Substance Abuse, Medication Adherence, and Criminality among Mentally Ill Parolees David Farabee & Sylvia Sanchez UCLA Integrated Substance Abuse Programs.

Slides:

Advertisements

Similar presentations

XR-NTX Implementation in Los Angeles County Desirée A. Crèvecoeur-MacPhail, PhD UCLA Integrated Substance Abuse Programs Santa Monica Blvd., Suite.

Advertisements

Pain Catastrophizing and Childbirth Satisfaction in a Group of Nulliparous Women Aaron Reposar, Beth D. Darnall, PhD, Katherine Volpe, Hong Li, MD, MPH.

Abstract People who enter substance abuse treatment under various degrees of legal pressure do at least as well at the end of treatment or at follow-up.

Aftercare Attendance Partially Moderated by History of Physical Abuse and Gender Louise F. Haynes 1 ; Amy E. Herrin 1 ; Rickey E. Carter 1 ; Sudie E. Back.

Predictors of Change in HIV Risk Factors for Adolescents Admitted to Substance Abuse Treatment Passetti, L. L., Garner, B. R., Funk, R., Godley, S. H.,

Substance Use: Substance use comparisons included lifetime and past 30 day use (Figure 3) and lifetime use. For past 30 day use, more men reported heroin.

Delay from Testing HIV Positive until First HIV Care for Drug Users: Adverse Consequences and Possible Solutions Barbara J Turner MD, MSEd* John Fleishman.

The Impact of Telepsychiatry for Patients with Co-morbid Disorders at a Rural County-Run Residential Treatment Clinic Presented at: Addiction Health Services.

Journal Club Alcohol, Other Drugs, and Health: Current Evidence November-December 2007.

Journal Club Alcohol, Other Drugs, and Health: Current Evidence May-June 2007.

The Prevalence of Mental Illness

OUTLINE HOW MEASURE M.I. IN COMMUNITY POPULATIONS? MAJOR INSTRUMENTS AND FINDINGS PROBLEMS WITH INSTRUMENTS POLICY IMPLICATIONS.

Prescription Drug Abuse and Misuse in the Elderly Thomas L. Patterson, Ph.D. Support for this work: NIMH Center Grants P30 MH49693 and MH45131, and by.

Impact of Side Effects of Antipsychotics on Attitude and Adherence to Treatment among Adult Psychiatric Outpatients at Mathari Hospital in Kenya Defense.

® Introduction Mental Health Predictors of Pain and Function in Patients with Chronic Low Back Pain Olivia D. Lara, K. Ashok Kumar MD FRCS Sandra Burge,

® Introduction Low Back Pain Remedies and Procedures: Helpful or Harmful? Lauren Lyons, Terrell Benold, MD, Sandra Burge, PhD The University of Texas Health.

UCLA Drug Abuse Research CenterForever Free Evaluation Forever Free Substance Abuse Treatment Program Outcomes Study Michael Prendergast, Ph.D., Principal.

Using Research/Evaluation Questions to Define Data Collection and Findings: Findings from the FY 2004 KTOS Follow-up Study Robert Walker, Allison Mateyoke-Scrivener,

Frequency and type of adverse events associated with treating women with trauma in community substance abuse treatment programs T. KIlleen 1, C. Brown.

It’s Possible to prevent social exclusion among mentally ill?: IPSE Project, " Clinical Case Management " in Schizophrenic Patients in two catchment areas.

NIDA Grants: U10DA015831, K24DA022288, U10DA020024, K23DA022297, U10DA Predictors of Outcome in the Multi-Site CTN Prescription Opioid Addiction.

Characteristics of Patients Using Extreme Opioid Dosages in the Treatment of Chronic Low Back Pain In this sample of 204 participants, 70% were female,

Demonstration of a Process- Outcome Link for Smoking Cessation Melissa M. Farmer, PhD 1,2 Elizabeth M. Yano, PhD 1,2 Brian S. Mittman, PhD 1,2 Scott E.

