Katherine E. Watkins

The ACA's Opportunity to Improve Care for Substance Use Disorders

The Affordable Care Act (ACA) will significantly increase coverage for the publicly funded treatment of substance use disorders. But in order to maximize the benefit to patients, families, and society, it's critical to invest in the development, validation, and use of performance measures.

California's Misguided Approach

Despite the frequency with which people are convicted of multiple DUI offenses, California continues to require that all individuals with a DUI attend a 30- or 60-hour education program. However, these programs aren't that effective.

Tool

CLARO Implementation Manual: Strategies and Supports for Successful Implementation of the CLARO Intervention

This manual describes how to implement the Collaboration Leading to Addiction Treatment and Recovery from Other Stresses (CLARO) intervention, which adapts the Collaborative Care Model for adults with opioid use disorder and depression and/or PTSD.

Journal Article

Design of CLARO+ (Collaboration Leading to Addiction Treatment and Recovery from Other Stresses, Plus): A Randomized Trial of Collaborative Care to Decrease Overdose and Suicide Risk Among Patients with Co-Occurring Disorders

We build upon a model of collaborative care in which care coordinators deliver preventative measures to high-risk patients and coordinate care with the patients' care team, to increase MOUD retention and decrease risk of suicide and overdose.

Journal Article

Findings from an Organizational Context Survey to Inform the Implementation of a Collaborative Care Study for Co-occurring Disorders

This study surveyed primary care and behavioral health staff from 13 clinics implementing a collaborative care intervention for opioid use disorders co-occurring with PTSD and/or depression as part of a multisite randomized controlled trial.

Journal Article

Disparities in Postoperative Opioid Prescribing by Race and Ethnicity: An Electronic Health Records-Based Observational Study from Northern California, 2015-2020

To examine racial and ethnic disparities in postoperative opioid prescribing.

Journal Article

Screening for Opioid Use Disorder and Co-Occurring Depression and Post-Traumatic Stress Disorder in Primary Care in New Mexico

This study helps quantify the extent of diagnostic and treatment service gaps for opioid use disorder and co-occurring mental health disorders in primary care settings serving rural and socioeconomically disadvantaged patients in New Mexico.

Tool

CLARO Intervention User Manual: A Guide for Care Teams and Individual Practitioners

The Collaboration Leading to Addiction Treatment and Recovery from Other Stresses research study advances collaborative care treatment for patients who have opioid use disorder with major depressive disorder and/or posttraumatic stress disorder.

Journal Article

Opioid Use Disorder Among Clients of Community Mental Health Clinics: Prevalence, Characteristics, and Treatment Willingness

The authors examined the prevalence of co-occurring opioid use disorder and willingness to engage in treatment among clients of eight Los Angeles County Department of Mental Health outpatient clinics.

Journal Article

Collaboration Leading to Addiction Treatment and Recovery from Other Stresses (CLARO): Process of Adapting Collaborative Care for Co-Occurring Opioid Use and Mental Disorders

To address a treatment and quality gap, RAND researchers adapted collaborative care for co-occurring opioid use disorder and mental health disorders.

Journal Article

Evaluating the Effectiveness of Email-Based Nudges to Reduce Postoperative Opioid Prescribing: Study Protocol of a Randomised Controlled Trial

Study protocol of a randomized controlled trial testing the effectiveness of two behavioral nudges, one based on peer behavior and one based on best practice guidelines, in reducing excessive postoperative opioid prescriptions.

Journal Article

The Opioid Use Disorder Core Outcomes Set (OUD–COS) for Treatment Research: Findings from a Delphi Consensus Study

The aim of this study was to develop the US National Institute on Drug Abuse (NIDA) National Drug Abuse Treatment Clinical Trials Network (CTN) opioid use disorder core outcomes set (OUD–COS).

