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HIV/AIDS and Drug Abuse Treatment Services - Part B
Literature Review
September, 1998
Barry S. Brown, Ph.D.
University of North Carolina at Wilmington
Hyperlinks to sections within this text:
Part B:
Special Populations
Staffing Issues
Recommendations for
Service Delivery and Research
References
Part A:
Executive Summary
Introduction
The
Response of Drug Abuse Treatment: Implementing New Initiatives
The
Response of Drug Abuse Treatment: New Initiatives Available for Implementation
Two populations that have assumed increasing significance for drug abuse treatment have been (a) those whose treatment is complicated by psychological symptoms, and (b) those whose treatment must be conducted in criminal justice settings. Drug abuse clients showing psychological symptoms (typically labeled as dually diagnosed or as mentally ill chemical abusers—MICAs) require a wider range of rehabilitation services (Woody, McLellan, O’Brien, & Luborsky, 1991), while the greater emphasis on the criminal justice system to contain drug abuse has led to a complementary emphasis on treatment strategies appropriate to criminal justice settings (Inciardi, 1996). Both the psychological functioning of treatment clients and the need to provide services in institutional settings have implications for the delivery of HIV prevention services.
Psychological Dysfunction
Psychological symptoms have a negative influence on both retention in drug abuse treatment (Rounsaville, Tierney, Crits-Christoph, Weissman, & Kleber, 1982) and treatment outcomes (McLellan, Woody, Luborsky, O'Brien, & Druley, 1983), suggesting that psychological dysfunction may be associated with a diminished ability on the part of drug users to take action necessary to protect their own health and well-being. Research on the relation between psychological functioning and HIV risk taking suggests that psychological problems are indeed associated with increased risk. Studies of out-of-treatment injection drug users have established a relationship between psychological dysfunction and both sexual risk taking (Joe, Knezek, Watson, & Simpson, 1991) and needle risk taking (Simpson, Knight, & Ray, 1993). Study of opiate users entering methadone treatment found a relationship between needle sharing and psychological dysfunction (Camacho, Brown, & Simpson, 1996; Metzger, Woody, & Druley, 1991) and between sex risk (number of partners, unprotected sex with injection drug users, and sex trading) and psychological symptoms (Camacho et al., 1996). Study of cocaine users entering treatment found a relationship between drug-taking behaviors and measures of depression and anxiety (Malow, Corrigan, Pena, Calkins, & Bannister, 1992).
The relation of psychological dysfunction to risk behaviors on the one hand, and to treatment dropout and relapse on the other, suggests a special concern with AIDS prevention efforts for this population in the treatment setting. Specifically, in the area of HIV education/prevention, traditional and innovative strategies can be adapted to this population’s needs. In addition, early retention strategies, adapted to this population's special needs and functioning, might be developed and explored for their capacity to increase clients’ length of stay and diminish levels of risk taking.
Criminal Justice Programming
Studies of entrants to federal and state correctional facilities indicate that about two-thirds of inmates have histories of drug abuse (Innes, 1988; Leukefeld & Tims, 1992 ). Rates of HIV infection in 10 correctional systems were found to vary between 2.1% and 7.6% for men and between 2.7% and 14.7% for women (Vlahov et al., 1991), but other studies obtained rates of 18.5% for New York City inmates (Magura, Rosenblum, & Joseph, 1992) and 18.8% for female inmates in New York State (Smith et al., 1990). In brief, the geography of HIV infection varies as widely among correctional populations as it does among populations in the general community. The potential for increasing evidence of seropositivity in institutional populations is significant given the proportion of entrants involved in drug use. Moreover, the large numbers of drug users suggest that correctional settings, with their literally captive populations at risk for disease, can play a unique role in preventing the further spread of that disease (Gaiter & Doll, 1996). Correctional settings have responded to those challenges through a mix of initiatives involving monitoring of client populations, preventive education and counseling, and drug abuse treatment programs.
Monitoring has involved HIV testing, although correctional systems have varied in their testing strategies. Thus, a survey of the states (44 responding), the Federal Bureau of Prisons, and the District of Columbia, in which multiple responses were permitted, revealed that although all respondents (states) reported some use of HIV testing, 35 tested at the request of a client, 30 tested at the request of a physician, and 20 tested at time of admission, with only 3 of the 20 using voluntary testing (Lillis, 1993). Findings of seropositivity are infrequently employed to segregate inmates. Only 9 of 44 systems isolate clients on the basis of seropositivity (Lillis, 1993), although 16 states remove those with symptoms of AIDS from the general population (Horner, 1993), and Florida maintains a separate institution for those with end-stage disease (Kidwell, 1993).
