Biomedical subjects

R R Gainey

Publications and source records attributed to R R Gainey.

6 recordsLinked to original sources

PubMed1999

An experimental intervention with families of substance abusers: one-year follow-up of the focus on families project.

AIMS: Children whose parents abuse drugs are exposed to numerous factors that increase the likelihood of future drug abuse. Despite this heightened risk, few experimental tests of prevention programs with this population have been reported. This article examines whether intensive family-focused interventions with methadone treated parents can reduce parents' drug use and prevent children's initiation of drug use. DESIGN: Parents were assigned randomly into intervention and control conditions and assessed at baseline, post-test, and 6 and 12 months following the intervention. Children were assessed at baseline, and 6- and 12-month follow-up points. SETTING: Two methadone clinics in Seattle, Washington. PARTICIPANTS: One hundred and forty-four methadone-treated parents, and their children (n = 178) ranging in age from 3 to 14 years old. INTERVENTION: The experimental intervention supplemented methadone treatment with 33 sessions of family training combined with 9 months of home-based case management. Families in the control condition received no supplemental services. MEASUREMENT: Parent measures included: relapse and problem-solving skills, self-report measures of family management practices, deviant peer networks, domestic conflict and drug use. Child measures included self-report measures of rules, family attachment, parental involvement, school attachment and misbehavior, negative peers, substance use and delinquency. FINDINGS: One year after the family skills training, results indicate significant positive changes among parents, especially in the areas of parent skills, parent drug use, deviant peers and family management. Few changes were noted in children's behavior or attitudes. CONCLUSIONS: Programs such as this may be an important adjunct to treatment programs, helping to strengthen family bonding and to reduce parents' drug use.

Adolescent↗

PubMed1998

A meta-analysis of predictors of continued drug use during and after treatment for opiate addiction.

AIMS: Many people treated for opiate addiction continue to use drugs during and after treatment. It may be possible to improve outcomes by addressing patient characteristics that predict continued drug use. This review uses meta-analytic techniques to identify risk factors for continued drug use in patients treated for opiate abuse. DESIGN AND MEASUREMENTS: A thorough search of the published literature yielded 69 studies that reported information on the bivariate association between one or more independent variables and continued use of illicit drugs during and after treatment for opiate addiction. FINDINGS: Most of the patient variables summarized have weak longitudinal relationships with continued drug use, although several variables display moderate longitudinal associations. Ten variables show statistically significant and longitudinally predictive relationships (average r > 0.1) with continued use, including: high level of pretreatment opiate/drug use, prior treatment for opiate addiction, no prior abstinence from opiates, abstinence from/light use of alcohol, depression, high stress, unemployment/employment problems, association with substance abusing peers, short length of treatment, and leaving treatment prior to completion. Several other variables may be potentially longitudinally predictive. CONCLUSIONS: To prevent relapse, treatment interventions should address multiple variables because no single variable strongly predicts continued drug use.

Crime↗

PubMed1997

Reducing parental risk factors for children's substance misuse: preliminary outcomes with opiate-addicted parents.

Parents in methadone treatment were offered an experimental intervention, Focus on Families, designed to reduce their risk of relapse and their children's risk of substance use. Experimentally assigned volunteers participated in systematic group training in relapse prevention and parenting skills, and received home-based case management services. Immediate posttreatment outcome results reported here include analyses of covariance controlling for baseline measures. Analyses show experimental parents held more family meetings to discuss family fun, displayed stronger refusal/relapse coping skills, demonstrated stronger sense of self-efficacy in role-play situations, and had lower levels of opiate use than control subjects. No significant differences in family bonding, family conflict, or other measures of drug use were found. The utility of intervening with drug-addicted parents in methadone treatment is discussed in light of these findings.

Adolescent↗

PubMed1994

Outpatient treatment for cocaine abuse: a controlled comparison of relapse prevention and twelve-step approaches.

This study sought to assess the efficacy of treatment for cocaine abuse and to compare the relative effectiveness of a cognitive-behavioral relapse prevention treatment with that of a Twelve-Step recovery support group in an outpatient group treatment setting. One hundred ten subjects seeking treatment were alternately assigned to relapse prevention or Twelve-Step treatment. Self-report data were collected at baseline, posttreatment, and 6-month follow-up. There were no differential effects of treatment type on cocaine or marijuana use over time. However, subjects in both treatment conditions reduced cocaine and marijuana use at posttreatment. Subjects in both groups reduced their alcohol use from pretreatment to posttreatment. Subjects receiving Twelve-Step treatment showed greater increases from posttreatment to 6-month follow-up in alcohol use than did relapse prevention participants. Treatment attendance was negatively related to cocaine use at posttreatment and cocaine and marijuana use at 6-month follow-up. Difficulties in conducting cocaine treatment outcome research are discussed as are treatment and research implications of the findings.

Adult↗

PubMed1993

Predicting treatment retention among cocaine users.

Few studies have addressed treatment retention among cocaine-using samples. The current study develops and tests a model of treatment retention at the individual level, employing data from 110 cocaine users who initiated outpatient treatment. The model includes measures of extent of drug involvement, social isolation and support, motivation, and demographic characteristics. Logistic regression is used to fit a final model, which includes measures of the following: living alone, use of multiple substances prior to treatment, length of cocaine use, and external motivation. Treatment implications and directions for further research are discussed.

Adult↗

PubMedDate not supplied

Participation in a parent training program for methadone clients.

Programs for drug abusers are plagued by high rates of dropout. Because of the strong relationship between longer treatment and positive outcome, researchers have begun to study individual and program-specific factors that influence premature termination of treatment. For the most part, these studies have focused on dichotomous measures of dropout or number of sessions attended. In this article, we extend this line of research in two ways. First, we develop and measure a number of indicators of treatment participation based on therapist ratings. Second, we develop a model of treatment participation that employs both individual and program-specific factors. The data show that tremendous variation in participation occurred even among those who attended a majority of sessions, which highlights the importance of obtaining more elaborate measures of treatment participation. The model predicting treatment participation suggests that initiation of heroin use later in life, continued use of marijuana, and behavioral indicators of motivation are the strongest predictors of program participation. Research and practical implications of the findings are discussed.

Adolescent↗