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Biomedical subjects

R L Hubbard

Publications and source records attributed to R L Hubbard.

At least 37 records · Page 2Linked to original sources
PubMed1991

Treatment predictors of tenure in methadone maintenance.

Tenure in methadone maintenance treatment was analyzed in terms of treatment process factors using a survival curve regression analysis. The treatment process framework included client variables at entry, program characteristics, treatment events, and client attitudes and satisfaction. The sample consisted of 606 methadone maintenance clients from 21 different clinics. Significant predictors included professional classifications of the diagnosing and treatment-planning staff members, measures of early treatment services, client attitudes and satisfaction, methadone dosage level, and frequency of urine monitoring. The results showed higher tenure rates when specialized professionals diagnosed problems and defined treatment plans, when service needs were addressed, when client attitudes and satisfaction were high, and when methadone dose was higher. Lower tenure rates were found among blacks and clients with lower sociodemographic status. Lower tenure also occurred among those who perceived the program as less accessible or less structured in its procedures.

Black or African American↗
PubMed1991

Conceptual framework for estimating the social cost of drug abuse.

Drug abuse imposes costs on individuals and society. Researchers have produced several studies on a subset of tangible costs of drug abuse and other illnesses, but key tangible costs sometimes have been overlooked and, even when recognized, rarely have been estimated. An assortment of intangible costs also have received very little research attention. This study outlines a comprehensive conceptual framework for estimating the social cost of drug abuse. We address both the tangible and intangible costs for the drug-abusing and non-drug-abusing population. Our conceptual framework is based on critical reviews of new and traditional methods for estimating the costs of illness and disease including cost-of-illness methods, averting behavior methods, and utility valuation techniques. We show how the proposed methods can be combined with existing data to estimate the total social cost of drug abuse. Using social cost estimates will enable policymakers to more accurately assess the total burden of drug abuse and related problems on society.

Costs and Cost Analysis↗
PubMed1991

The impact of time in treatment on the employment and earnings of drug abusers.

We use data from a longitudinal survey to estimate the effects of time in drug abuse treatment on post-treatment weeks worked and earnings for 2,420 clients in three treatment modalities. The regression analysis shows that time in treatment had a positive and statistically significant impact on these labor market outcomes, but the effects were small for all modalities. Although residential clients experienced the largest relative changes in weeks worked and real earnings, a benefit-cost calculation suggests that additional residential treatment cannot be justified from earnings improvements alone. These results may indicate a need for more employment services while in treatment.

Cost-Benefit Analysis↗
PubMed1991

Unmet service needs in methadone maintenance.

Most drug abuse treatment agencies maintain a wide array of ancillary services, either on-site or through off-site referral resources, for helping meet the diverse social, medical, and psychological needs of clients. The extent to which these needs are met may be an important factor in client retention and outcomes. Perceived unmet service needs and their relationship to client outcomes were therefore studied in relationship to a framework for studying drug abuse treatment process factors. The outcomes in the present study were time in treatment and relapse to opioid use during treatment, and these were examined in relation to perceived need for services and their delivery (whether or not these services were received). The sample consisted of 590 methadone maintenance clients in 21 clinics in the RTI/TOPS data system. The results showed that the measure of unmet needs for services was not significantly related to time to relapse or to time in treatment. However, there appeared to be an indirect effect. There were differences for clinic type and a few significant interactions with other predictor variables used to study treatment process.

Combined Modality Therapy↗
PubMed1990

Treating combined alcohol and drug abuse in community-based programs.

The key issues in effective treatment of combined alcohol and drug abuse are identified as comprehensive diagnosis, effective services, and long-term recovery. Empirical data from community-based alcohol and drug treatment studies are presented, illustrating the extent of combined abuse, the lack of treatment for combined abuse, and the negative effects of combined abuse on treatment outcomes. Reconsideration is given to issues such as the concentration of diagnosis on a primary pattern of abuse, the orientation toward concurrent treatment of combined abuse, the requirement of immediate abstinence vs. gradual reduction of combined abuse patterns, and the role of relapse in recovery from combined abuse.

Alcoholism↗
PubMed1990

Developmental variation in the context of marijuana initiation among adolescents.

