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M Argeriou

Publications and source records attributed to M Argeriou.

At least 19 recordsLinked to original sources
PubMed2001

Public sector managed care for substance abuse treatment: opportunities for health services research.

Observations of reduced utilization of alcohol and drug abuse treatment following the introduction of managed behavioral health care suggest that substance abuse services may be especially responsive to managed care restrictions and limits. In publicly funded treatment systems, patient attributes, system and provider characteristics, and financing mechanisms may heighten susceptibility to unintended effects. The State Substance Abuse and Mental Health Treatment Managed Care Evaluation Program reviewed state managed care programs for publicly funded alcohol and drug treatment services and is evaluating programs in Arizona, Iowa, Maryland, and Nebraska. The article describes initiatives and outlines evaluation activities. It discusses the opportunities and challenges of assessing public managed care plans.

Arizona↗
PubMed2000

The costs of crime and the benefits of substance abuse treatment for pregnant women.

Although many pregnant, drug-dependent women report extensive criminal justice involvement, few studies have examined reductions in crime as an outcome of substance abuse treatment programs for pregnant women. This is unfortunate, because maternal criminal involvement can have serious health and cost implications for the unborn child, the mother and society. Using the Addiction Severity Index, differences in pre- and posttreatment criminal involvement were measured for a sample of 439 pregnant women who entered publicly funded treatment programs in Massachusetts between 1992 and 1997. Accepted cost of illness methods were supplemented with information from the Bureau of Justice Statistics to estimate the costs and benefits of five treatment modalities: detoxification only (used as a minimal treatment comparison group), methadone only, residential only, outpatient only, and residential/outpatient combined. Projected to a year, the net benefits (avoided costs of crime net of treatment costs) ranged from US$32,772 for residential only to US$3,072 for detoxification. Although all five modalities paid for themselves by reducing criminal activities, multivariate regressions controlling for baseline differences between the groups showed that reductions in crime and related costs were significantly greater for women in the two residential programs. The study provides economic justification for the continuation and possible expansion of residential substance abuse treatment programs for criminally involved pregnant women.

Adult↗
PubMed1993

The use of shelters as substance abuse stabilization sites.

The feasibility of providing postdetoxification residential substance abuse programming (stabilization) in large emergency shelters was examined as part of a demonstration project funded by the National Institute on Alcohol Abuse and Alcoholism under Section 613 of the Stewart B. McKinney Act (Public Law 100-71). The program completion rates of 773 homeless/near-homeless substance-abusing individuals assigned to two large shelters (71% and 62%) and two traditional substance abuse treatment agencies (68% and 54%) were comparable. These data support the expansion of shelter services to include substance abuse programming and intervention. Shelters represent windows of opportunity into the lives of homeless substance-abusing men and women, and full advantage of this opportunity should be taken to impact this subgroup of the homeless.

Adult↗
PubMed1992

Substance abuse treatment management information systems: balancing federal, state, and service provider needs.

There is increased interest in documenting the characteristics and treatment outcomes of clients served with Alcohol, Drug Abuse, and Mental Health Block Grant funds. The evolution of federal client-based management systems for substance abuse treatment services demonstrates that data collection systems are important but require continued support. A review of the Massachusetts substance abuse management information system illustrates the utility of a client-based data set. The development and implementation of a comprehensive information system require overcoming organizational barriers and project delays, fostering collaborative efforts among staff from diverse agencies, and employing considerable resources. In addition, the need to develop mechanisms for increasing the reliability of the data and ongoing training for the users is presented. Finally, three applications of the management information system's role in shaping policy are reviewed: developing services for special populations (communities of color, women, and pregnant substance abusers, and injection drug users), utilizing MIS data for evaluation purposes, and determining funding allocations.

Computer Communication Networks↗
PubMed1992

The Fifth Edition of the Addiction Severity Index.

The Addiction Severity Index (ASI) is 12 years old and has been revised to include a new section on family history of alcohol, drug, and psychiatric problems. New items were added in existing sections to assess route of drug administration; additional illegal activities; emotional, physical, and sexual abuse; quality of the recovery environment; and history of close personal relationships. No changes were made in the composite scoring to maintain comparability with previous editions. This article discusses the clinical and research uses of the ASI over the past 12 years, emphasizing some special circumstances that affect its administration. The article then describes the rationale for and description of the changes made in the ASI. The final section provides "normative data" on the composite scores and severity ratings for samples of opiate, alcohol, and cocaine abusers as well as drug abusing inmates, pregnant women, homeless men, and psychiatrically ill substance abusers.

Adolescent↗
PubMed1991

Alcoholism, drug abuse, and the homeless.

Credible estimates of the prevalence of alcohol and drug abuse suggest that alcohol abuse affects 30% to 40% and drug abuse 10% to 15% of homeless persons. A review of policies that address substance abuse among the homeless finds that interventions alternate between control and rehabilitation. However, the unique needs of a changing homeless population require an integration of alcoholism and drug abuse recovery services with programs for women, adolescents, and the mentally ill. Alcohol- and drug-free housing is essential to support and maintain recovery. Psychology can contribute in the development of effective programs for homeless individuals struggling with addiction and alcoholism.

Alcoholism↗
PubMed1988

Rearrest following residential treatment for repeat offender drunken drivers.

