INNOVATIVE JOB PLACEMENT MODEL FOR METHADONE PATIENTS

描述：(申请人摘要) 治疗计划中的药物使用者，包括美沙酮患者， 从历史上看，劳动力参与率很低。在全国范围内，76 %的美沙酮患者在入院时失业，几乎 出院时的速度相同。传统上，吸毒者在接受治疗时会经历 由于现成的供应，极大地阻碍了人们就业 公共援助、成瘾障碍的残疾津贴和医疗补助。 然而，政策变化现在正在创造一个新的环境。最近的联邦和 国家福利改革立法(例如，联邦个人责任和 1996年《工作机会协调法案》；纽约州福利改革法案 1997年)要求戒毒服务对象在#年做好工作准备 具体的时间框架或失去公共利益和其他支持。的确有 有证据表明大多数美沙酮患者有潜在的能力和兴趣 在生产活动中。然而，很少有美沙酮项目能提供足够的 职业服务。拟议的研究将实施和评估 创新职业康复模式，促进社会转型 美沙酮患者从福利到竞争就业。具体目标 是：1)实施物质的个人安置和支持模式 美沙酮治疗阿片成瘾者中的吸毒者(IPS-SU)。创新的IPS 职业康复模式最初是开发的，手册和 对严重精神疾病(SMI)人群的评价良好。 2)通过以下方式对IPS-SU模型的有效性进行随机现场试验 自愿将失业的美沙酮患者分配给：(A) 创新的IPS-SU模式(N=144)，或(B)传统职业服务 程序(N=144)。在6个月、12个月和18个月后评估主要结果 录取，是衡量竞争性就业的指标；次要结果是 美沙酮方案保留、药物使用和患者其他措施 功能正常。 3)确定静态和动态患者属性和干预 可预测患者结局差异的过程变量。 4)对改进后的IPS进行效益-成本和成本-效果分析 职业康复计划。

DESCRIPTION: (Applicant's Abstract) Substance users in treatment programs, including methadone patients, historically have had poor rates of workforce participation. Nationally, 76 percent of methadone patients are unemployed at admission, with virtually the same rate at discharge. Traditionally, addicts in treatment have experienced substantial disincentives to enter employment because of the ready availability of public assistance, disability benefits for addiction disorders and Medicaid. However, policy changes are now creating a new environment. Recent federal and state welfare reform legislation (e.g., federal Personal Responsibility and Work Opportunity Reconciliation Act of 1996; New York State Welfare Reform Act of 1997) requires that drug treatment clients achieve work readiness in specific time frames or lose public benefits and other supports. There is evidence that most methadone patients are potentially capable of and interested in productive activity. However, few methadone programs have offered adequate vocational services. The proposed study will implement and evaluate an innovative vocational rehabilitation model to facilitate the transition of methadone patients from welfare to competitive employment. The specific aims are: 1) To implement and Individual Placement and Support Model for Substance Users (IPS-SU) among opiate addicts in methadone treatment. The innovative IPS vocational rehabilitation model was originally developed, manualized and favorably evaluated for a seriously mentally-ill (SMI) population. 2) To conduct a randomized field trail of the IPS-SU model's efficacy by voluntarily assigning unemployed methadone patients to either: (a) the innovative IPS-SU model (N=144), or (b) a traditional vocational services program (N=144). The primary outcomes, assessed at 6, 12, and 18 months after admission, are measures of competitive employment; the secondary outcomes are methadone program retention, substance use, and other measures of patient functioning. 3) To determine the static and dynamic patient attributes and intervention process variable which may predict differences in patient outcomes. 4) To conduct benefit-cost and cost-effectiveness analyses of the modified IPS vocational rehabilitation program.