American Association for the Treatment of Opioid Dependence, Inc National Conference, Atlanta April 25, 2006 Evaluation of the Impact of Opioid Treatment.

Prevalence of Chronic Disease & Comorbid Conditions in the CHAIN Cohort CHAIN Report Peter Messeri, Gunjeong Lee, Sara Berk Mailman School of Public.

Medication Adherence, Substance Use and Psychiatric Symptom Severity among Mental Health Jail Diversion Program Clients Elizabeth N. Burris, Evan M. Lowder,

Does reduction in cocaine use represent psychosocial benefit? Ivan D. Montoya, M.D., M.P.H. Deputy Director, NIDA-DPMC.

Introduction The United States has one of the largest criminal justice populations in the world with over 6.94 million people under the supervision of.

Gaps in Drug Benefits: Impact on Utilization and Spending for Drugs Used by Medicare Beneficiaries with Serious Mental Illness Linda Simoni-Wastila, PhD.

Obtaining housing associated with achieving abstinence after detoxification in adults with addiction Tae Woo Park, Christine Maynié-François, Richard Saitz.

The University of Georgia Smoking Cessation Programs in Addiction Treatment Centers: An Organizational Analysis Hannah K. Knudsen, Ph.D. Lori J. Ducharme,

® Introduction Changes in Opioid Use for Chronic Low Back Pain: One-Year Followup Roy X. Luo, Tamara Armstrong, PsyD, Sandra K. Burge, PhD The University.

Participants were recruited from 6 drug free, psychosocial treatment (PT) and 5 methadone maintenance (MM) programs (N = 628) participating in a NIDA Clinical.

Lipoatrophy and lipohypertrophy are independently associated with hypertension: the effect of lipoatrophy but not lipohypertrophy on hypertension is independent.

Presented By: Mohammed Al-Issa. Objectives of the Study To assess the degree of satisfaction among dialysis patients in their dialytic therapy. To assess.

Introduction Introduction Alcohol Abuse Characteristics Results and Conclusions Results and Conclusions Analyses comparing primary substance of abuse indicated.

SCHOOL OF NURSING UNIVERSITY OF CALIFORNIA, SAN FRANCISCO Not Ready for Prime Time? A Web-Based SBIRT Intervention in an Urban Safety-Net HIV Clinic Carol.

Introduction Results and Conclusions Categorical group comparisons revealed no differences on demographic or social variables. At admission to treatment,

1 The impact of ongoing illicit drug use on virologic suppression in HIV-infected injection drug users receiving HAART Authors: Harout Tossonian, Jesse.

Introduction Results and Conclusions On demographic variables, analyses revealed that ATR clients were more likely to be Hispanic and employed, whereas.

Psychosocial Changes Among Special Populations in a Prison-based Therapeutic Community David Farabee, Michael Prendergast, & Jerome Cartier University.

UCLA Integrated Substance Abuse Programs Amity In-Prison Therapeutic Community: Five-Year Outcomes Association of Criminal Justice Research (CA) Sacramento,

Table 1. Prediction model for maximum daily dose of buprenorphine-naloxone in a 12-week treatment condition Baseline Predictors Maximum Daily Dose Standardized.

Introduction Results and Conclusions Analyses of demographic and social variables revealed that women were more likely to have children, be living in a.

Introduction Results Treatment Needs and Treatment Completion as Predictors of Return-to-Prison Following Community Treatment for Substance-Abusing Female.

Relational Discord at Conclusion of Treatment Predicts Future Substance Use for Partnered Patients Wayne H. Denton, MD, PhD; Paul A. Nakonezny, PhD; Bryon.

® Changes in Opioid Use Over One Year in Patients with Chronic Low Back Pain Alejandra Garza, Gerald Kizerian, PhD, Sandra Burge, PhD The University of.

