Employment outcomes for hard-to-reach persons with chronic and severe substance use disorders receiving assertive community treatment.

Abstract:

:Many persons with chronic and severe substance use disorders (SUDs) enter and exit public substance dependence treatment systems with limited benefit, but continue overuse of high-cost health and human services. Less than a third holds jobs, earning income below U.S. federal poverty levels. Long-term integrated substance dependency treatment, rehabilitation, and support services will be essential to resolve substance dependence and employment problems. This single-group program evaluation reports adaptation of Assertive Community Treatment (ACT), a multi-component, team-based service model originally designed for persons with severe mental illnesses and multiple disabilities, for effectiveness with persons with severe SUDs. The ACT model delivers an integrated package of treatment, rehabilitation, and support to reduce substance misuse and increase employment. Of the 35 clients admitted 12 months prior to conclusion of this 2-year service demonstration, only one left treatment prematurely. Generally, clients modestly reduced substance misuse and increased employment. However, the evaluation design and small sample limit inferences of causation and generalizability of these promising outcomes. Persuading states to adopt expensive team-based approaches for this population will require firm evidence of favorable cost-benefit ratios.

journal_name

Subst Use Misuse

journal_title

Substance use & misuse

authors

Gold PB,Meisler N,Duross D,Bailey L

doi

10.1081/ja-200034667

subject

Has Abstract

pub_date

2004-01-01 00:00:00

pages

2425-89

issue

13-14

eissn

1082-6084

issn

1532-2491

journal_volume

39

pub_type

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