Journal Article

Perspectives Regarding Medications for Opioid Use Disorder Among Individuals with Mental Illness

Clients at publicly-funded mental health clinics support MOUD treatment, signaling a need to expand access and build awareness of MOUDs in these settings.

Tool

How to Integrate Pharmacotherapy for Substance Use Disorders at Your Mental Health Clinic: A Step-By-Step Guide for Screening and Treating Adults with Co-Occurring Mental Illness and Alcohol and/or Opioid Use Disorders with Pharmacotherapy in Mental Health Clinics

RAND researchers provide a toolkit to support the delivery of effective, evidence-based pharmacotherapy for clients with co-occurring substance use and mental health disorders and simplify care implementation in mental health clinics.

Tool

Medication Management of Co-Occurring Opioid Use Disorder in Mental Health Settings: A Guide for Practitioners

Researchers and clinicians provide a guide for identifying clients with co-occurring opioid use and mental health disorders in mental health settings and treating these clients with an appropriate opioid use disorder medication.

Journal Article

Organizational Capacity and Readiness to Provide Medication for Individuals with Co-Occurring Alcohol Use Disorders in Public Mental Health Settings

Organizational capacity and readiness constraints impede the delivery of medication treatment for alcohol use disorder in a large mental health system.

Journal Article

Assessment of Postoperative Opioid Prescriptions Before and After Implementation of a Mandatory Prescription Drug Monitoring Program

In this study of adult patients who received a postoperative prescription for opioid medication, mandatory consultation with EHR-based alerts was associated with decreases in prescription quantities.

Journal Article

Design of CLARO (Collaboration Leading to Addiction Treatment and Recovery from Other Stresses): A Randomized Trial of Collaborative Care for Opioid Use Disorder and Co-Occurring Depression And/Or Posttraumatic Stress Disorder

This article describes the CLARO collaborative care for co-occurring disorders intervention and clinical trial.

Journal Article

Study Design to Evaluate a Group-based Therapy for Support Persons of Adults on Buprenorphine/Naloxone

This study will evaluate whether the adapted intervention, also known as integrating support persons into recovery, is effective in increasing patient retention on buprenorphine when compared to usual care.

Journal Article

Attitudes About Medications for Alcohol Use Disorder Among Individuals with Serious Mental Illness: A Health Belief Model Analysis

We sought to examine, among individuals treated in publicly funded community mental health clinics, perceived need for and attitudes toward medications for alcohol use disorder.

Tool

Medications for Alcohol Use Disorder in Mental Health Settings

This tool reviews how clinicians who work in mental health settings can provide pharmacotherapy treatment for an alcohol use disorder that co-occurs with a primary mental health condition.

Journal Article

Randomized Clinical Trial Examining Cognitive Behavioral Therapy for Individuals With a First-Time DUI Offense

The current study aims to elucidate the effectiveness of the services DUI programs provide compared to cognitive behavioral therapy (CBT) to prevent impaired driving.

Journal Article

Rates and Impact of Adherence to Recommended Care for Unhealthy Alcohol Use

The objectives of this study were to describe quality of care for unhealthy alcohol use among patients visiting primary care settings and to determine whether better quality of alcohol care was linked to reduced alcohol consumption 6 months later.

Journal Article

Sustaining Alcohol and Opioid Use Disorder Treatment in Primary Care: A Mixed Methods Study

Access to external funding and staff support are two important factors for the sustainability of substance use disorder treatment provision within primary care clinics.

Journal Article

Patient Predictors of Substance Use Disorder Treatment Initiation in Primary Care

Primary care clinics are opportune settings for the delivery of substance use disorder treatment, but little is known about which patients initiate treatment in these settings.

Journal Article

Effects of Motivational Interviewing Fidelity on Substance Use Treatment Engagement in Primary Care

Motivational interviewing is used extensively to improve health and substance use-related outcomes, but therapists may need more training in strategic use of the approach.

