DRUG ABUSE TREATMENT EMERGENCY DEPARTMENT LINKAGES

描述：(申请人？S摘要) 问题复杂的吸毒者经常接触医疗急救 各部门。急诊科可以帮助患者了解药物滥用情况 治疗和与不太急性的护理相联系。这项随机试验将测试 两种联系策略的效果：(1)过渡性病例管理；和(2) 美沙酮免费治疗代金券-阿片依赖注射药物代金券 从公立综合医院急诊科招募的用户。这个 主要目的是测试干预措施的效果：(1)招生 参加药物滥用治疗；(2)招募参加医疗和 社会服务；(3)改善阿片类药物的使用结果；和(4)改变 参与者？急诊卫生服务利用模式。 参与者将是阿片依赖注射吸毒者，在 以医院为基础的急诊科，以2乘2的方式随机分配 因子设计将收到：(1)过渡性病例管理，(2)代金券 免费美沙酮治疗，(3)病例管理和代金券，或(4)常规护理 (简要联系和转介)。案例管理会有一种认知行为 全神贯注。评估将在随机化之前进行，后续评估将在 6个月、12个月和18个月。基本假设将检验以下因素的效果：(1)代金券 关于戒毒招生工作；(2)招收戒毒工作案例管理 其他服务；(3)凭证与案例管理相结合 阿片类药物的使用；和(4)关于保健费用的病例管理 参与者。为了确定参与和留存的预测因素，这项研究 将收集有关治疗过程的信息并准备治疗 可在其他设置中使用的手册。 治疗研究工作将评估将医疗保健联系在一起的创新模式 接受药物滥用治疗。它对跨组成部分的TRC研究做出了贡献， 包括自我推荐与向巴特基博士推荐优惠券，尼古丁 与霍尔博士的相关性，以及与霍尔博士对过程变量的测量。 哈瓦西。它还有助于《真相与和解委员会》中描述的合作研究 核心，包括药物滥用治疗和统计分析、精神病学和 药物滥用共病，以及评估阿片类药物滥用者的环境。

DESCRIPTION: (Applicant?s Abstract) Drug abusers with complex problems have frequent contact with medical emergency departments. Emergency departments can assist patients in accessing drug abuse treatment and linking with less acute care. This randomized trial will test the effects of two linkage strategies: (1) transitional case management; and (2) vouchers for free methadone treatment --- with opioid-dependent injection drug users recruited from the emergency department of a public general hospital. The primary aims are to test the effects of the interventions on: (1) enrolling participants in drug abuse treatment; (2) enrolling participants in medical and social services; (3) improving opioid use outcomes; and (4) changing participants? pattern of utilization of acute health services. Participants will be opioid-dependent injection drug users recruited at a hospital-based emergency department, randomly assigned in a two-by-two factorial design to receive: (1) transitional case management, (2) vouchers for free methadone treatment, (3) case management and vouchers, or (4) usual care (brief contact and referral). Case management will have a cognitive behavioral focus. Assessments will occur before randomization and follow-up assessments at 6, 12 and 18 months. Primary hypotheses will test the effects of: (1) vouchers on enrollment in drug abuse treatment; (2) case management on enrollment in other services; (3) the combination of vouchers and case management in reducing opioid use; and (4) case management on the cost of health care used by the participants. To identify predictors of participation and retention, the study will gather information about the treatment process and prepare treatment manuals that can be used in other settings. The treatment research effort will assess innovative models linking health care with drug abuse treatment. It contributes to cross-component TRC studies, including self-referral versus voucher-referral with Dr. Batki, nicotine dependence with Dr. Hall, and measurement of process variables with Dr. Havassy. It also contributes to collaborative studies described in the TRC core, including drug abuse treatment and statistical analyses, psychiatric and substance abuse comorbidity, and assessing the environments of opioid abusers.