Preventive education/counseling has been reported to be as widespread as HIV testing (CDC, 1992; Hammett, Harrold, Gross, & Epstein, 1994), probably not coincidentally in that counseling is an essential part of testing programs. Hammett and colleagues (1994) found that 94% of state systems report preventive education/counseling at intake, and about 75% report preventive programming during the period of incarceration, although less than half provide such programming in prerelease settings. However, the findings from state systems cannot be taken to mean that all institutions in the state provide programming; moreover, the content and effectiveness of those programs are unknown. As described by Inciardi (1996), HIV prevention education/counseling has either or both of two objectives: the prevention of HIV spread in institutions and the prevention of HIV spread after discharge. Although the content of programs would clearly overlap, emphases might vary depending on the community of concern. For example, the institutional emphasis might be exclusively on sexual activity; although in this latter regard, Mahon (1996) notes that injection drug use is by no means unknown in institutional settings and routinely involves a sharing of makeshift syringes when it does occur.
For obvious reasons, the drug abuse treatment programs finding greatest favor in institutional settings have involved variations of the therapeutic community adapted to the prison setting. The prototypical prison-based therapeutic communities, Cornerstone (Field, 1985, 1989, 1992) and Stay'n Out (Wexler, Falkin, Lipton, & Rosenblum, 1992; Wexler & Williams, 1986), predate the concern with HIV infection but are significant as initiatives with promise for reducing relapse to drug use and thereby reducing the risk of seroconversion. Recent work by Inciardi and colleagues (Inciardi, 1996; Inciardi, Martin, Lockwood, Hooper, & Wald, 1992) uses a therapeutic community model applied consistently across institutional and prerelease (work release) settings. Findings from an 18-month follow-up comparing individuals exposed to therapeutic community programming administered for their full periods of criminal justice supervision, for portions of their supervision (during either institutional or prerelease programming), or not at all, indicated a dramatic advantage for the group receiving the consistently administered therapeutic community program in terms of reductions in injection and other drug use and in criminal activity (Inciardi, 1996).
An additional initiative developed for opiate users admitted to correctional settings for comparatively brief periods involves the daily administration of methadone in association with a client needs assessment, postrelease planning, and linkage to a community-based methadone treatment program. Thus, the Key Extended Entry Program (KEEP) is designed to recruit clients for long-term treatment employing, in part, role induction techniques (i.e., an introduction to the treatment client role). Correctional clients are expected to report to methadone programs in the community within 24 hours of their release. As reported by Magura and colleagues (1992), 83% of male and 79% of female KEEP clients entered methadone treatment compared to 57% of male and 42% of female matched non-KEEP clients, and nearly twice as many KEEP clients as non-KEEP clients were still in treatment 5 months later. Although the use of methadone in correctional settings may have limited application, it presents an effective strategy for involving lock-up or briefly sentenced injection drug users in programs that can achieve both HIV prevention and rehabilitation objectives.
Project ARRIVE is an AIDS education/relapse prevention initiative for high-risk parolees, organized to provide 24 group sessions of HIV education/prevention over an 8-week period to persons exiting correctional facilities on parole. A comparison of ARRIVE graduates (42% of program entrants) with non-ARRIVE clients (persons assigned to ARRIVE who never attended) yielded generally positive results. ARRIVE clients reported using injection drugs less frequently and having fewer injection drug-using friends than non-ARRIVE clients and were more likely to use condoms and refrain from having sex with high-risk partners (Wexler, Magura, Beardsley, & Josepher, 1994). However, the study findings must be viewed as suggestive only, given the use of extreme samples (i.e., program graduates and refusers, rather than random or matched samples) and the restriction of ARRIVE clients to program completers.
It should be noted that only about one-third of criminal justice clients become incarcerated (Byrne, Lurigio, & Baird, 1989). Consequently, diversion programs, probation, and other community-based sentencing initiatives have implications for HIV prevention. Diversion programs have been of two main types. The Treatment Alternatives to Street Crime (TASC) program was first enacted in 1972 and has been implemented with varying degrees of enthusiasm over the intervening years. In general, enthusiasm has been associated closely with level of federal funding available to states for implementation (Weinman, 1992). TASC has been effective in linking criminal justice clients to community treatment and achieving positive behavior change (Hubbard et al., 1989; Inciardi & McBride, 1991). Moreover, Tyon (1988) reported that two-thirds of TASC clients had never been in drug abuse treatment. Thus, the criminal justice system generally, and TASC in particular, have the potential to modify behaviors of drug users who choose not to enter or who do not have access to drug abuse treatment. More recently, drug court programs, first organized in Miami (Goldkamp, 1994), have reinvigorated the interest in diversion from criminal justice processing to community-based treatment.