Introduction Results and Conclusions On counselor background variables, no differences were found between the MH and SA COSPD specialists on race/ethnicity,

Barriers to Providing Health Services for HIV/AIDS, Hepatitis C Virus Infection, and Sexually Transmitted Infections in Substance Abuse Treatment Programs.

Background Objectives Results Methods Within State Geographic Variation in Antipsychotic Medication Treatment for Medicaid-insured Children and Adolescents.

1 Is the ACT model effective in a contemporary Danish psychiatric setting? Preliminary Results from a Danish Multi-centre Trial of Assertive Community.

The Role of Residential Segregation in Disparity Research: A Case Example of ADHD Diagnosis and Treatment Dinci Pennap, MPH, 1 Mehmet Burcu, MS, 1 Daniel.

Study Design & Population A retrospective cohort design was applied to the Medicaid administrative claims data of youth continuously enrolled in a Mid-Atlantic.

Medical and Emergency Medical Use by People Experiencing Homelessness before and after Placement in Supportive Housing James Petrovich, PhD, LMSW TCU Department.

Urine Drug Monitoring: Indiana Council of Community Mental Health Centers Jerry Vaccaro, M.D. President, Ingenuity Health October 15, 2015.

Texas COSIG Project Gender Differences in Substance Use Severity and Psychopathology in Clients with Co-Occurring Disorders 5 th Annual COSIG Grantee Meeting.

Methamphetamine Use Among Offenders Association for Criminal Justice Research (CA) March 17, 2005 Jerry Cartier / David Farabee / Michael Prendergast University.

Introduction Results and Conclusions Comparisons of psychiatric hospitalization rates in the 12 months prior to and after baseline assessment revealed.

InvolvE Outcomes of Involuntary Admissions in Hospitals In England Newham Centre for Mental Health Institute of Psychiatry Liverpool University Bristol.

Introduction Results and Conclusions Numerous demographic variables were found to be associated with treatment completion. Completers were more likely.

Psychotherapy Success in Patients with Social Anxiety Disorder.

Randomized Controlled CTN Trial of OROS-MPH + CBT in Adolescents with ADHD and Substance Use Disorders Paula Riggs, M.D., Theresa Winhusen, PhD., Jeff.

Medication Adherence and Substance Abuse Predict 18-Month Recidivism among Mental Health Jail Diversion Program Clients Elizabeth N. Burris 1, Evan M.

Clare Meernik, MPH 1 ; Anna McCullough, MSW, MSPH, CTTS 1 ; Leah Ranney, PhD 1 ; Barbara Walsh 2 ; Adam O. Goldstein, MD, MPH 1 Predictors of Quit for.

Gathering Community Support

NAMI Smarts for Advocacy Medication: Protecting Choice

American Public Health Association Annual Meeting November 5, 2007

Nathan D. Culver, Pharm.D., BCPS; Hera Saleem, Student Pharmacist;

A systematic review of the relationship between substance abuse and psychotropic medication adherence: opportunities to improve outcomes for patients with.

Certified Community Behavioral Health Clinic

Presentation transcript:

Substance Abuse, Medication Adherence, and Criminality among Mentally Ill Parolees David Farabee & Sylvia Sanchez UCLA Integrated Substance Abuse Programs Department of Psychiatry and Biobehavioral Sciences Santa Monica, Suite 150 Los Angeles, CA Funded by the National Institute of Justice (99-CE-VX-0003). The views and conclusions expressed in this presentation are those of the authors and do not necessarily reflect the position of the funding agency.

UCLA Integrated Substance Abuse Programs 2 Background It has been estimated that 30 % to 60% of all patients do not adhere to any part of their prescribed treatment (Ley, 1998). 50% to 70% of patients fail to accurately follow their prescriptions—often resulting in significant health problems (Haynes, Taylor, & Sackett, 1979). Medication adherence, regardless of the type of illness has been cited as the “most significant reason for failed therapy” (Robbins, 1980). Less is known, however, about psychiatric medication among parolees--most of whom enter treatment under legal pressure.