Journal Article

Commentary: Applying the Community Partners in Care Approach to the Opioid Crisis

Consideration of how the CPIC approach of comparing coalition and individual technical assistance interventions to implement behavioral health treatments across sectors might be adapted to address the opioid epidemic.

Journal Article

Evidence for Misspecification of a Nationally Used Quality Measure for Substance Use Treatment

Our results suggest that the omission of MAT in the current version of the HEDIS measure "Initiation and Engagement of Alcohol and Other Drug Dependence Treatment" results in meaningful measurement error.

Journal Article

Initiation and Engagement as Mechanisms for Change Caused by Collaborative Care in Opioid and Alcohol Use Disorders

This research sheds light on how collaborative care (CC) may work to increase abstinence in a sample of primary care patients with opioid and alcohol use disorders (OAUD).

Journal Article

Predictors of Treatment Initiation for Alcohol Use Disorders in Primary Care

This study suggests that either treatment may not be delivered equitably or that patient preference may be an important factor in determining who gets what treatment.

Journal Article

Demographic and Mental Health Characteristics of Individuals Who Present to Community Health Clinics With Substance Misuse

Patients of community health clinics who screen positive for alcohol or opioid misuse have a high probability of an alcohol- or substance-use disorder and a slightly higher prevalence of mental illness than the overall clinic population. 

Journal Article

Internalized Stigma as an Independent Risk Factor for Substance Use Problems Among Primary Care Patients: Rationale and Preliminary Support

High rates of internalized stigma - self-applied negative stereotypes - among primary care patients with opioid or alcohol use disorders were significantly related to greater substance use problems.

Report

The Costs of Implementing Collaborative Care for Opioid and Alcohol Use Disorders in Primary Care

This report describes the costs of implementing the substance use motivation and medication integrated treatment (SUMMIT) program, separating the resources spent by a multi-site large health center in Los Angeles County and the external facilitators.

Journal Article

Association Between Process Measures and Mortality in Individuals with Opioid Use Disorders

Three possible measures for quality of care may help reduce deaths from opioid addiction by one-third.

Journal Article

Barriers to Integrating the Continuum of Care for Opioid and Alcohol Use Disorders in Primary Care: A Qualitative Longitudinal Study

Some perceived barriers to implementing the continuum of care for opioid and alcohol use disorders in primary care clinics persist over time, but most barriers decreased.

Journal Article

Collaborative Care for Opioid and Alcohol Use Disorders in Primary Care: The SUMMIT Randomized Clinical Trial

Among adults with opioid and alcohol use disorders, a collaborative care intervention—which integrates behavioral health care into primary care—increased both access to treatment and abstinence.

Journal Article

Association Between Process Based Quality Indicators and Mortality for Patients With Substance Use Disorders

Receiving appropriate care is associated with lower mortality for patients with substance use disorders.

Journal Article

Association Between Quality Measures and Perceptions of Care Among Patients With Substance Use Disorders

Two quality measures – receipt of psychotherapy and psychosocial treatment – were associated with patient perceptions of their own improvement.

Tool

SUMMIT Study Protocol: Step-by-Step Procedures for Providing Screening, Brief Intervention, and Treatment Services to Primary Care Patients with Opioid or Alcohol Use Disorders

This integrated collaborative care protocol was created for a research study that looked at ways to implement medication-assisted and behavioral treatment for patients with opioid and alcohol use disorders in a community health clinic.

Journal Article

Quality of Care Measures for the Management of Unhealthy Alcohol Use

Proposed quality of care measures for unhealthy alcohol use focus on screening, assessment, treatment, and follow-up in outpatient care.

Journal Article

Implementing the Chronic Care Model for Opioid and Alcohol Use Disorders in Primary Care

This paper describes the process of planning and developing an intervention for delivering treatment for opioid and alcohol use disorders in primary care.

Journal Article

Patient-Reported Offers of Alcohol Treatment for Primary Care Patients at High-Risk for an Alcohol Use Disorder

Most primary care patients in this study, who were at high risk for an alcohol use disorder, report that they were not offered treatment after an annual screening.

