1. The Addiction Severity Index (ASI) Across Cultures TRI science addiction 2005 NIDA International Forum June 17th, 2005 Workshop II - The Ireland Room B Thanks to NIDA: Steve Gust & Erin Winstanley

2. The Addiction Severity Index (ASI) Across Cultures TRI science addiction Today’s Presenters:

3. Selection, Modification and Inter-rater Reliability on the use of the ASI in Egypt Sample: Adult Inpatient Hospital Program in Cairo Nasser Loza, Egypt TRI science addiction

4. Elaborating and using the ASI across different national realities and treatment conditions – The EuropASI in Greek Treatment Programmes Sample: Adults in 6 Drug-Free Therapeutic Communities in Greece Gerasimos Papanastasatos, Greece TRI science addiction

5. Understanding the Israeli addict population – ASI profiles of former Soviet Union and native Israeli opiate abusers Sample – Adults in detoxification, day treatment and methadone maintenance programs Richard Isralowitz, Israel TRI science addiction

6. Incorporating the ASI: Exploring assessment and outcomes in a residential treatment facility in Northern Ireland Sample: Adult Residential Treatment Facility in Northern Ireland Debra Wilson & Pauline Murnin, Ireland TRI science addiction

7. The Brazilian experience on the implementation of the ASI – where are we right now? Sample: Adult Cocaine Abusers @ HIV clinics in Brazil and a Validity Study of the ASI 6 Flavio Pechansky, Brazil TRI science addiction

8. Experiences using the ASI in different countries. and… Richard Rawson, USA TRI science addiction

9. ASI International Use and Data from 10 Countries Deni Carise, USA TRI science addiction

10. Introduction TRI science addiction In addition to those presenting here, researchers and clinicians in the following countries have used the ASI: The ASI has been translated and modified for use in many countries.

11. Introduction Countries TRI science addiction Thailand Scotland Hungary Ukraine The Netherlands Sweden Iran Pakistan Spain Italy Belgium Canada The Caribbean Chile Guatemala Morocco Tunisia Portugal Russia Norway

12. Introduction Deni’s Presentation TRI science addiction Today, data are presented from the US Drug Evaluation Network System and various samples in: Belgium Brazil GreeceIreland Italy Norway RussiaScotland Sweden

13. Data Sets TRI science addiction

14. Introduction TRI science addiction Data Sets USA Deni Carise & A. Thomas McLellan 8,479 patients from 14 inpatient/ residential, 4 methadone maintenance and 18 out-patient treatment programs BrazilFlavio Pechansky & Felix Kessler 193 cocaine-dependent clients from 3 HIV Clinics

15. Introduction TRI science addiction Data Sets GreeceGerasimos Papanastasatos & Erianna Daliani 500 clients from 4 residential and 2 OP programs Ireland Debra Wilson & Pauline Murnin 162 clients from 1 inpatient program

16. Introduction Data Sets Belgium 1 Joke De Wilde 117 Clients from 4 adult residential drug-free TC’s Belgium 2 Veerle Raes 3,712 clients from a large drug addiction treatment program

17. ItalyJoke De Wilde 101 clients from 5 adult residential drug-free TC’s Norway Edle Ravndal 482 clients from 10 IP, 4 MM, 3 OP youth and 4 youth “collectives”. RussiaEvgeny Krupitsky 332 clients from 1 adult hospital detox & treatment program. Data Sets TRI science addiction

18. ScotlandRowdy Yates 134 clients from 1 adult OP drug treatment program. Sweden Jonas Larsson, David Oberg & Bjorn Sallmen 201 prisoners from 16 SA prison-based treatment programs Data Sets TRI science addiction

19. Data Sets TRI science addiction

20. AgeAge GenderGender Alcohol & Drug Composite scoresAlcohol & Drug Composite scores Days heavy drinkingDays heavy drinking Days used marijuanaDays used marijuana Days used cocaineDays used cocaine TRI science addiction Data Presented:

21. Medical, Psychiatric, Family and Legal: Composite ScoresComposite Scores Days problemsDays problems Days conflictsDays conflicts Percent reporting symptomsPercent reporting symptoms Illegal behaviorIllegal behavior Employment variablesEmployment variables TRI science addiction Data Presented:

22. International Data Sample NAge (SD)% Male Belgium 1 11724 (6)84 Brazil193-89 Greece50026 (5)84 Ireland16241 (10)69 Italy10128 (4)88 Norway48231 (8)67 Russia33223 (0)74 Scotland13427 (6)68 Sweden20136 (11)95 U.S.A.842935 (11)66