Community-based sentencing has chiefly involved a use of surveillance strategies. Byrne and colleagues (1989) report 10,000 offenders placed on house arrest, and Schmidt (1989) reports 2,300 offenders on electronic monitoring. A program for drug offenders combining electronic monitoring and randomly placed phone calls with counseling, NA/AA meetings, emphasis on employment, and use of urine surveillance led to 59% of clients being abstinent at the end of the 28-week program and 79% having reduced their frequency of drug use (Jolin & Stipak, 1992).
Although diversion and community-based sentencing programs chiefly have been organized to reduce jail and prison overcrowding, they nevertheless offer the potential to reach drug users who would otherwise escape the attention of public programs. Moreover, by involving those clients in treatment and/or HIV prevention programs, they provide an opportunity to modify risk-taking behaviors that otherwise would be unavailable.
Issues for drug abuse treatment staff can be grouped into three domains: types of staff needed, training needs, and the hiring and retaining of staff. The intensity of these issues has varied by locale; however, in some measure all programs serving drug users—and particularly those serving injection drug users—have witnessed change. In many programs there has been heightened awareness of HIV risk while an emphasis on traditional rehabilitation goals has been virtually uninterrupted. In other programs (e.g., in much of the urban Northeast), rehabilitation has shared center stage with concerns about HIV prevention and/or with efforts to provide compassionate care to AIDS clients.
The need for adequate medical staff to diagnose and respond to HIV infection and to the increasing rates of viral hepatitis and tuberculosis is obvious. Whether the necessary assistance is available on-site or through liaison with community agencies, the protection of client and community demands an adequate medical presence. The presence of AIDS patients in the drug treatment client population increases the program staff’s responsibilities. Medical staff are needed to prescribe and administer antiretroviral and other HIV-related medications and regularly monitor clients’ health status. The presence of AIDS patients modifies the roles and responsibilities of other staff as well. Counselor responsibility for case management activities can include not only the acquisition of health care and social services, but also arrangements with legal aid services (e.g., for the development of living wills), with hospice care, and finally with agencies providing client burial or cremation (Carroll, in press; Sorensen, DePhilippis, & Batki, in press). In New York City programs, an AIDS coordinator position has been created to assist in the management of AIDS clients and to provide in-service training to staff (Maslansky & Leguillow, in press).
Training in HIV prevention and services for AIDS clients has been organized at the state as well as the local program level (Brown, 1995; Gustafson, 1991; Maslansky & Leguillow, in press; McCarty et al., 1996). Training in HIV prevention has been developed both to permit staff to protect themselves from infection and to enable staff to provide education/counseling for AIDS prevention to clients. As described above, work with drug abuse clients showing evidence of AIDS has required both additional skills and increased psychological preparation to assume the burden of work with the sick and dying.
Recruitment of both professional and paraprofessional staff has been more difficult in the wake of the AIDS epidemic (Brown, 1991; Gustafson, 1991; Sorensen & Miller, 1996). Gustafson (1991) reports that staff retention has increased in difficulty as well. Counselors, and most particularly paraprofessional counselors, showed the highest rates of turnover among all staff in a survey of New York State programs, with 70% of programs reporting difficulties retaining paraprofessional counselors. Although low wages are a major reason for that difficulty, fear of AIDS was frequently cited as a staff concern (Gustafson, 1991).
Efforts to retain staff involve training to deal with fear of infection (Sorensen, Costantini, & London, 1989) and the stress counselors experience in working with HIV-infected clients (Coyle & Soodin, 1992). Training also enables staff to remain current regarding new developments in HIV disease and prevention. Thus, it is important to note that training has cognitive and emotional components significant to counselor functioning.
In addition to training, staff support groups can play an important role in helping counselors cope with the stress of working with AIDS clients (Baginski, 1993; Frost et al., 1991), and grief counseling can allow counselors to cope with disease and death (Brown & Beschner, 1989). Individual and/or group counseling also may be warranted for some treatment staff. The challenge to drug abuse treatment thus becomes not only the development of innovative programs to prevent HIV infection and to treat AIDS patients, not only the marrying of harm reduction and traditional treatment objectives, but also the recruitment, training, and retention of the staff needed to carry out those programs with competence and enthusiasm.