Tool

SUMMIT: Procedures for Medication-Assisted Treatment of Alcohol or Opioid Dependence in Primary Care

This tool reviews how primary care providers should discuss and treat alcohol or opioid dependence with their patients, including using extended-release, injectable naltrexone and administering buprenorphine/naloxone.

Journal Article

Association Between Quality Measures and Mortality in Individuals with Co-Occurring Mental Health and Substance Use Disorders

This study suggests that the association between process-based measures of care quality and mortality in veterans with co-occurring mental and substance use disorders could be used to improve performance and reduce mortality in this population.

Tool

Candidate Quality Measures to Assess Care for Alcohol Misuse: Technical Specifications

This tool presents detailed technical specifications for the set of quality measures identified and specified in a study of the link between improvements in processes of care for alcohol misuse and improvements in outcomes, known as the AQual study.

Tool

Brief Treatment for Substance Use Disorders: A Guide for Behavioral Health Providers

Brief Treatment for Substance Use Disorders: A Guide for Behavioral Health Providers is a clinician guidebook that describes a six-session brief treatment for patients with alcohol and opiate use disorders.

Journal Article

Study Design to Evaluate Cognitive Behavioral Therapy Among a Diverse Sample of Adults with a First-Time DUI Offense

The proposed study addresses 2 important public health problems: (1) Individuals convicted of a DUI are mandated to attend a DUI program, but many recidivate and, (2) There is a disproportionate lack of access to AUD treatment for Latino populations.

Report

Resources and Capabilities of the Department of Veterans Affairs to Provide Timely and Accessible Care to Veterans

The Department of Veterans Affairs health care system, with broad resources and capabilities, provides timely and high-quality care to most, but not all, patients. Meeting veterans' needs over the next five years will require additional capacity.

Journal Article

The Quality of Medication Treatment for Mental Disorders in the Department of Veterans Affairs and in Private-Sector Plans

The quality of mental health care provided by the U.S. Department of Veterans Affairs (VA) was compared with care provided to a comparable population treated in the private sector.

Journal Article

A Pilot Study Comparing In-Person and Web-Based Motivational Interviewing Among Adults with a First-Time DUI Offense

Receiving a DUI may be significant enough to reduce short-term behaviors, but future research should explore whether more intensive interventions are needed to sustain long-term changes.

Commentary

Driving Under the Influence of Alcohol: Could California Do More to Prevent It?

RAND researchers consider whether California could do more to reduce driving under the influence (DUI) and other threats to public health and safety imposed by repeat DUI offenders.

Journal Article

An Organizational Readiness Intervention and Randomized Controlled Trial to Test Strategies for Implementing Substance Use Disorder Treatment Into Primary Care: SUMMIT Study Protocol

Millions of people who need treatment for substance use disorders (SUD) do not receive it.

Report

Measuring the Quality of Care for Psychological Health Conditions in the Military Health System: Candidate Quality Measures for Posttraumatic Stress Disorder and Major Depressive Disorder

Researchers identified, developed, and described a framework and candidate set of measures to monitor, assess, and improve the quality of care delivered by the military health system for posttraumatic stress disorder and major depressive disorder.

Research Brief

Without Quality Measures, Increasing Access to Substance Use Treatment May Not Improve Patient Outcomes

Expanded coverage under the Affordable Care Act could provide evidence-based substance use care for many individuals whose condition now goes untreated, but effective quality measures must be developed and tested to ensure high-quality care.

Journal Article

The Affordable Care Act: An Opportunity for Improving Care for Substance Use Disorders?

The ACA expands coverage for substance use treatment, but provides no measures for assessing its quality.

Journal Article

The Cost-Effectiveness of Depression Treatment for Co-Occurring Disorders: A Clinical Trial

The authors aimed to determine the economic value of providing on-site group cognitive behavioral therapy (CBT) for depression to clients receiving residential substance use disorder (SUD) treatment.

