ISSN:0965-2140    

DOI:10.1080/09652149640130

出版商:Carfax Publishing Limited    

年代:1996

数据来源: WILEY

摘要:

Entry to treatment is often precipitated by suggestions or pressure from relatives or friends, but we know little of the circumstances in which suggestions to cut down on drinking include advice to seek professional help. In 1993, 1034 Ontario adults were asked in a random digit dialling telephone survey if they had said something to a friend or relative about their drinking, or suggested they cut down. About 35% had said something within the last year, and 15% had taken the further step of suggesting they seek professional help or helping them get assistance. Respondents were asked a series of questions about the circumstances of the most recent time they had said something to the person. Whether respondents who said something recommended seeking professional help is related to these circumstances, and to the respondent's demographics and relationship to the drinker.

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1996.9156432.x

出版商:Carfax Publishing Limited    

年代:1996

数据来源: WILEY

摘要:

It is useful to view the social handling of alcohol problems in US communities from the perspective of a whole network of human service systems that share in the burden of identifying and responding to problem drinkers. This analysis examines the management of alcohol problems in different community service systems by mapping patterns in the institutional encounters of problem drinkers across alcohol treatment, drug treatment, mental health treatment, social welfare and criminal justice systems in a single US community. Findings highlight the prominence of large bureaucratic systems for social welfare and criminal justice as sources of referrals for smaller service systems offering treatment for alcohol problems. However, large proportions of problem‐drinking service recipients in the community remain exclusive clients of the welfare and criminal justice systems, making no contact with therapeutically orientated service settings. Compared with problem drinkers who obtain treatment services, problem drinkers on the case‐loads of criminal justice and welfare agencies tend to be younger, of higher socio‐economic status, are more likely to be male, and tend to drink less heavily and to experience fewer symptoms of alcohol dependence. Given the distinctive characteristics of problem drinkers found exclusively in criminal justice and welfare settings, it may be advisable for communities to introduce early intervention programs in these systems that target services to this particular subgroup of problem dri

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1996.9156573.x

出版商:Carfax Publishing Limited    

年代:1996

数据来源: WILEY

摘要:

In Canada, individuals experiencing problems related to their alcohol and drug use receive treatment and rehabilitative care through services provided primarily through the publicly funded health and social service system. During the past decade, however, an increasing number of Canadians have received treatment for substance abuse at facilities located in the United States, with most of the cost for this treatment borne by the various provincial health insurance plans. This paper provides a comprehensive analysis of the Ontario experience of treatment for substance abuse in the United States. First, the policy and planning context for the use of American treatment programs by Ontario residents and the rationale for recent changes to the reimbursement guidelines for such out‐of‐country treatment is reviewed. Secondly, the major trends in utilization of American programs over the past decade will be described and comparisons drawn to trends in the development of Ontario's own treatment system. This information has been used to help guide the development of treatment services in Ontario. In addition, the data serve as a baseline to measure the impact of various policy and program initiatives recently introduced in Ontario to reduce the utilization of treatment resources based in the United Sta

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1996.9156714.x

出版商:Carfax Publishing Limited    

年代:1996

数据来源: WILEY

摘要:

Minnesota's treatment outcomes monitoring system is a cooperative effort between the State alcohol and drug abuse agency and 366 licensed treatment providers. A minimum dataset is required on all treatment admissions to provide a state‐wide system profile. In addition, data are being collected on a sample of 30 patients from each program to measure patient characteristics and severity of problems, patient perceptions of needed assistance, actual nature and amount of services received, patient satisfaction and patient functioning 6 months following discharge from treatment. The dimensions measured include alcohol and other drug use, physical health, psychological well‐being, employment and financial status, family and social relationships and criminality. The aggregated data will be analysed to determine what types of services are associated with more favorable outcomes for different types of patients. The findings will be used to develop standards for treatment placement and service delivery based on individual patient profiles. This report provides an overview of the plan and an illustration of how patient profiles can be developed for purposes of treatment service matching and outcomes monitor

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1996.9156875.x

出版商:Carfax Publishing Limited    

年代:1996

数据来源: WILEY

摘要:

The Substance Abuse Monitor is a comprehensive community‐based addictions information system that forms the basis for an innovative approach to community needs assessment. This paper describes: (1) the conditions that created the need and support for the monitoring system; (2) the community development strategy that was employed to secure the commitment of agencies to the project; (3) the specifics of the needs assessment procedures; (4) some of the theoretical, clinical and methodological issues on which the procedures are based; (5) the practical applications of the system; and (6) the limitations of the system. The establishment of the database was based upon the idea that there would be benefits at several levels: the community, the participating agencies, the individual counsellors and the clients. The realization of these benefits requires that the information collected and the results generated must be capable of addressing specific service delivery problems with practical and tangible solutions. It is argued that the project has been successful in generating such solutions, and has considerable potential as an ongoing needs assessment too

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1996.9157016.x

出版商:Carfax Publishing Limited    

年代:1996

数据来源: WILEY

摘要:

During the 1970s, the Methadone Dispensing Circuit (MDC) was initiated by the municipality of Amsterdam in order to cope with the heroin addiction epidemic that afflicted the city. In the MDC, methadone is dispensed to opiate addicts on a maintenance basis in low‐threshold public health programmes, as well as in high‐threshold treatment programmes. The MDC is an essential part of the local drug policy in the city. It is designed to get in touch with all opiate addicts who are not able to manage their lives in a proper way, and to stimulate them to regulate their addiction. This paper describes the genesis of the MDC as a result of a historical and political process. Determining factors in this process proved to be the urgency of the drug problem, the widespread consensus among local politicians, most of the general practitioners (GPs) and alternative relief institutions about the low‐threshold dispensing, and finally its success, particularly the lower rate of drug‐related death and less disruption of public order. In the second part of the paper, data on the functioning and effectiveness of the MDC are presented. It is concluded that the effectiveness of the MDC could be improved by better management and the application of more sensible diagnostic methods. The transferability of the 'Amsterdam model' to other places is discussed; besides the burden of the drug problem, it depends on the acceptance of the underlying value orie

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1996.9157117.x

出版商:Carfax Publishing Limited    

年代:1996

数据来源: WILEY

摘要:

This paper first outlines the history of illicit drug issues in Switzerland, and then describes drug treatment services and shifts in treatment concepts. In the last 15 years the drug treatment system in Switzerland has expanded considerably. In particular there has been an unprecedented growth of the non‐residential sector and of low‐threshold programmes, including methadone treatment, the establishment of injection rooms and controlled drug‐prescription pilot projects. In the second part, the paper considers some selected factors that promote or impede changes in drug treatment systems, such as treatment policy and the public response to treatment measures. This is manifested in the influence of community action groups on local programme develo

ISSN:0965-2140    

DOI:10.1046/j.1360-0443.1996.9157238.x

出版商:Carfax Publishing Limited    

年代:1996

数据来源: WILEY

ISSN:0965-2140    

DOI:10.1080/09652149640211

出版商:Carfax Publishing Limited    

年代:1996

数据来源: WILEY