Service Delivery
Service delivery issues with which drug abuse treatment programs must now contend include the treatment of AIDS clients on the one hand and the implementation of AIDS prevention strategies on the other. The treatment of AIDS clients demands the affiliation of drug abuse programs with health care facilities in all but those rare instances where comprehensive medical services are available at the drug abuse treatment site. Treatment of AIDS clients additionally demands an expansion of the case management responsibility of drug abuse programs either through use of the existing counseling staff or through the designation of selected staff as case managers. Providing services to AIDS clients demands staff training and preparation in terms of both treatment strategies and psychological preparation to permit workers skilled in rehabilitation to undertake care for the sick and dying. The treatment of AIDS clients demands a revised set of goals appropriate to those clients’ limitations and individualized in accord with each client’s particular situation. In addition to training, the preparation of drug abuse treatment staff may demand the use of support groups, as well as the availability of individual or group counseling.
HIV prevention (i.e., the provision of prevention education/counseling) and the availability of HIV testing have become requirements for all programs serving injection drug users. However, it can be argued that HIV prevention should be available to all drug abuse clients, since virtually all drugs can be perceived as disinhibiting or as offering the potential for sex trading. Education materials also should be available for clients’ sexual partners as should partner counseling that is initiated in association with the drug abuse client. Because retention in treatment is associated with positive change in behaviors as well as maintenance of seronegativity, an emphasis should be placed on early retention strategies that have been effective, particularly those strategies involving role induction. Because relapse to drug use involves both negative behaviors and the risk of HIV infection, an emphasis should be placed on the relapse prevention strategies that have proven of value in maintaining positive behaviors.
Beyond providing the most effective treatment possible, the drug abuse programming community must determine the nature and extent of responsibility it will assume for out-of-treatment injection and other drug users. Clearly, there are effective strategies to reduce risk-taking behaviors on the one hand and to encourage treatment entry on the other. Those strategies involve outreach/bleach distribution and needle exchange. Where those activities are undertaken by community groups other than treatment programs, it is incumbent on the community organization and the treatment program to coordinate their efforts.
In addition to outreach and needle exchange programs to serve individuals who do not choose to enter treatment or who do not have access to treatment, interim methadone should be available for opiate users who must be placed on treatment program waiting lists. Interim methadone has been effective in reducing HIV risk and in permitting opiate users to remain accessible to drug abuse treatment. The significance of comprehensive treatment for positive behavior change is well established. Allowing clients to survive long enough to make use of methadone maintenance should be a priority for drug abuse programming.
Other initiatives such as medical maintenance and LAAM may offer a capacity to serve greater numbers of injection drug users while doing no harm to the capacity to provide effective treatment. In addition, 180-day detoxification may prove useful to efforts to attract opiate users, again without sacrificing the potential to provide comprehensive services. Indeed, 180-day detoxification offers the potential to transform detoxification from an ameliorative strategy to a treatment strategy.
Criminal justice programming, too, demands training of service providers to have the knowledge, skills, and comfort level to respond to persons with HIV disease and to guide prevention efforts. HIV prevention education/counseling should be provided to injection and other drug users (and all criminal justice clients) at intake and at each stage of criminal justice processing. Institutional programs using modified therapeutic community programs consistently applied from closed prison settings through work release or other aftercare settings, as well as diversion programs, have demonstrated a capacity to reduce HIV risk taking and to increase positive posttreatment functioning.
The adoption or increasing use of the strategies described above enhance the ability of drug abuse programming to protect the health of drug users and other community members without compromising the integrity of current treatment programming. To accomplish the implementation of these and additional strategies will require continuing leadership from those agencies that have a responsibility for oversight of treatment and HIV/AIDS research and that have an appreciation for the significance of those findings to drug abuse programming.
