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Youth in foster care use drugs too: examining factors that influence foster parent willingness to foster substance-using youth
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Abstracts / Drug and Alcohol Dependence 140 (2014) e86–e168
medical practice offices offering BMT for ∼20,000–30,000 patients and 270 public or private MMT programs across the country with ∼12,000 active patients. At the same time, there are 28 government drug rehabilitation centers with ∼7000 residents/inmates, and ∼115 privately managed drug rehabilitation centers with ∼2000 residents. Recently, we observed a shift from heroin and morphine as the main problem drugs to ATS. In South East Asia, ATS ranks among the top 3 drugs and accounts for half of the world’s methamphetamine users. Opiate users in Malaysia who are undergoing MMT or BMT frequently abuse ATS and treatments for co-occurring opiate and ATS dependent patients are urgently needed. The incidence rate of HIV appears to leveled off in the recent years with ∼4000 new cases per year detected in 2009, 2010, and 2011 while ∼6000 per year were detected in the early 2000s. Conclusions: While changes observed in recent data on newly detected HIV cases cannot be directly linked to the introduction and expansion of MAT programs in Malaysia, implementation of MATs in early 2000s was followed by steadily increasing number of opiate dependent individuals receiving MAT treatments. New trends in drug use patterns underscore the need to develop and implement effective MAT treatments for co-occurring opiate and ATS and poly substance abuse disorders. Financial support: USM Research University Grant (1001CDADAH816174), NIDA DA14718, CMHC/DMHAS/State of Connecticut. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.288 Substance abuse treatment-seeking and barriers to care in persons with alcohol use disorders and comorbid mood or anxiety disorders Christopher N. Kaufmann 1 , R. Crum 1,2,3 , Lian Yu Chen 1 , R. Mojtabai 1 1
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States 2 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States 3 Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States Aims: To compare the utilization of substance use disorder treatment services among individuals diagnosed with an alcohol use disorder (AUD) with and without a comorbid mood or anxiety disorder. Methods: We used data from the National Epidemiologic Survey on Alcohol Related Conditions to examine perceived unmet need for substance use treatments and barriers to such care in 5003 individuals with an AUD with a comorbid mood or anxiety disorder compared to 6734 individuals with an AUD but without a mood or anxiety disorder. We hypothesized that the comorbid group would have greater use of services, but would also experience more barriers to care, than the non-comorbid group. Results: Overall, the comorbid group was more likely to use substance treatment services than the non-comorbid group (18% vs. 12%, p < 0.001). However, the comorbid group was also more likely to perceive an unmet need for such care (8% vs. 3%, p < 0.001) and reported a larger mean number of barriers to care (2.81 vs. 2.20, p = 0.031). Participants with comorbid disorders were more likely than those with non-comorbid AUD to experience financial barriers to care (19% vs. 10%, p = 0.032).
Conclusions: Compared to individuals with AUD only, those with AUD and a comorbid mood or anxiety disorder experience a greater level of unmet need for substance use treatments and a larger number of barriers to such care, especially financial barriers. These individuals might benefit from expansion of financial access to mental health care and integration of services envisioned under the Affordable Care Act. Financial support: National Institute on Drug Abuse (DA030460-02 & T32DA007292) and National Institute on Alcohol Abuse and Alcoholism (AA016346). http://dx.doi.org/10.1016/j.drugalcdep.2014.02.289 Youth in foster care use drugs too: examining factors that influence foster parent willingness to foster substance-using youth Ö. Kaynak, K. Meyers, Elena Bresani Treatment Research Institute, Philadelphia, PA, United States Aims: Youth in foster care are more likely than the general population to have an alcohol and other drugs (AOD) problem. There are no data examining the willingness of foster care parents to foster adolescents who use AOD. This study examines the willingness of a national sample of foster parents to foster AOD-using youth and examines drug, individual and agency-level factors that influence the decision. Methods: Licensed foster parents (N = 752, 86% female, M age = 46.55) completed a 145-item nationally distributed online survey. Independent variables consisted of AOD-specific trainings attended, confidence in addressing the behaviors of AOD youth, confidence in having a positive effect on AOD youth, past helpfulness of placement agency in dealing with problem youth, and past difficulty attaining services for problem youth. Covariates included whether parents fostered a child with an AOD problem in the past, years as a foster parent, number of children typically fostered, religiosity, therapeutic foster parent status, and foster home type. The dependent variable was willingness to foster an AOD-using youth. Logistic regression analyses in SPSS were used. Results: A slight majority of foster parent participants (61%) were willing to foster an AOD-using youth but willingness decreased by type of drug used (e.g., 18% for designer drugs). Attending AOD trainings was a significant predictor of willingness to foster (b = .38, p < .05), however, this effect was mediated by parental confidence in dealing with AOD behaviors (b = .87, p < .001) and in having a positive effect on youth (b = .31, p < .05). Parents who reported that their foster care agency was not helpful were significantly less willing to foster (b = −.60, p < .05). Conclusions: These findings shed light on barriers that impede parent willingness to foster AOD-using foster care youth. At an individual level, providing foster parents with skill-based training that increases confidence is needed. At a systems level, increasing placement agency responsiveness, foster care slots, other fostering models, and AOD training is indicated. Financial support: NIDA Grant #P50-DA027841. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.290
