with others. They also reported lower self-efficacy for situations involving physical discomfort and interpersonal conflict, more use of a self-blaming coping style, and lower levels of interpersonal competence. Implications for treatment are discussed in light of these findings.

Food Insecurity Among Drug Addicts in Israel: Implications for Social Work Practice

Abstract: The intent of this article is to introduce the problem of food insecurity and hunger as a concern for social workers addressing drug addiction and the needs of addicts in Israel. This article discusses the results of a study comparing the food insecurity problem among ad- dicts and non-drug addicts. Specifically, the objectives of this study were: (1) to conduct an analysis of the level of food insecurity in Israel; (2) to examine which individual characteristics are related to food inse- curity among addicts and non-addicts; and (3) to better understand how food insecurity can be addressed in the context of social work treat- ment for addicts. Policy and practice recommendations are discussed. (Article copies available for a fee from The Haworth Document Delivery Ser- vice: 1-800-HAWORTH. E-mail address: Website: © 2005 by The Haworth Press, Inc. All rights reserved.)

Factors Associated with Drug Treatment Entry Patterns Among Hispanic Women Injection Drug Users Seeking Treatment

Abstract: SUMMARY This paper examines patterns of drug treatment entry and factors that are associated with these patterns among 1,849 Hispanic women injection drug users (IDUs) The data analyzed originates from a statewide drug-treatment database covering seven years, 1996–2002 Through the use of logistic regression analyses, the study identified significant differences in predisposing, need and enabling factors in the use of detoxification only, residential treatment, or methadone maintenance Compared to other Hispanics, Puerto Rican women were 40 percent less likely to use only detoxification services and one and a half times more likely to use methadone maintenance Having health insurance was an especially important factor associated with methadone treatment utilization Two of the most important factors associated with residential treatment use were history of mental health services utilization and involvement with the criminal justice system This article discusses specific social work practice implicatio

Recovery Processes in a Treatment Program for Women

Abstract: Recovery processes of 32 women were explored in six focus groups following completion of treatment in a community based women-specific substance abuse group program. Grounded theory analysis yielded an over-arching theme of Building a House of Recovery and several sub-themes describing women's perceptions of the processes that were central to their recovery.

Club Drug Use, Sexual Behavior, and HIV Risk Among Community and Internet Samples of Hispanic MSM: Implications for Clinicians

Abstract: Hispanic men who have sex with men (MSM) are at high risk of HIV infection. This study reports on the club drug use and sexual behaviors of two distinct samples (community and Internet) of Hispanic MSM living in the AIDS epicenter of Miami-Dade County. Both samples reported high rates of unprotected anal sex and high numbers of sex partners; rates of club drug use (cocaine, ecstasy, methamphetamines, GHB, amyl nitrites, and Viagra) were also high. Recent use of club drugs was associated with both unprotected receptive and insertive anal sex in the Internet sample, but not in the community sample. Implications for social work practice are discussed.

Psychiatric, Family, and Ethnicity-Related Factors That Can Impact Treatment Utilization Among Hispanic Substance Abusing Adolescents.

Abstract: SUMMARY There is great significance to improving our understanding of predictors of treatment utilization among Hispanic substance abusing youth. One hundred and ten Hispanic substance abusing adolescents and their parents participated in a study of treatment utilization. Analyses showed that adolescents with lower numbers of externalizing disorders (χ2 = 4.18, df = 1, p < .05) and parents with better parenting strategies (χ2 = 8.73, df = 2, p < .05), predicted overall treatment utilization (residential + outpatient). Better parenting practices and higher parental years in the U.S. predicted more utilization of outpatient services and lower parenting stress predicted more utilization of residential services. Without specialized engagement strategies, adolescents and families most in need may be the least likely to engage in recommended treatment.

Culturally competent intervention with families of Latino youth at risk for drug abuse.

Abstract: SUMMARY A culturally specific intervention for families with children at risk for substance abuse was implemented by Proyecto Juventud (Youth Project), a community-based family services program located in the rural southwestern United States. This intervention, incorporating culturally appropriate language, beliefs, values, and principles, provided substance abuse education to families. Participants were pretested at intake and posttested at one year, utilizing one measure for knowledge of drugs and drug abuse, and a second measure for family functioning. Results indicated that parents' scores relating to drug and drug abuse knowledge showed a trend of improvement on 16 out of 20 items. The results on family functioning were inconclusive. The study illustrated the importance of using a cultural approach with Latino families in the area of substance abuse prevention.

Community Providers’ Views of Alcohol Problems and Drug Problems

Abstract: This study contrasts community health and social service providers' views on alcohol vs. other drug abuse. A probability sample of 457 social work and other providers from a county's public and private medical and mental health clinics, welfare and criminal justice systems, and substance abuse programs, as well as clergy, private therapists, and physicians were interviewed. For both alcohol and drug problems, providers thought only of severe dysfunctions, which suggest that less severe forms of these problems may evade detection. In addition, drug problems were viewed as more harmful than alcohol problems, which may result in providers minimizing alcohol problems.

Childhood Sexual Abuse and Drug Use Among Low-Income Urban Puerto Rican Women

Abstract: SUMMARY This study examines the relationship between childhood sexual abuse and adult drug use among low-income urban Puerto Rican women. Interviews were conducted with 718 women, 408 involved in drug use and a comparison group of 310 non drug-users. Results demonstrate a strong association between childhood sexual abuse and adult drug use. The impact of childhood sexual abuse was greater for women reporting greater abuse severity, abuse by a family member, and increased abuse duration. Findings support a direct effects model of childhood sexual abuse on adult drug use. The increased rates of drug use among victims of childhood sexual abuse did not appear to be mediated by other childhood maltreatment or family background factors. Implications for practice and research are discussed.