Research
Although a number of treatment initiatives have sufficient research support to justify their application, the refinement of those strategies and the study of new ones demand additional investigation. Thus, strategies for risk reduction among newly admitted and out-of-treatment drug users are less successful than we would wish in terms of reducing sexual risk taking. The structure of sexual risk reduction strategies may vary between male and female clients, and strategies of both sexual and needle risk reduction may need to be adapted to the special needs of clients showing psychological problems. Moreover, studies can clarify the impact of risk-reduction strategies on clients who drop out of treatment early. Studies also can explore the impact of AIDS education/prevention delivered on-site as a part of drug treatment services and off-site at cooperating medical service or HIV agencies. Studies of HIV risk reduction strategies should involve spouses and sexual partners as well as treatment clients. Drug abuse treatment is part of a larger public health concern and, consistent with that concern, has unique potential to reach and to protect the lives of its clients’ partners and offspring. Just as treatment programs have a responsibility to work with and through clients to counsel and protect partners, research has a responsibility to assess the efficacy of different prevention approaches. To do less risks consigning an unknown number of partners and children to disease and death.
The refinement of early retention and relapse prevention strategies has significance for the effectiveness of treatment generally and for HIV risk reduction specifically. Indeed, the significance of relapse for contracting and spreading lethal disease should lead all follow-up studies, if not all treatment effectiveness studies, to assess HIV risk at baseline and at times of posttreatment assessment. Continuing study of outreach strategies, again with particular regard to the ability to affect sexual behaviors and to reach sexual partners, should receive further attention, as should study of efforts to coordinate the activities of outreach and needle exchange programs with drug abuse treatment. Risk reduction and treatment interventions play complementary roles in relation to the drug abuser. To have them function independently or coordinate haphazardly does not serve the needs of either the client or the community.
Innovative strategies of delivering methadone need to be explored both for their capacities to attract injection drug users who might otherwise continue at risk (e.g., such strategies as 180-day detoxification and mobile methadone programs) and for their abilities to free up treatment slots (e.g., such strategies as medical maintenance and LAAM substitution programs).
Ultimately, all programming depends on having sufficient numbers of well-prepared staff. Yet, few studies have explored the efficacy of different training strategies, and there is little monitoring of the impact of HIV/AIDS on the numbers and types of staff available to provide drug abuse treatment. The ability of training programs and supportive strategies (e.g., support groups, individual counseling) to retain staff, to maintain morale, and, most important, to permit effective staff functioning should be addressed. In addition, it would be useful to monitor staffing patterns and turnover in communities showing high and low rates of AIDS, change in drug abuse treatment programming in those communities, and the ways in which program efforts to respond to the AIDS crisis may be complicated by the demands on programs to respond to managed care initiatives. In addition to monitoring staffing patterns, there is a need to monitor the response of drug abuse treatment to HIV/AIDS concerns more generally. Although any such effort will be complicated by other issues (e.g., changing drug use patterns and funding patterns), there is a need to understand the responsiveness of treatment to HIV/AIDS.
The primary care and criminal justice communities also demand study. The former requires study of impediments to service delivery to drug abuse clients and of the ability of differing strategies to overcome those impediments and guarantee appropriate service to drug abuse clients. The latter requires study of the effectiveness of HIV prevention education/counseling delivered as a coordinated program through the several stages of criminal justice processing (i.e., from lockup through sentence completion or parole). Studies also can be undertaken to clarify differences between drug users in the criminal justice system who have and have not elected drug abuse treatment and to assess the effectiveness of innovative programs to modify the drug-using and other risk-taking behaviors of each of these populations.
Finally, it must be noted that this research agenda, or indeed any research agenda, requires a strategy of technology transfer if the findings from those studies are to make a difference in the functioning of treatment programs and ultimately in the lives of the clients those programs serve. The implementation of new initiatives found to have efficacy depends on our ability to communicate and to demonstrate those strategies in a language and manner that permit their use by the clinical staffs on whom treatment depends. The challenges those staffs confront and the needs of their clients demand not only that we conduct clinically useful research, but that we communicate our findings in a way that guarantees their clinical utility.
Abdul-Quadar, A. S., Friedman, S. R., Des Jarlais, D., Marmor, M. M., Maslansky, R., & Bartelme, S. (1987). Methadone maintenance and behavior by intravenous drug users that can transmit HIV. Contemporary Drug Problems, 14, 425-434.
American Society of Addiction Medicine. (1995a). Public policy statement on primary medical care for HIV infected patients in addiction treatment. Journal of Addictive Diseases, 14, 129-130.
American Society of Addiction Medicine. (1995b). Public policy statement on HIV testing of patients in addiction treatment facilities. Journal of Addictive Diseases, 14, 131-133.
American Society of Addiction Medicine. (1995c). Public policy statement on HIV/AIDS education for drug and alcohol treatment. Journal of Addictive Diseases, 14, 197-198.