Journal Article

Veterans' Perceptions of Behavioral Health Care in the Veterans Health Administration: A National Survey

This study provided national estimates of perceptions of behavioral health care services among patients of the Veterans Health Administration (VHA) with a diagnosis of bipolar I disorder, major depression, posttraumatic stress disorder, schizophrenia, or substance use disorder.

Journal Article

Training Addiction Counselors to Implement an Evidence-Based Intervention: Strategies for Increasing Organizational and Provider Acceptance

This article makes recommendations for selecting and training addiction counselors to deliver group-base cognitive behavioral therapy for depression and provides suggestions for the structure and process of their ongoing clinical supervision.

Journal Article

Do Client Attributes Moderate the Effectiveness of a Group Cognitive Behavioral Therapy for Depression in Addiction Treatment?

The study goal was to determine whether client attributes were associated with outcomes from group cognitive behavioral therapy for depression (GCBT-D) as delivered in community-based addiction treatment settings.

Journal Article

The Quality of Mental Health Care for Veterans of Operation Enduring Freedom/Operation Iraqi Freedom

Efforts to maintain and/or increase OEF/OIF veteran participation in VA MH/SUD services should be informed by their characteristics, such as younger age and better physical health relative to other veterans.

Report

Evaluating the Impact of Prevention and Early Intervention Activities on the Mental Health of California’s Population

This report describes a collection of frameworks for evaluating prevention and early intervention funding for mental health services for the California population.

Journal Article

Treating Depression and Substance Use: A Randomized Controlled Trial

To meet the call for more "transportable" interventions, the authors conducted a pilot study to test a group cognitive–behavioral therapy (CBT) for depression and substance use that was designed for delivery by outpatient substance abuse treatment counselors.

Journal Article

Group Cognitive-Behavioral Therapy for Clients with Major Depression in Residential Substance Abuse Treatment

Group cognitive behavioral therapy was an effective treatment for major depression for clients in residential substance abuse treatment, thus extending the effectiveness of group CBT for major depression to a new setting, patient population, and type of provider.

Periodical

RAND Review: Vol. 36, No. 1, Spring 2012

Stories cover Iran's nuclear threat, social security in Mexico, programs for veterans, crime costs, U.S. efforts in Afghanistan, the health insurance mandate, legal defense, marijuana legalization, global education, and Louisiana's coastal planning.

Journal Article

Multicultural Web-Based Motivational Interviewing for Clients with a First-Time DUI Offense

A culturally relevant web-based Motivational Interviewing in English and Spanish was developed to serve as a standalone or adjunctive program in DUI educational settings. This study evaluated its feasibility and acceptability among clients.

Journal Article

The Moderating Effects of Group Cognitive–behavioral Therapy for Depression Among Substance Users

This study examined the prospective longitudinal relationship between changes in depressive symptoms on alcohol and or drug use among addiction participants in treatment, and whether group cognitive-behavioral therapy for depression (GCBT-D) moderated the relationship.

Journal Article

Suicidal Ideation Among Patients with Bladder Pain Syndrome/Interstitial Cystitis

Bladder pain syndrome or interstitial cystitis (BPS/IC) severity may not increase the likelihood of suicidal ideation except via severity of depression symptoms.

Journal Article

Assessing and Improving Organizational Readiness to Implement Substance Use Disorder Treatment in Primary Care: Findings from the SUMMIT Study

An organizational readiness intervention improved some implementation outcomes related to integrating treatment for opioid and alcohol use disorders in primary care, but not all.

Testimony

Suicide Prevention Efforts and Behavioral Health Treatment in the Veterans Health Administration

Testimony presented before the House Veterans' Affairs Committee, Subcommittee on Health on December 2, 2011.

Research Brief

The Cost and Quality of VA Mental Health Services

The quality of mental health care delivered by the U.S. Department of Veterans Affairs (VA) is generally as good or better than care delivered by private health plans, although it falls short of the high standards set in VA guidelines.

