Examination of referral source and discharge outcomes among women in residential substance use disorder treatment. Other Scholarly Work

Rivera, Dean, Dueker, Donna, Sanchez, Mariana et al. (2021). Examination of referral source and discharge outcomes among women in residential substance use disorder treatment. . JOURNAL OF SUBSTANCE ABUSE TREATMENT, 125 108319. 10.1016/j.jsat.2021.108319

cited authors

  • Rivera, Dean; Dueker, Donna; Sanchez, Mariana; Amaro, Hortensia

abstract

  • Background

    Court-mandated substance use disorder (SUD) treatment, compared to nonmandated treatment, has been associated with increased retention and completion. However, due to limitations of previous studies, whether child protective services (CPS) and criminal justice (CJ) mandated treatment improve treatment completion and retention among women in residential treatment remains unclear.

    Purpose

    This study investigated differences in treatment completion and progress based on three clinical discharge outcomes (i.e., completer, noncompleter with significant progress, and noncompleter without significant progress). We hypothesized that women mandated by (1) CJ will have a better treatment discharge outcome (i.e., treatment completer and noncompleter with satisfactory progress) compared to women who are CPS mandated; (2) CPS will have a better treatment discharge outcome (i.e., treatment completer and noncompleter with satisfactory progress) compared to nonmandated women.

    Methods

    Study staff conducted multinomial logistic regression analyses on data for a diverse sample of 161 women mandated or nonmandated (CJ: N = 71, CPS: N = 66, nonmandated: N = 24) into residential SUD treatment to determine each group's clinically defined treatment discharge outcomes while controlling for covariates.

    Results

    Multinomial logistic regression analyses revealed that being mandated by the CJ system predicted being a treatment completer compared to those who were CPS mandated (RR = 9.88, p = .009). The study found no differences in discharge status of completer without satisfactory progress between those who were CPS mandated and those who were CJ mandated or nonmandated. For women mandated by the CPS system compared to nonmandated women, the risk of being a treatment completer relative to noncompleters with satisfactory progress was not significant (RR = 1.08, p = .897). Analyses showed that being mandated by the CJ system predicted an improved clinically defined discharge outcome of treatment completer compared to women who were nonmandated to treatment (RR = 10.74, p = .016). In several of the models, drug and alcohol craving was associated with increased odds of being a noncompleter of treatment without satisfactory progress.

    Conclusions

    This study demonstrates that improved treatment completion and discharge status cannot be assumed based solely on being mandated by the CJ or CPS systems. As evidenced by variability in treatment discharge outcomes within and among referral groups, the paper suggests directions for future research.

publication date

  • June 1, 2021

published in

keywords

  • Child
  • Criminal Law
  • Female
  • Humans
  • Patient Discharge
  • Referral and Consultation
  • Residential Treatment
  • Substance-Related Disorders

Digital Object Identifier (DOI)

Medium

  • Print-Electronic

start page

  • 108319

volume

  • 125