American Society of Addiction Medicine. (1995d). Public policy statement on needle exchange. Journal of Addictive Diseases, 14, 199.
Baginski, Y. (1993). Caregiver ethics: Walking the fine line. Caring, 12, 48-52.
Ball, J. C., Lange, W. R., Myers, C. P., & Friedman, S. R. (1988). Reducing the risk of AIDS through methadone maintenance treatment. Journal of Health and Social Behavior, 29, 214-226.
Banys, P., Tusel, D. J., Sees, K. L., Reilly, P. M., & DeLucchi, K. L. (1993). Low (40 mg.) versus high (80 mg.) dose methadone in a 180-day heroin detoxification program. In L. Harris (Ed.), Problems of drug dependence, 1992: Proceedings of the 54th Annual Scientific Meeting [NIDA Monograph 132] (p. 217). Washington, DC: U.S. Government Printing Office.
Barthwell, A. G. (1993). Screening for infectious diseases among substance abusers: The recommendations of a consensus panel. Rockville, MD: Center for Substance Abuse Treatment.
Barthwell, A. G. (1995). Intake procedures/HIV prevention, counseling and testing strategies. In B. S. Brown (Ed.), Substance treatment in the era of AIDS. Rockville, MD: Center for Substance Abuse Treatment.
Battjes, R. J., Pickens, R. W., & Amsel, Z. (1991). HIV infection and AIDS risk behaviors among intravenous drug users entering methadone treatment in selected cities. Journal of Acquired Immune Deficiency Syndromes, 4, 1148-1154.
Battjes, R. J., Pickens, R. W., Haverkos, H. W., & Sloboda, Z. (1994). HIV risk factors among injecting drug users in five U.S. cities. AIDS, 8, 681-687.
Becker, M. H., & Joseph, J. G. (1988). AIDS and behavioral change to reduce risk: A review. American Journal of Public Health, 78, 394-410.
Bell, J., Caplehorn, J. M., & McNeil, D. R. (1994). The effect of intake procedures on performance in methadone maintenance. Addiction, 89, 463-471.
Birch & Davis Associates. (1991). Crack pipe as pimp: An eight-city ethnographic study of the sex-for-crack phenomenon. Silver Spring, MD: Author.
Brady, J. V. (1993a). Enhancing drug abuse treatment by mobile health service. In J. Inciardi, F. Tims, & B. Fletcher (Eds.), Innovative approaches in the treatment of drug abuse: Program models and strategies (pp. 35-42). Westport, CT: Greenwood Press.
Brady, J. V. (1993b). What's a radical behaviorist like you doing in a nice pharmacology club like C.P.P.D.? In L. Harris (Ed.), Problems of drug dependence 1992: Proceedings of the 54th Annual Scientific Meeting [NIDA Monograph 132] (pp. 19-28). Washington, DC: U.S. Government Printing Office.
Brettle, R. P. (1991). HIV and harm reduction for injection drug users. AIDS, 5, 125-136.
Brown, B. S. (1991). AIDS and the provision of drug user treatment. International Journal of the Addictions, 25, 1503-1514.
Brown, B. S. (1995a). Reducing impediments to technology transfer in drug abuse programming. In T. E. Backer, S. L. David, & G. Soucy (Eds.), Reviewing the behavioral science knowledge on technology transfer [NIDA Monograph 155] (pp. 169-185). Washington, DC: U.S. Government Printing Office.
Brown, B. S. (1995b). Substance abuse treatment in the era of AIDS. Rockville, MD: Center for Substance Abuse Treatment.
Brown, B. S. (1996). Comments on "Harm reduction and decriminalization in the United States: A personal perspective." by Robert L. DuPont. Substance Use and Misuse, 31, 1949-1952.
Brown, B. S., & Beschner, G. M. (1989). AIDS and HIV infection—Implications for drug abuse treatment. Journal of Drug Issues, 19, 141-162.
Brown, B. S., Beschner, G. M., & National AIDS Research Consortium. (1993). Handbook on risk of AIDS: Injection drug users and sexual partners. Westport, CT: Greenwood Press.
Brown, B. S., Hickey, J. E., Chung, A. S., Craig, R. D., & Jaffe, J. H. (1989). The functioning of individuals on a drug abuse treatment waiting list. American Journal of Drug and Alcohol Abuse, 15, 261-274.
Brown, B. S., & Needle, R. (1994). Modifying the process of treatment to meet the threat of AIDS. International Journal of the Addictions, 29, 1739-1752.