Report

Veterans Health Administration Mental Health Program Evaluation: Capstone Report

Evaluation of mental health services provided by the VA for veterans with selected mental diagnoses and recommendations for improving capacity and quality monitoring.

Report

A Fidelity Coding Guide for a Group Cognitive Behavioral Therapy for Depression

Description of fidelity rating tools for the Building Recovery by Improving Goals, Habits, and Thoughts (BRIGHT) and BRIGHT-2 interventions for depression and substance abuse, interrater reliability of measures, and a training plan for coders.

Report

Building Recovery by Improving Goals, Habits, and Thoughts (BRIGHT): A Group Cognitive Behavioral Therapy for Depression in Clients with Co-Occurring Alcohol and Drug Use Problems — Group Leader's Manual

This is the group leader's manual for BRIGHT, a manualized group cognitive behavioral therapy program for depression in individuals with co-occurring alcohol and drug use problems.

Report

Building Recovery by Improving Goals, Habits, and Thoughts (BRIGHT): A Group Cognitive Behavioral Therapy for Depression in Clients with Co-Occurring Alcohol and Drug Use Problems — Group Member's Workbook

This is the group member's workbook for BRIGHT, a manualized group cognitive behavioral therapy program for depression in individuals with co-occurring alcohol and drug use problems.

Report

Building Recovery by Improving Goals, Habits, and Thoughts (BRIGHT-2): An Integrated Group Cognitive Behavioral Therapy for Co-Occurring Depression and Alcohol and Drug Use Problems — Group Member's Workbook

This is the group member's workbook for BRIGHT-2, a manualized group cognitive behavioral therapy program for co-occurring depression and alcohol and drug use problems.

Report

Building Recovery by Improving Goals, Habits, and Thoughts (BRIGHT-2): An Integrated Group Cognitive Behavioral Therapy for Co-Occurring Depression and Alcohol and Drug Use Problems — Group Leader's Manual

This is the group leader's manual for BRIGHT-2, a manualized group cognitive behavioral therapy program for co-occurring depression and alcohol and drug use problems.

Journal Article

An Effectiveness Trial of Group Cognitive Behavioral Therapy for Patients with Persistent Depressive Symptoms in Substance Abuse Treatment

Providing group cognitive behavioral therapy for depression to clients with persistent depressive symptoms receiving residential substance abuse treatment is associated with improved depression and substance use outcomes.

Journal Article

Depressive Disorders and Panic Attacks in Women with Bladder Pain Syndrome/Interstitial Cystitis: A Population-Based Sample

Clinicians should be alert to complaints of bladder pain in patients seeking treatment for depressive or anxiety disorders and to complaints of emotional or personal problems in patients seeking treatment for painful bladder symptoms.

Journal Article

Developing Medical Record-Based Performance Indicators to Measure the Quality of Mental Healthcare

This paper presents the methodology used to develop a comprehensive set of performance indicators in a national evaluation of the mental healthcare delivered by the Veterans Health Administration.

Journal Article

Analysis of Rolling Group Therapy Data Using Conditionally Autoregressive Priors

This article describes a new approach to analyzing client outcomes when a rolling admissions policy is used in group therapy.

Journal Article

Care for Veterans with Mental and Substance Use Disorders: Good Performance, but Room to Improve on Many Measures

The 15 % of veterans with mental health illness accounted for about one-third of total VA costs, mostly for non-mental health conditions. VA quality of care was generally better than care in private plans, but quality varied across VA regions.

Journal Article

Training Addiction Counselors to Implement CBT for Depression

Training addiction counselors to deliver group therapy can bring effective mental treatment to depressed individuals who are also substance abusers.

Journal Article

Exploring Productivity Outcomes from a Brief Intervention for At-Risk Drinking in an Employee Assistance Program

This exploratory study examines changes in workplace productivity and related costs for clients receiving a Brief intervention (BI) for at-risk drinking in the employee assistance program (EAP).

