Social Research Center

Recently Completed Research Projects

Entry and Engagement in Methadone Maintenance Treatment

The majority of individuals in need of drug abuse treatment remain untreated, and a sizeable proportion of drug abusers who enter treatment exit after a brief tenure. Thus, research that contributes toward an understanding of drug abusers’ entry and engagement in drug abuse treatment, and their subsequent outcomes, is critical to efforts to improve treatment. Given the threat of HIV infection, improving treatment entry and engagement is particularly important with regard to opioid addicts, who are at especially high risk for HIV infection, and methadone maintenance treatment, which is widely used for the treatment of opioid dependence. This five-year services research study comprehensively examines treatment entry and engagement, using a biopsychosocial theoretical perspective to guide the investigation. Informed by this perspective, the proposed study will examine three domains - namely, personal characteristics, treatment attributes, and environmental influences - that are hypothesized to affect opioid addicts’ motivation to change and motivation for treatment, their entry into and subsequent engagement in methadone maintenance treatment, and, ultimately, their recovery. Within each of these domains, the effects of specific, potentially relevant variables, selected on the basis of previous research and theory, will be examined. Two groups of adult opioid addicts will be studied, including addicts who are not currently in nor interested in seeking treatment (N = 200) and opioid addicts newly admitted to methadone maintenance treatment (N = 400), with both groups involved in the examination of treatment entry, and the admission group alone involved in the examination of treatment engagement.comprehensive assessments will be conducted at baseline and 3 months (the 3-month assessment involving only the admission group to study their initial engagement in treatment), and 6 and 12 months thereafter. Two separate, but complementary, structural equation models are posited to predict (1) treatment entry and (2) treatment engagement and outcomes. These models, along with hypothesized components of these models, will be tested using structural equation modeling techniques, including the comparison of hypothesized models with plausible alternate models. While the primary study approach is quantitative, a strong qualitative research component will be included to provide for in-depth examination of motivation to change and motivation for treatment, and of other variables that emerge in the quantitative research as being important for understanding treatment entry and engagement.

The Effects of Manualized Treatment in a Seamless System

The overarching purpose of this study is to assist offenders in adopting a crime-free, drug-free lifestyle, and to increase the probability that they will successfully complete supervision. The intervention involves three complementary components: 1) an initial collaborative goal-setting session between the drug-involved offender, the Probation Agent (PO), and the Addiction Treatment Counselor or Clinician; 2) 18 weeks of group counseling, involving the drug-involved offenders, the Clinician, and the PO; and 3) 6 sessions designed to help the offender improve communications with significant others and strengthen informal social control networks in the community that can support the offender’s efforts at desistance.

Substance Abuse, HIV/AIDS, and Hepatitis Prevention in urban Native Americans

Now, and for many decades, drug and alcohol use and abuse problems have continued to occur in Native American communities. More recently, HIV/AIDS and hepatitis have appeared in all but a few of these communities. Along with the frustration, pain, and senseless deaths that result from these problems, Native Americans must struggle with treating and preventing a problem that doesn't seem to fit within their own traditional healing systems. This study seeks to build a foundation for delivering and sustaining effective and culturally relevant services to prevent and reduce the onset of substance abuse (SA), and transmission of HIV/AIDS and hepatitis among urban Native Americans and Native American reentry populations in Baltimore, MD. The overall purpose of this project is to implement a culturally responsive SA/HIV/AIDS/Hepatitis program that will increase and sustain service capacity to Native Americans in order to address SA, HIV, and hepatitis problems. The increases in service capacity are designed to: (1) build skills and knowledge; (2) promote new peer group norms of preventive communications and behaviors; and (3) help sustain new health promoting habits. Using the Strategic Prevention Framework as a model to develop culturally relevant service capacity specifically for urban Native Americans, the five goals of the project are to: (1) Conduct a community needs assessment; (2) Mobilize and build capacity to address SA/HIV and hepatitis prevention needs; (3) Develop a comprehensive strategic plan; (4) Implement evidence based prevention programs and infrastructure development activities; and, (5) Assess program effectiveness. Service capacity will be enhanced through partnership with an urban Native American program, LifeLines Foundation that serves substance abusing Native Americans in Maryland. Through this partnership, we will develop workgroups that provide syntheses of state and local indicator data specifically on Native Americans; select culturally appropriate evidence based programs; and, utilize culturally appropriate evaluations. Culturally competent Native American evaluations will work in partnership with the local community utilizing both quantitative and qualitative methodology that will serve the purposes of on-going monitoring and evaluation in order to assess program effectiveness, ensure service delivery quality, identify successes, encourage needed improvement, and promote sustainability of effective policies, programs, and practices.