Brown, B. S., Nurco, D. N., & Tims, F. M. (1996). Report of a conference on HIV/AIDS and drug abuse treatment. Journal of Substance Abuse Treatment, 13, 373-374.
Brown L. S., Jr. (1991). The impact of AIDS on drug abuse treatment. In R. W. Pickens, C. G. Leukefeld, & C. R. Schuster (Eds.), Improving drug abuse treatment [NIDA Monograph 106] (pp. 385-393). Washington, DC: U.S. Government Printing Office.
Bux, D. A., Iguchi, M. I., Lidz, V., Baxter, R. C., & Platt, J. J. (1993). Participation in an outreach-based coupon distribution program in free methadone detoxification. Hospital and Community Psychiatry, 44, 1066-1072.
Byrne, J. M., Lurigio, A. J., & Baird, C. (1989). The effectiveness of the new intensive supervision programs. Research on Corrections, 2, 1-48.
Calsyn, D. A., Freeman, G., Saxon, A. J., & Whittaker, S. (1990). Addict beliefs about access to HIV test results. In L. S. Harris (Ed.), Problems of drug dependence, 1989: Proceedings of the 51st Annual Scientific Meeting [NIDA Monograph 95] (p. 417). Washington, DC: U.S. Government Printing Office.
Calsyn, D. A., Saxon, A., & Freeman, G. (1992). Lack of efficacy of AIDS education in reducing HIV-risk transmission behaviors among injection drug users. American Journal of Public Health, 82, 573-575.
Camacho, L. M., Brown, B. S., & Simpson, D. D. (1996). Psychological dysfunction and HIV/AIDS risk behavior. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 11, 198-202.
Carey, K. B., & Carey, M. P. (1990). Enhancing treatment attendance of mentally ill chemical abusers. Journal of Behavior Therapy and Experimental Psychiatry, 21, 205-209.
Carlson, G. A., & McLellan, A. T. (1987). The voluntary acceptance of HIV-antibody testing by intravenous drug users. Public Health Reports, 102, 391-394.
Carroll, J. X. (in press). Service delivery strategies appropriate to residential treatment programs. In B. S. Brown (Ed.), Substance abuse treatment in the era of AIDS (pp. 61-87). Rockville, MD: Center for Substance Abuse Treatment.
Carroll, K. M., Rounsaville, B. J., & Gawin, F. H. (1991). A comparative trial of psychotherapies for ambulatory cocaine abusers: Relapse prevention and interpersonal psychotherapy. American Journal of Drug and Alcohol Abuse, 17, 229-247.
Carroll, K. M., Rounsaville, B. J., & Keller, D. S. (1991). Relapse prevention strategies for the treatment of cocaine abuse. American Journal of Drug and Alcohol Abuse, 17, 249-255.
Carvell, A. M., & Hart, G. J. (1990). Help-seeking and referrals in a needle exchange: A comprehensive service to injecting drug users. British Journal of Addiction, 85, 235-240.
Center for Addictive Behaviors. (1994). The mobile methadone program: A study of an innovative service delivery system for drug abuse treatment. Salem, MA: Center for Addictive Services.
Center for Substance Abuse Treatment. (1995). LAAM in the treatment of opiate addiction. [Treatment Improvement Protocol (TIP) Series No. 22]. Rockville, MD: Center for Substance Abuse Treatment.
Centers for Disease Control and Prevention. (1992). HIV prevention in the U.S. correctional system. Morbidity and Mortality Weekly Report, 41, 389-391, 397.
Centers for Disease Control and Prevention. (1994). HIV/AIDS surveillance report. Atlanta, GA: Author.
Centers for Disease Control and Prevention. (1996a). HIV/AIDS surveillance report–U.S. HIV and AIDS cases reported through June 1996. Atlanta, GA: Author.
Centers for Disease Control and Prevention. (1996b). HIV/AIDS Prevention Newsletter, August 1996. Atlanta, GA: Author.
Chaisson, R. E., Bacchetti, P., Osmond, D., Brodie, B., Sande, M. A., & Moss, A. R. (1989). Cocaine use and HIV infection in intravenous drug users. Journal of the American Medical Association, 261, 561-609.
Chaisson, R. E., Osmond, D., Bacchetti, P., Brodie, B., Sande, M. A., & Moss, A. R. (1988). Cocaine, race, and HIV infection in IV drug users. Presented at the Fourth International Conference on AIDS, Stockholm, Sweden.