Journal Article

Transforming Mental Healthcare in the Veterans Health Administration: A Model for Measuring Performance to Improve Access, Quality, and Outcomes

This paper describes the conceptual framework and research design of a national evaluation of the quality of mental healthcare provided to veterans by the Veterans Health Administration, and present results on the reported availability of evidence-based practices.

Draft

Veterans Health Administration Mental Health Program Evaluation Technical Manual

Presents the technical specifications for the performance indicators developed during a study to evaluate the Veterans Health Administration in the U.S. Department of Veterans Affairs mental health services.

Journal Article

A Comparison of Two Depressive Symptomatology Measures in Residential Substance Abuse Treatment Clients

Comorbid depression is common among substance abusers, making routine assessment of depression critical for high-quality care. The authors evaluated two of the most commonly used depressive symptomatology measures in a sample of clients in residential substance abuse treatment settings.

Journal Article

Developing an Integrated Treatment for Substance Use and Depression Using Cognitive-Behavioral Therapy

Providing a unified treatment approach to meet the substance abuse and mental health needs of clients is the preferred model for addressing co-occurring disorders.

Journal Article

The Health Value and Cost of Care for Major Depression

Describes a new approach to estimating the health value of alternative treatment patterns and applies the approach to common treatment patterns for major depression.

Journal Article

Training Addiction Counselors in Group CBT for Depression: Preliminary Findings

Limited access to empirically supported interventions for depression within public sector AOD treatment settings could be increased if CBT for depression were provided within these settings. The authors adapted an existing CBT treatment manual and trained addiction counselors to deliver the intervention.

Research Brief

The Behavioral Health Care System Is Poised for Change

This fact sheet provides an overview of the Institute of Medicine's quality improvement framework for behavioral health care and highlights current quality improvement projects that incorporate the framework's recommendations.

Journal Article

Applying the Institute of Medicine Quality Chasm Framework to Improving Health Care for Mental and Substance Use Conditions

Describes findings that shaped the reports recommendations: co-occurrence of mental health, substance use, and general health conditions; and differences in the delivery of services for mental health/substance use and general health care.

Journal Article

Improving Service Delivery for Individuals with Co-Occurring Disorders: New Perspectives on the Quadrant Model

Examines the usefulness of the quadrant model for improving service delivery for persons with co-occurring disorders. Although useful for conceptualizing factors, its further development is unlikely to result in improved care at the clinical level.

Journal Article

Obtaining Utility Estimates of the Health Value of Commonly Prescribed Treatments for Asthma and Depression

Comparing the costs and health value associated with alternative quality improvement efforts , this study employs expert panel methodology to elicit numerical estimates based on a 0 to 1 utility scale of the health benefit of usual treatment patterns for 2 medical conditions, depression and asthma.

Research Brief

Integrating Treatment for People with Co-Occurring Mental Health and Substance Abuse Disorders in Public Systems of Care

This fact sheet describes an analysis to review progress in, identify challenges for, and point to promising directions for future integrated financing arrangements and care of people with co-occurring mental health and substance abuse disorders.

Draft

A Collaboration Between Researchers and Practitioners to Improve Care for Co-Occurring Mental Health Disorders in Outpatient Substance Abuse Treatment

Describes a community-based intervention trial intended to address the gap in effective service provision for clients in substance abuse treatment programs with co-occurring disorders.

Report

Improving Care for Depression in Patients With Comorbid Substance Misuse

Investigates whether quality improvement programs for depression would be effective among substance misusers.

Journal Article

Improving Care for Depression in Patients with Comorbid Substance Misuse

Co-occurring substance misuse is associated with depression and increased risk for poorer depression treatment outcomes under usual care conditions.

