INNOVATIVE JOB PLACEMENT MODEL FOR METHADONE PATIENTS

描述：（申请人摘要） 治疗方案中的物质使用者，包括美沙酮患者， 从历史上看，劳动力参与率很低。全国76 %的美沙酮患者在入院时失业， 出院时的心率相同。传统上，接受治疗的瘾君子会经历 由于容易获得就业机会， 公共援助，成瘾障碍和医疗补助的残疾福利。 然而，政策的变化正在创造一个新的环境。最近联邦和 国家福利改革立法（例如，联邦个人责任 1996年工作机会协调法;纽约州福利改革法 （1997年）要求药物治疗客户在 或失去公共利益和其他支持。有 有证据表明，大多数美沙酮患者可能有能力和兴趣 在生产活动中。然而，很少有美沙酮方案提供足够的 职业服务。拟议的研究将实施和评估一项 创新的职业康复模式，以促进 美沙酮患者从福利到竞争性就业。具体目标 1）实施物质的个人安置和支持模式 美沙酮治疗中阿片类药物成瘾者中的使用者（IPS-SU）创新的IPS 职业康复模式最初是开发，手动化， 对严重精神疾病（SMI）人群进行了有利的评价。 2)通过以下方式对IPS-SU模型的有效性进行随机田间试验： 自愿将失业美沙酮病人分配至： 创新IPS-SU模式（N=144），或（B）传统职业服务 程序（N=144）。在术后6个月、12个月和18个月评估的主要结局 入学，是竞争性就业的措施;次要结果是 美沙酮计划保留，物质使用和患者的其他措施 功能 3)确定静态和动态患者属性和干预 可以预测患者结果差异的过程变量。 4)对改良的IPS进行效益成本和成本效益分析 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.