Drug Abuse Treatment Access, Service Mix, and Need

描述（由申请人提供）： 这项卫生服务研究将分析来自各州样本和全国家庭药物滥用调查的现有数据，以了解，衡量和描述美国的药物滥用治疗需求。治疗需求在理解许多药物滥用服务研究问题中起着核心作用，包括资源分配，治疗利用，管理式护理，种族差异，国家治疗差距，滥用者从监狱转移到治疗，以及基于办公室的美沙酮治疗。然而，目前还没有一个完善和有效的衡量治疗需求的标准。物质使用障碍诊断是最常用的治疗需求指标，但许多接受治疗的人没有诊断，一般人群中大多数诊断的人没有接受或不想接受治疗。最初开发基于调查的诊断量表的主要学者最近认为，诊断和治疗需求是不平等的，应该以不同的方式衡量，他们认为需要进行更多的研究才能达到令人满意的治疗需求。这项拟议的研究将使用现有的调查数据开发一种标准化的治疗需求衡量标准，并将在一系列不同的州调查和NHSA上交叉验证该措施。州调查包括成人和青少年家庭和非家庭样本（囚犯，无家可归者和治疗客户）。调查问卷包含DIS、治疗史问题和反映治疗需求概念的其他措施。拟议的研究将分析数据，以测试在建议中提出的治疗需要的理论分析，构建一个综合措施的需要，并评估结构效度的需要量表。该量表的一个版本将适用于2000-2002年NHSDA数据，该研究将估计目前的国民治疗差距。

DESCRIPTION (provided by applicant): This health services research study will analyze existing data from a sample of states and the National Household Survey on Drug Abuse to understand, measure, and describe substance abuse treatment need in the US. Treatment need plays a central role in understanding many substance abuse services research issues, including resource allocation, treatment utilization, managed care, racial disparities, the national treatment gap, diversion of abusers from jail to treatment, and office-based methadone treatment. However, there is no well-developed and validated measure of treatment need. Having a substance-use disorder diagnosis is the most commonly used indicator of treatment need, but many people who receive treatment do not have a diagnosis, and most people in the general population who have a diagnosis do not receive or want treatment. Leading scholars who originally developed survey-based diagnostic scales have recently argued that diagnosis and treatment need are not equal and should be measured differently, and they believe that additional research is required to arrive at a satisfactory measure of treatment need. The proposed study will develop a standardized measure of treatment need using existing survey data designed for this purpose and will cross-validate the measure on a series of diverse state surveys and the NHSDA. The state surveys included adult and adolescent household and nonhousehold samples (prisoner, homeless, and treatment client). The survey questionnaire contained the DIS, questions on treatment history, and other measures that reflect the concept of treatment need. The proposed study will analyze the data to test the theoretical analysis of treatment need presented in the proposal, construct a composite measure of need, and assess the construct validity of the need scale. A version of the scale will be applied to 2000-2002 NHSDA data, and the study will estimate the current national treatment gap.