Abstracts / Drug and Alcohol Dependence 140 (2014) e86–e168
medical practice offices offering BMT for ∼20,000–30,000 patients and 270 public or private MMT programs across the country with ∼12,000 active patients. At the same time, there are 28 government drug rehabilitation centers with ∼7000 residents/inmates, and ∼115 privately managed drug rehabilitation centers with ∼2000 residents. Recently, we observed a shift from heroin and morphine as the main problem drugs to ATS. In South East Asia, ATS ranks among the top 3 drugs and accounts for half of the world’s methamphetamine users. Opiate users in Malaysia who are undergoing MMT or BMT frequently abuse ATS and treatments for co-occurring opiate and ATS dependent patients are urgently needed. The incidence rate of HIV appears to leveled off in the recent years with ∼4000 new cases per year detected in 2009, 2010, and 2011 while ∼6000 per year were detected in the early 2000s. Conclusions: While changes observed in recent data on newly detected HIV cases cannot be directly linked to the introduction and expansion of MAT programs in Malaysia, implementation of MATs in early 2000s was followed by steadily increasing number of opiate dependent individuals receiving MAT treatments. New trends in drug use patterns underscore the need to develop and implement effective MAT treatments for co-occurring opiate and ATS and poly substance abuse disorders. Financial support: USM Research University Grant (1001CDADAH816174), NIDA DA14718, CMHC/DMHAS/State of Connecticut. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.288 Substance abuse treatment-seeking and barriers to care in persons with alcohol use disorders and comorbid mood or anxiety disorders Christopher N. Kaufmann 1 , R. Crum 1,2,3 , Lian Yu Chen 1 , R. Mojtabai 1 1
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States 2 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States 3 Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States Aims: To compare the utilization of substance use disorder treatment services among individuals diagnosed with an alcohol use disorder (AUD) with and without a comorbid mood or anxiety disorder. Methods: We used data from the National Epidemiologic Survey on Alcohol Related Conditions to examine perceived unmet need for substance use treatments and barriers to such care in 5003 individuals with an AUD with a comorbid mood or anxiety disorder compared to 6734 individuals with an AUD but without a mood or anxiety disorder. We hypothesized that the comorbid group would have greater use of services, but would also experience more barriers to care, than the non-comorbid group. Results: Overall, the comorbid group was more likely to use substance treatment services than the non-comorbid group (18% vs. 12%, p < 0.001). However, the comorbid group was also more likely to perceive an unmet need for such care (8% vs. 3%, p < 0.001) and reported a larger mean number of barriers to care (2.81 vs. 2.20, p = 0.031). Participants with comorbid disorders were more likely than those with non-comorbid AUD to experience financial barriers to care (19% vs. 10%, p = 0.032).
Conclusions: Compared to individuals with AUD only, those with AUD and a comorbid mood or anxiety disorder experience a greater level of unmet need for substance use treatments and a larger number of barriers to such care, especially financial barriers. These individuals might benefit from expansion of financial access to mental health care and integration of services envisioned under the Affordable Care Act. Financial support: National Institute on Drug Abuse (DA030460-02 & T32DA007292) and National Institute on Alcohol Abuse and Alcoholism (AA016346). http://dx.doi.org/10.1016/j.drugalcdep.2014.02.289 Youth in foster care use drugs too: examining factors that influence foster parent willingness to foster substance-using youth Ö. Kaynak, K. Meyers, Elena Bresani Treatment Research Institute, Philadelphia, PA, United States Aims: Youth in foster care are more likely than the general population to have an alcohol and other drugs (AOD) problem. There are no data examining the willingness of foster care parents to foster adolescents who use AOD. This study examines the willingness of a national sample of foster parents to foster AOD-using youth and examines drug, individual and agency-level factors that influence the decision. Methods: Licensed foster parents (N = 752, 86% female, M age = 46.55) completed a 145-item nationally distributed online survey. Independent variables consisted of AOD-specific trainings attended, confidence in addressing the behaviors of AOD youth, confidence in having a positive effect on AOD youth, past helpfulness of placement agency in dealing with problem youth, and past difficulty attaining services for problem youth. Covariates included whether parents fostered a child with an AOD problem in the past, years as a foster parent, number of children typically fostered, religiosity, therapeutic foster parent status, and foster home type. The dependent variable was willingness to foster an AOD-using youth. Logistic regression analyses in SPSS were used. Results: A slight majority of foster parent participants (61%) were willing to foster an AOD-using youth but willingness decreased by type of drug used (e.g., 18% for designer drugs). Attending AOD trainings was a significant predictor of willingness to foster (b = .38, p < .05), however, this effect was mediated by parental confidence in dealing with AOD behaviors (b = .87, p < .001) and in having a positive effect on youth (b = .31, p < .05). Parents who reported that their foster care agency was not helpful were significantly less willing to foster (b = −.60, p < .05). Conclusions: These findings shed light on barriers that impede parent willingness to foster AOD-using foster care youth. At an individual level, providing foster parents with skill-based training that increases confidence is needed. At a systems level, increasing placement agency responsiveness, foster care slots, other fostering models, and AOD training is indicated. Financial support: NIDA Grant #P50-DA027841. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.290