Friedmann Peter D, Lemon Stephenie C, Stein Michael D, D'Aunno Thomas A
Division of General Internal Medicine, Department of Medicine, Brown Medical School and Rhode Island Hospital, Providence, Rhode Island 02903, USA.
Am J Drug Alcohol Abuse. 2003;29(1):105-15. doi: 10.1081/ada-120018841.
This study assessed the association of sources of client referral with enrollment of treatment-naive clients. Data from the 1995 (n = 618) and 2000 (n = 745) waves of the National Drug Abuse Treatment Survey (DATSS), a panel study of outpatient substance abuse treatment units (OSAT), were analyzed. Enrollment of treatment-naive clients was defined as the percentage of OSAT clients who entered treatment in the past 30 days with no prior treatment for substance abuse. A generalized estimating equation model simultaneously assessed the association of each referral source with the dependent variable, while controlling for potential confounding and accounting for correlation of unit-level responses over time. In the multivariable model, OSAT units with a greater proportion of treatment-naïve clients had received more referrals from employee assistance programs and the criminal justice system, and fewer referrals from mental health agencies. No effect of referral from medical or social service agencies was observed. These results highlight the role of coercive community institutions in treatment outreach efforts to persons in earlier phases of the "addiction career."
本研究评估了客户转介来源与未接受过治疗的客户入组治疗之间的关联。分析了1995年（n = 618）和2000年（n = 745）全国药物滥用治疗调查（DATSS）的数据，这是一项针对门诊药物滥用治疗单位（OSAT）的面板研究。未接受过治疗的客户入组治疗被定义为在过去30天内开始接受治疗且之前未接受过药物滥用治疗的OSAT客户的百分比。一个广义估计方程模型在控制潜在混杂因素并考虑单位层面反应随时间的相关性的同时，同时评估了每个转介来源与因变量之间的关联。在多变量模型中，未接受过治疗的客户比例较高的OSAT单位从员工援助计划和刑事司法系统获得的转介更多，而从心理健康机构获得的转介较少。未观察到来自医疗或社会服务机构转介的影响。这些结果突出了强制性社区机构在针对“成瘾生涯”早期阶段人群的治疗外展工作中的作用。