Multiple offenders are at high risk for continued drunken driving. Massachusetts, therefore, mandated that individuals convicted of a second drunken driving offense either be committed for a minimum of 7 days in a house of correction or enter a 14-day residential alcoholism treatment program for second offenders. A 2-year follow-up study of arrest rates assessed the impact of the two sentencing options on subsequent arrests for driving under the influence of liquor (DUIL). The incarcerated sample (N = 190) was slightly younger, had more prior DUIL charges and exhibited greater criminality than those who entered treatment (N = 199). Offenders admitted to the 14-day program were significantly less likely to be rearrested for drunken driving (10 vs 20%). A summary odds ratio suggested that when adjusted for differences in prior arrests, the risk of rearrest was 1.9 times greater among incarcerated offenders. Although a 2-year follow-up is insufficient to assess the complete impact of the 14-day program, the two-fold difference in the risk of rearrest suggests that mandated short-term residential treatment may provide an effective intervention among repeat offender drunken drivers.

Adult↗
PubMed1985

Criminality among individuals arraigned for drinking and driving in Massachusetts.

Criminal record searches of 1406 randomly selected driving under the influence of liquor (DUIL) offenders in Massachusetts revealed a history of prior court arraignments in 76.5% of the cases. Half (51.2%) had been arraigned for criminal offenses other than or in addition to traffic and DUIL, and one-fourth (27.7%) had been previously arraigned for DUIL. Among those with prior DUIL arrests, 68% also had criminal arrests. A 3-year follow-up indicated that 63% of those rearrested for DUIL had prior criminal arrests. Eight subgroups of offenders were created by categorizing the sample according to the presence or absence of criminal, traffic and prior DUIL offenses. Rates of recidivism differed among the subgroups and illustrated the utility of using criminal history data to differentiate DUIL offenders. The need to develop alternative court management-rehabilitation strategies responsive to subgroup differences is discussed.

Adult↗
PubMed1985

Legislated policies and recidivism for driving under the influence of liquor in Massachusetts.

Legislation on driving under the influence of liquor was changed significantly in Massachusetts on 1 December 1975; it permitted courts to continue cases without a finding if defendants were place probation and assigned to driver alcohol education. The effect of the revisions on the incidence of rearrest was assessed. The 3-yr arrest records of 522 individuals arrested for drunken driving 2 yr before the changes (1973) were compared with 716 and 690 offenders arrested 1 (1976) and 2 (1977) yr post-law modification. Sample participants were selected randomly. The legislation strongly affected court dispositions. Over 70% of the 1976-1977 cases were continued without findings and more offenders were sanctioned. The proportion found not guilty dropped from 1973 to 1976-1977. Absolute rearrest rates were similar for each cohort. Probability of arrest, however, rose substantially between 1973 and 1980. Relative to the increased arrest rate, there was a significant decline in rearrests 2 and 3 yr after a drunken driving arrest during the post-law period. The legislation apparently contributed to an amelioration of the drunken driving problem by encouraging judicial reforms and educational interventions.

Accidents, Traffic↗
PubMed1978

Reaching problem-drinking Blacks: the unheralded potential of drinking driver programs.

The potential of court-enforced treatment of problem drinking drivers in reaching and effectively treating problem drinking Blacks is examined through an analysis of the experience of one such drinking driver program. The findings support the contention that the potential of court-enforced treatment is significant and should not be overlooked in any plan aimed at providing treatment services to the Black community.

Adult↗
PubMed1976

Black alcoholism. A comment on NIAAA's plan to combat the problem.

The National Institute on Alcohol Abuse and Alcoholism's Interim Guidelines for the Establishment of Black Alcoholism Projects are criticized for their possible latent function of redirecting treatment energies away from the primary problem of alcoholism.

Black or African American↗
PubMedDate not supplied

Use of the Addiction Severity Index with homeless substance abusers.

The Addiction Severity Index (ASI) is a widely adopted assessment instrument that provides severity ratings of the multiple problems exhibited by alcohol and drug dependent persons and allows for quantitative assessment (composite scores) of client status in these problems areas over time. ASI change scores of homeless and near homeless substance abusers, generated by contrasting ASI composite scores at two points in time, show a high level of agreement to objective relapse data from the Massachusetts Bureau of Substance Abuse Services Management Information System. Clients readmitted to a publicly funded detoxification facility exhibited significantly lower mean change scores on five of the seven problems areas measured by the ASI. These data illustrate the applicability of the ASI to homeless men and women and the utility of the ASI in measuring client improvement.

Adult↗
PubMedDate not supplied

Substance abuse treatment for pregnant women: a window of opportunity?

The use of substance abuse treatment services by pregnant and nonpregnant women was compared to explore the effects of pregnancy on treatment utilization and outcomes. Treatment service records for 227 pregnant drug- and alcohol-dependent women and a matched comparison group of 277 nonpregnant women were retrieved from the Massachusetts Bureau of Substance Abuse Services Management Information System. Treatment services received by the two groups of women during a 6-month period following an index detoxification were tabulated and compared. Treatment services for pregnant women differed quantitatively and qualitatively from the services received by nonpregnant women over the 6-month time period. After controlling for background characteristics and substance abuse history, pregnant women were 1.7 times more likely to be readmitted to detoxification, 2.8 times more likely to enter residential facilities, and 5.4 times more likely to enter methadone programs. For both groups, the use of outpatient and/or residential treatment services following discharge from detoxification significantly reduced the risk of subsequent detoxification admissions. The increased likelihood of admission to detoxification, residential, and methadone services suggests that treatment programs have improved access to care for pregnant women. Multiple detoxification admissions suggest, however, that some pregnant women have difficulty entering stable recovery. Given the brevity of the gestational period and the detrimental effects of drug and alcohol use on fetal outcomes, the use of continuing treatment services for pregnant women is strongly recommended.

Adolescent↗