23. International Data – Drug & Alcohol Alc. CSDrink 5+ Drg. CSCocaineCannabis Belgium 1.11 (.19)2 (5).17 (.13)1 (5)5 (8) Brazil.25 (.20)10 (9).19 (.10)13 (10)21 (11) Greece-0 (2).21 (.11)0 (2)2 (6) Ireland.67 (.26)16 (10).07 (.14)0 (1)3 (8) Italy.20 (.27)6 (11).26 (.17)2 (6)8 (12) Norway.08 (.14)2 (6).31 (.13)0 (3)10 (12) Russia.28 (.00)-.08 (.01)-- Scotland.07 (.18)4 (9).43 (.09)1 (4)16 (13) Sweden.52 (.28)13 (12).05 (.09)1 (4)2 (7) U.S.A..21 (.26)3 (7).12 (.13)3 (7)2 (6)

24. International Data – Medical & Psychiatric Med. CS Med. Prob. Psy. CS% Dep.Psy. Prob. Belgium 1.35 (.32)10 (12).49 (.24)3813 (12) Brazil.24 (.28)12 (9).23 (.22)2115 (11) Greece.21 (.29)4 (8).21 (.18)219 (11) Ireland.40 (.41)11 (13).48 (.26)5918 (13) Italy.17 (.23)2 (6).38 (.26)279 (12) Norway.25 (.32)8 (12).27 (.23)3311 (13) Russia.23 (.01)-.25 (.01)-- Scotland.34 (.39)8 (5).32 (.26)6411 (12) Sweden.34 (.37)10 (14).24 (.21)289 (13) U.S.A..17 (.30)5 (10).19 (.23)308 (11)

25. International Data – Family & Legal Fam. CSConflictsLeg. CSIllegal ActWorkEmp. Prob. Belgium 1.20 (.22)2 (6).34 (.23)2 (7)2 (5)4 (8) Brazil.24 (.21)10 (10).12 (.17)8 (9)22 (9)9 (10) Greece.34 (.20)5 (9)-1 (5)3 (8)5 (13) Ireland.29 (.26)7 (11).09 (.19)0 (3)4 (8)6 (11) Italy.36 (.26)7 (11).30 (.29)6 (10)4 (9)1 (1) Norway.16 (.19)4 (9).31 (.28)10 (13)5 (10)3 (9) Russia.41 (.01)-.17 (.02)--- Scotland.38 (.23)6 (8).40 (.25)17 (13)1 (5)9 (11) Sweden.18 (.20)3 (8).28 (.13)4 (10)5 (10)8 (13) U.S.A..16 (.21)3 (7).18 (.21)1 (4)8 (10)8 (12)

26. Belgium 2 Veerle Raes Data collected 1998 - 2004 3,712 interviews 383 Inpatient; 3,329 Outpatient All collected from a large “illegal drug addiction treatment program” (may under-represent alcohol use). Larger Belgium Data Set TRI science addiction

27. USA vs. Belgium Data by Modality U.S.A. (IP)Belgium 2 (IP)U.S.A. (OP)Belgium 2 (OP) Sample N 3,1333833,8853,329 Age (SD) 36 (11)25 (6)33 (10)27 (7) % Male 71867782 Alc. CS.33 (.27).1 (.2).16 (.23).1 (.1) Drink 5+ 5 (9)2 (5)2 (6)3 (6) Drg. CS.11 (.14).2 (.1).09 (.11).2 (.1) Cocaine 3 (8)2 (5)2 (6)2 (5) Cannabis 2 (6)4 (8)2 (6)11 (12)

28. USA vs. Belgium Data by Modality U.S.A. (IP)Belgium 2 (IP)U.S.A. (OP)Belgium 2 (OP) Med. CS.16 (.29).3 (.3).15 (.28).2 (.3) Med. Prob. 4 (9)8 (11)5 (10)7 (11) Psy. CS.20 (.24).3 (.2).16 (.22).2 (.2) % Dep.31342530 Psy. Prob.8 (12)14 (12)6 (11)10 (11) Fam. CS.15 (.21).3 (.2).13 (.20).1 (.2) Conflicts3 (8) 2 (7)2 (6) Leg. CS.20 (.22).3 (.2).18 (.20).2 (.2) Illegal Act1 (5)3 (7)1 (4)1 (5) Work8 (10)1 (5)9 (11)8 (11) Emp. Prob. 8 (12)3 (8)9 (12)5 (10)

29. Conclusions TRI science addiction

30. Conclusions TRI science addiction Data presented just for discussion - No conclusions please! Data were collected from too many different locations (prisons, HIV clinics, in patient, outpatient treatment programs) and from too many different samples (opiate only users, primary alcohol users, an all inpatient sample, an outpatient only sample, etc.) for valid comparisons to be made.

31. Limitations TRI science addiction

32. The End TRI science addiction