A longitudinal sample of 3,454 secondary school students is used to examine the variations in the contexts of marijuana initiation which may be attributable to developmental changes during adolescence. Concepts representing the context of initiation include attachments to parents and peers, exposures to drug-related attitudes of parents and peers and behaviors of peers, and the decision-making process, which involves the weighing of expected costs and benefits of use. Measures representing these concepts are included in logistic regression models predicting initiation. Regression parameters are compared for students in the sixth, seventh, and eighth grades. Results show that only parental attachment measures influence initiation for the youngest group; a mix of parental and peer attachment and peer exposure measures affects initiation for the middle group; and only measures of peer attachment and exposure and of the relative importance of the costs of use predict initiation for the oldest group. The results suggest that developmental factors do influence the context of marijuana initiation.

Adolescent↗
PubMed1986

Patterns of alcohol and drug abuse in drug treatment clients from different ethnic backgrounds.

In this paper we have sought to identify differences in alcohol consumption patterns and problems among young adult males from white, black, and Hispanic ethnic groups entering drug treatment programs. In overall consumption patterns we found results similar to those obtained in general population studies. However, about one-third of the clients in all ethnic groups could be classified as heavier drinkers (drinking at least once a week and 4 or more drinks per drinking occasion) in the period immediately prior to treatment. About one-fourth of the clients in each ethnic group consumed a daily average of 2.5 ounces of absolute alcohol. Compared with the other ethnic groups, blacks were the most likely to be abstainers and reported regular alcohol use and drunkenness at later ages. Regardless of the pattern of development, similar proportions of the clients in all ethnic groups reported heavier drinking levels by age 21-30. Consistent with the current hypotheses in the literature, whites reported much higher levels of alcohol-related problems and prior treatment. Despite having similar levels of drinking, black and Hispanic ethnic groups did not appear to recognize alcohol as a problem or to report alcohol-related problems to the extent that whites did. Examination of drug-use patterns showed great variation in the nature and extent of drug use among the three ethnic groups. Whites were distributed among the seven patterns of use. Heroin use with cocaine, marijuana, and alcohol was the predominant pattern for blacks and Hispanics. Although the patterns of drug use differed greatly, these patterns were not differentially related to alcohol consumption or alcohol-related problems within ethnic groups. On the contrary, the drug-use patterns appeared to be a stronger predictor than ethnicity of use and problems. Multiple-nonnarcotic-users reported the highest levels of alcohol consumption and the greatest numbers of alcohol-related problems. This group typically reported the highest number of alcohol-related problems. Expression of a current need for treatment and a history of prior alcohol treatment were highest for black multiple-nonnarcotic-users. Our examination of the influences of family and friends was based on a limited number of questions available in the data. Heavier drinking was reported by clients who lived with friends, had family or friends who drank regularly, or had extensive involvement in the drug-use network, including drug sales. No ethnic differences were found.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1985

Drug abuse treatment process: a review of the literature.

The literature on drug abuse treatment is reviewed in two sections. The first of these briefly describes the three major treatment modalities (outpatient methadone, residential, and outpatient drug-free). The objectives and approaches of each modality are outlined, and a number of issues surrounding each modality are sketched. The second section of the review covers general studies of drug abuse treatment. In particular, studies of retention, counselor characteristics, program policies and goals, the nature and extent of services received by clients, the context in which treatment is administered, methadone dosage levels, and other such variables are reviewed. Various typologies of treatment are presented and discussed. Conclusions and implications for future research are also discussed.

Aftercare↗
PubMed1985

HTLV-III exposure among drug users.

The Centers for Disease Control hierarchical classification of those at risk for acquired immunodeficiency syndrome (AIDS) underestimates the number of cases in which illicit drug use may play a role in the exposure to human T-cell leukemia virus type III. The immunosuppressive effects of nitrite inhalants are not sufficiently documented to elucidate their role as a cofactor in the development of AIDS. The currently available data on the immunosuppressive effects of self-administered parenteral drugs and their diluents indicate an associated elevation of immunoglobulin M, depressed helper/suppression T-cell ratios, and even damage to DNA. Illicit psychoactive drugs and their diluents may influence the virulence of the virus among parenteral drug users. An association between parenteral drug use and prostitution is not unexpected. Female prostitutes who use parenteral drugs may be at high risk for exposure to the virus and thus may transmit this infectious agent to their clients and their families.

Acquired Immunodeficiency Syndrome↗