TY - JOUR
T1 - Facilitating entry into drug treatment among injection drug users referred from a needle exchange program
T2 - Results from a community-based behavioral intervention trial
AU - Strathdee, Steffanie A.
AU - Ricketts, Erin P.
AU - Huettner, Steven
AU - Cornelius, Lee
AU - Bishai, David
AU - Havens, Jennifer R.
AU - Beilenson, Peter
AU - Rapp, Charles
AU - Lloyd, Jacqueline J.
AU - Latkin, Carl A.
N1 - Funding Information:
The authors gratefully acknowledge support from the National Institute on Drug Abuse (grant number DA09225), Dr. David Vlahov, Dr. Peter Hartsock, staff of the Baltimore Needle Exchange Program and Baltimore Substance Abuse Systems, Inc. and associated drug treatment programs, and staff and participants of the Treatment Retention Intervention. This manuscript is dedicated to the memory of Dr. Harvey Siegal who was instrumental in the design of this evaluation.
PY - 2006/7/27
Y1 - 2006/7/27
N2 - We evaluated a case management intervention to increase treatment entry among injecting drug users referred from a needle exchange program (NEP). A randomized trial of a strengths based case management (intervention) versus passive referral (control) was conducted among NEP attenders requesting and receiving referrals to subsidized, publicly funded opiate agonist treatment programs in Baltimore, MD. Logistic regression identified predictors of treatment entry within 7 days, confirmed through treatment program records. Of 247 potential subjects, 245 (99%) participated. HIV prevalence was 19%. Overall, 34% entered treatment within 7 days (intervention: 40% versus control: 26%, p = 0.03). In a multivariate "intention to treat' model (i.e., ignoring the amount of case management actually received), those randomized to case management were more likely to enter treatment within 7 days. Additional 'as treated' analyses revealed that participants who received 30 min or more of case management within 7 days were 33% more likely to enter treatment and the active ingredient of case management activities was provision of transportation. These findings demonstrate the combined value of offering dedicated treatment referrals from NEP, case management and transportation in facilitating entry into drug abuse treatment. Such initiatives could be implemented at more than 140 needle exchange programs currently operating in the United States. These data also support the need for more accessible programs such as mobile or office-based drug abuse treatment.
AB - We evaluated a case management intervention to increase treatment entry among injecting drug users referred from a needle exchange program (NEP). A randomized trial of a strengths based case management (intervention) versus passive referral (control) was conducted among NEP attenders requesting and receiving referrals to subsidized, publicly funded opiate agonist treatment programs in Baltimore, MD. Logistic regression identified predictors of treatment entry within 7 days, confirmed through treatment program records. Of 247 potential subjects, 245 (99%) participated. HIV prevalence was 19%. Overall, 34% entered treatment within 7 days (intervention: 40% versus control: 26%, p = 0.03). In a multivariate "intention to treat' model (i.e., ignoring the amount of case management actually received), those randomized to case management were more likely to enter treatment within 7 days. Additional 'as treated' analyses revealed that participants who received 30 min or more of case management within 7 days were 33% more likely to enter treatment and the active ingredient of case management activities was provision of transportation. These findings demonstrate the combined value of offering dedicated treatment referrals from NEP, case management and transportation in facilitating entry into drug abuse treatment. Such initiatives could be implemented at more than 140 needle exchange programs currently operating in the United States. These data also support the need for more accessible programs such as mobile or office-based drug abuse treatment.
KW - Case management
KW - Drug abuse treatment
KW - HIV/AIDS
KW - Injection drug use
KW - Methadone maintenance
KW - Needle exchange programs
KW - Transportation
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U2 - 10.1016/j.drugalcdep.2005.11.015
DO - 10.1016/j.drugalcdep.2005.11.015
M3 - Article
C2 - 16364566
AN - SCOPUS:33747000844
SN - 0376-8716
VL - 83
SP - 225
EP - 232
JO - Drug and alcohol dependence
JF - Drug and alcohol dependence
IS - 3
ER -