Journal Article

Substance Abuse with Mental Disorders: Specialized Public Systems and Integrated Care

Separate public financing and regulation of substance (SA) abuse treatment distinct from mental health (MH) treatment preserves a focus on the special needs of those with substance abuse but creates challenges to providing appropriate care for the large number of people with co-occurring conditions.

Journal Article

An Update on Adolescent Drug Use: What School Counselors Need to Know

School counselors need to have accurate and age-appropriate prevention education information in order to counsel teens on drug use.

Journal Article

Research-practice Partners Assess Their First Joint Project

Advisability of consulting collaboratively with clinic staff during the planning of studies and the pretesting of study protocols.

Journal Article

Review of Treatment Recommendations for Persons with a Co-Occurring Affective or Anxiety and Substance Use Disorder

The authors review and evaluate the literature and guidelines on care for individuals with a co-occurring affective or anxiety disorder and substance use disorder.

Journal Article

Training Substance Abuse Treatment Staff to Care for Co-Occurring Disorders

This article describes an intervention to improve the quality of mental health care provided in outpatient substance abuse treatment programs.

Journal Article

Prevalence and Characteristics of Clients with Co-Occurring Disorders in Outpatient Substance Abuse Treatment

Identifying people with probable mental health disorders as they enter treatment may increase access to care among those with limited prior access.

Journal Article

Using the Chronic Care Model to Improve Treatment of Alcohol Use Disorders in Primary Care Settings

Work is needed on developing tools, self-management support resources and training strategies before the CCM can be evaluated in real world settings.

Report

Health Information on the Internet: Accessibility, Quality, and Readability in English and Spanish

Health Information on the Internet: Accessibility, Quality, and Readability in English and Spanish

Report

Evidence Based Care Models for Recognizing and Treating Alcohol Problems in Primary Care Settings

This report discusses how a chronic disease management model can be adapted to improve the detection, treatment, and management of patients with alcohol-related problems in primary care settings.

Report

Prenatal Cocaine Exposure: Scientific Considerations and Policy Implications

This report presents an overview of the current state of knowledge regarding the effects of cocaine on the developing brain and offers policy considerations for addressing the issues that arise from cocaine use by pregnant women.

Journal Article

Changes in Mental Health and Service Use After Termination of SSI Benefits

Supplemental Security Income (SSI) benefits for a substance abuse disability were terminated by federal legislation as of January 1, 1997.

Report

The Health and Mental Health of Disabled Substance Abusers

Examines the effect of terminated Supplemental Security Income benefits on individuals in Los Angeles County who are disabled by substance abuse.

Journal Article

A National Survey of Care for Persons with Co-Occurring Mental and Substance Use Disorders

Use of appropriate mental health and comprehensive substance abuse care among adults in the US with probable co-occurring disorders.

Journal Article

Using the Internet to Access Health Information: Can It Deliver?

The Internet has the potential to be a powerful resource for both patients and health care professionals.

Journal Article

Drug Use and Disability Payments in Los Angeles County After SSI Reform

This paper describes the economic, health, and other effects of SSI reform among Los Angeles County SSI recipients.

Journal Article

The Impact of Terminating Disability Benefits of Substance Abusers on Substance Use and Treatment Participation

In March 1996 Congress terminated SSI and SSDI benefits to individuals disabled primarily by drug addiction and alcoholism.

Journal Article

Prenatal Cocaine Exposure: Scientific Considerations and Policy Implications

This report presents an overview of the current state of knowledge regarding the effect of cocaine on the developing brain and offers policy considerations for addressing the issues that arise from cocaine use by pregnant women.

Journal Article

The Role of Gender in Engaging the Dually Diagnosed in Treatment

Individuals with both a serious mental illness and substance abuse are particularly difficult to engage in treatment.

Journal Article

Termination of Social Security Benefits Among Los Angeles Recipients Disabled by Substance Abuse

Recipients of Social Security disability benefits with comorbid psychiatric problems lost benefits because they did not appeal or appeal was denied.