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几个州和全国药物滥用家庭调查的现有数据，以了解、衡量和描述美国的药物滥用治疗需求。治疗需要在了解许多药物滥用服务研究问题方面发挥着核心作用，包括资源分配、治疗利用、管理保健、种族差异、国民待遇差距、将滥用者从监狱转移到治疗以及以办公室为基础的美沙酮治疗。然而，目前还没有完善和有效的治疗需求措施。被诊断为药物使用障碍是最常用的治疗需求指标，但许多接受治疗的人没有得到诊断，而普通人群中大多数有诊断的人没有接受或想要接受治疗。最初开发基于调查的诊断量表的主要学者最近认为，诊断和治疗需求不是相等的，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得出令人满意的治疗需求衡量标准。拟议的研究将利用为此目的设计的现有调查数据来制定治疗需求的标准化衡量标准，并将在一系列不同的州调查和NHSDA上交叉验证该衡量标准。州调查包括成人和青少年家庭样本和非家庭样本(囚犯、无家可归者和治疗对象)。调查问卷包括DIS、关于治疗历史的问题以及其他反映治疗需求概念的措施。这项拟议的研究将对数据进行分析，以检验提案中提出的治疗需要的理论分析，构建需要的复合测量，并评估需要量表的结构效度。该量表的一个版本将应用于2000-2002年NHSDA的数据，这项研究将估计当前的国民待遇缺口。

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.