UCLA Integrated Substance Abuse Programs 3 Study Goals Assess the rates of antipsychotic medication adherence among severely mentally ill parolees. Compare medication adherence of mentally ill (non- substance dependent and comorbid parolees). Identify pre- and during-treatment predictors of antipsychotic medication adherence.

UCLA Integrated Substance Abuse Programs 4 Study Design/Measures Data were collected from 125 psychotic parolee outpatients at the Los Angeles Parole Outpatient Clinic (LA-POC). In order to be eligible, subjects must have (1) been admitted to the LA- POC within the past 14 days, and (2) been prescribed antipsychotics. The baseline interview included the Addiction Severity Index (ASI); Treatment Insight Questionnaire; Perceived Coercion Scale; and self-reported medication adherence. Subjects were also asked to provide urine and hair samples in order to corroborate self-reported use of illicit drugs and antipsychotic medications.

UCLA Integrated Substance Abuse Programs 5 Sample Characteristics (N=125)

UCLA Integrated Substance Abuse Programs 6 Self-Reported Lifetime Arrest Categories (N=118)

UCLA Integrated Substance Abuse Programs 7 Past-Month Cocaine Use: Self-Report vs. Hair Assays Self-reported cocaine use during the past 30 days was unrelated to objective measures based on hair assays (Contingency co- efficient-.07, p=ns). 6% of the sample tested positive for opiates; fewer than 2% tested positive for amphetamine or PCP.

UCLA Integrated Substance Abuse Programs 8 Anti-Psychotic Med. Adherence: Self-Report vs. UAs Self-reported adherence did not closely correspond with objective measures based on urinalysis (Contingency co-efficient-.06, p=ns). 29% of those reporting high adherence had no trace of the prescribed medication in their urine.

UCLA Integrated Substance Abuse Programs 9 Medication Adherence by Illicit Drug Use (Objective Measures) Anti-psychotic medication adherence did not vary as a function of co-occurring illicit drug use (p=.90)

UCLA Integrated Substance Abuse Programs 10 Currently Experiencing Side Effects from Medication However, co-occurring illicit drug use was significantly associated with reports of negative medication side effects (p<.05).

UCLA Integrated Substance Abuse Programs 11 Predicting Adherence: Log Odds Ratios for Pre-Treatment Factors After controlling for age, race, and gender, neither perceived coercion nor perceived need for treatment (at baseline) were predictive of adherence.

UCLA Integrated Substance Abuse Programs 12 Predicting Adherence: Log Odds Ratios for During- Treatment Factors After controlling for age, race, and gender, three treatment-related variables emerged as significant predictors of adherence: –Having a “sponsor” control the parolee’s medication; –Perception that the medication is helping; and –Being prescribed an atypical (vs. typical) antipsychotic.

UCLA Integrated Substance Abuse Programs 13 Conclusions Self-report measures of illicit drug use and medication adherence corresponded poorly with objective measures. Co-morbid cocaine use was not associated with poorer medication adherence. Cocaine use was, however, associated with a significant increase in the likelihood of reporting negative medication side effects.

UCLA Integrated Substance Abuse Programs 14 Conclusions (Cont.) Pre-treatment factors (perceived need for treatment and perceived coercion) did not predict anti-psychotic medication adherence. However, treatment-related factors (medication effectiveness and patient monitoring) were associated with 3- to 9- fold increases in medication adherence.

UCLA Integrated Substance Abuse Programs 15 References Haynes, R., Taylor, D.W., & Sackett, D.L. (1979). Compliance in healthcare. Baltimore, MD: Johns Hopkins University Press. Ley, P. (1988). Communicating with patients: Improving communication, satisfaction, and compliance. London: Croom Helm. Robbins, J.A. (1980). Patient compliance. Primary Care 7, No. 4, pp