Outcomes of the Decision to Terminate Drug Abuse: An Application of Rational Choice Theory

Abstract: Cusson and Pinsonneault's theory of desistance from criminal behavior and Trevor Bennet's analysis of drug-taking careers provide the theoretical underpinnings for this study of 180 young men with histories of substance abuse. All the participants were living in the community and had decided to quit at least once previously. One hundred were drug-free; eighty were active users. The hypothesis predicted that the decision to quit would have had the highest probability of success under two conditions: (a) the impetus for the decision was a traumatic event, and (b) an alternative lifestyle was available to the person when he quit using drugs, and its details and accessibility known in advance. The hypothesis was confirmed.

A comparison of African American and Cuban American adolescent juvenile offenders: risky sexual and drug use behaviors.

Abstract: Racial and ethnic disparities exist in HIV seroconversion rates, with African American and Hispanic youth in the 13-19-year-old age group representing 61% and 21% of new AIDS cases, respectively. The aim of this study was to examine sexual and drug use behaviors among a sample of 138 African American and Cuban American juvenile offenders. Cuban American adolescents showed higher levels of unprotected sex, higher levels of sex while using drugs, and higher levels of drug/alcohol use in the three and six months prior to confinement. These differences may be explained by multiple factors, including differences in acculturation levels among the Cuban American adolescents, differences in health messages targeted at the two groups, and family mores and norms.

“A Port in a Storm”: Client Perceptions of Substance Abuse Treatment Outreach in a Soup Kitchen

Abstract: Substance use is associated with many problems, including homelessness, mental illness, isolation, and poverty, yet ambivalence about change leads many affected individuals to defer treatment or drop out prematurely. This paper describes a manualized, time-limited, low-threshold group model for treatment outreach to residentially unstable drug and alcohol users who, though wanting help, are not yet committed to ending or reducing substance use. The model is based on principles of group work, motivational enhancement, and cognitive-behavioral therapy. Findings from a qualitative analysis of progress notes, illustrated with case studies, tie participant goals to strategies of the treatment model and participant perceptions of the change process.

Substance Abuse Among Puerto Rican and Dominican Gang Members in a Small City Setting

Abstract: SUMMARY Joining a gang increases an adolescent's risk for substance abuse. To better understand the contextual development of drug use behavior, this retrospective ethnographic study describes a sample of 76 young small-city mainland Puerto-Rican and Dominican males who joined gangs when they were younger. Data is presented and discussed on the drug abuse behavior including their drug using progression and the context in which such use occurs. The young average age of onset 11.2 (sd = 2.6) combined with the rapid progression to more dangerous drugs, which generally occurs within six years, demonstrates the elevated risk associated with small city gang membership. Differences in the patterns of drug use were also found between the English and Spanish speaking groups. The authors discuss the implications of the study findings on the development of interventions. Recommendations address future research possibilities on drug abuse within Latino gangs.

The Use of the 12 Steps of the Anonymous Program to Heal Trauma

Abstract: (2005). The Use of the 12 Steps of the Anonymous Program to Heal Trauma. Journal of Social Work Practice in the Addictions: Vol. 5, No. 3, pp. 103-105.

Dual Relationships: The Challenges for Social Workers in Recovery

Abstract: Over the last ten years there is increasing focus in social work literature about non-sexual dual relationships. This has included consideration of different types of dual relationships that occur primarily during or after the establishment of professional social worker-client relationship. However, the specific concerns facing social workers who are themselves in recovery from substance use disorders remain absent from these discussions. This article identifies challenges facing social workers in recovery from substance use disorders who also work with clients dealing with these disorders. Recommended actions and policies that can assist professionals and agencies in balancing personal and practice issues are presented.

How Certain Are You

Abstract: How certain are you that what you are doing with your clients really works? Most of us have a gut sense that what we are doing makes a difference. Yet, at least for me, this is not good enough. For years as a practitioner, I yearned to be convinced that what I was doing with clients really did help to improve their lives. Perhaps that’s why I ended up as an academician–struggling to better understand the processes and outcomes of human behavior and change, and teaching this knowledge as best I can to students. Indeed, I am perpetually engaged in thinking about and researching what works best with what type of client, when, where, how, and why. In the midst of these uncertain times globally, it is common to find each of us struggling to attempt to achieve certainty locally. The rapid spread of the evidence-based practice (EBP) movement both here and in Europe is perhaps a reflection of that need. Yet, despite my long-held need to know better that what I am doing with clients works, I find myself ambivalent about jumping aboard the EBP train. In my experience, there are as many social work scholars and practitioners angry, upset, and against the move toward EBP as there are in support of it. It is more than a little ironic that our attempt to put social work beyond the reach

Through the Looking Glass: How a TC Graduate Brings a Social Work Perspective to the Therapeutic Community: An Interview with Jeffrey Savoy

Abstract: Savoy: I was introduced to TC, or Therapeutic Communities, as the recipient of their services. As an adolescent and young adult I suffered a pretty serious chemical dependency problem. Knowing what I know now, I’m sure that I met the diagnostic criteria for alcohol and marijuana abuse by the age of 13, and the criteria for polysubstance dependence by the time I was 15 or 16. By the age of 26, I was unemployed, homeless, and hopelessly addicted to heroin.