Conviser, R., & Rutledge, J. H. (1989). Can public policies limit the spread of HIV among IV drug users? Journal of Drug Issues, 19, 113-128.
Cooper, J. R. (1989). Methadone treatment and acquired immunodeficiency syndrome. Journal of the American Medical Association, 262, 1664-1668.
Coyle, A., & Soodin, M. (1992). Training, workload and stress among HIV counselors. AIDS Care, 4, 217-221.
Coyle, S. L. (1993). The NIDA HIV counseling and education intervention model: Intervention manual. Rockville, MD: National Institute on Drug Abuse.
Coyle, S. L., Boruch, R. F., & Turner, C. F. (1991). Evaluating AIDS prevention programs. Washington, DC: National Academy Press.
De Leon, G. (1991). Retention in drug-free therapeutic communities. In R. W. Pickens, C. G. Leukefeld, & C. R. Schuster (Eds.), Improving drug abuse treatment [NIDA Monograph 106] (pp. 218-224). Washington, DC: U.S. Government Printing Office.
Department of Health and Human Services. (1989, March). Food and Drug Administration regulations in the Federal Register. 21 CFR Part 21. Washington, DC: Food and Drug Administration/Author.
Department of Health and Human Services. (1993, March). Substance abuse prevention and treatment block grants. Federal Register. Washington, DC: Author.
Des Jarlais, D. C., & Friedman, S. R. (1988). Intravenous cocaine, crack, and HIV infection. Journal of the American Medical Association, 259, 1945-1946.
DuPont, R. L. (1996). Harm reduction and decriminalization in the United States: A personal perspective. Substance Use and Misuse, 31, 1929-1945..
El-Bassel, N., & Schillig, R. F. (1992). 15-month followup of women methadone patients taught skills to reduce heterosexual HIV transmission. Public Health Reports, 107, 500-504.
Etheridge, R. M., Craddock, S. G., Dunteman, G. H., & Hubbard, R. L. (1995). Treatment services in two national studies of community-based drug abuse treatment programs. Journal of Substance Abuse, 7, 9-26.
Field, G. (1985). The Cornerstone program. A client outcome study. Federal Probation, 49, 50-55.
Field, G. (1989). The effects of intensive treatment on reducing the criminal recidivism of addicted offenders. Federal Probation, 63, 51-56.
Field, G. (1992). Oregon prison drug treatment programs. In C. G. Leukefeld & F. M. Tims (Eds.), Drug abuse treatment in prisons and jails [NIDA Monograph 118] (pp. 142-155). Washington, DC: U.S. Government Printing Office.
Finklestein, I. (1990, February 28). Testimony to FDA from Chairperson, New York State Committee of Methadone Program Administrators.
Friedman, S. R., Des Jarlais, D. C., Ward, T. P., & Jose, B. (1993). Drug injectors and heterosexual AIDS. In L. Sherr (Ed.), AIDS and the heterosexual population (pp. 41-65). Langhorne, PA: Harwood Academic/Gordo and Breach Science.
Friedmann, P., Des Jarlais, D. C., Peyser, N. P., Nichols, S. E., Drew, E., & Newman, R. G. (1994). Retention of patients who entered methadone maintenance via an interim methadone clinic. Journal of Psychoactive Drugs, 26, 217-221.
Frost, J. C., Makadon, H. J., Judd, D., Lee, S., O'Neil, S. F., & Paulsen, R. (1991). Care for caregivers: A support group for staff caring for AIDS patients in a hospital-based primary care practice. Journal of General Internal Medicine, 6, 162-167.
Fullilove, R. E., Fullilove, M. T., Bowser, B. E., & Gross, S. A. (1989). Crack use and risk for AIDS among black adolescents. Paper presented at the Fifth International Conference on AIDS, Montreal, Canada.
Fullilove, R. E., Fullilove, M. T., Bowser, B. E., & Gross, S. A. (1990). Risk of sexually transmitted disease among black adolescent crack users in Oakland and San Francisco, California. Journal of the American Medical Association, 263, 851-855.
Gaiter, J., & Doll, L. S. (1996). Editorial: Improving HIV/AIDS prevention in prisons is good public health policy. American Journal of Public Health, 86, 1201-1203.
General Accounting Office. (1993). Needle exchange programs: Research suggests promise as an AIDS prevention GAO strategy. Washington, DC: U.S. Government Printing Office.
Genser, S. G., & Schlenger, W. (1993). Linking drug abuse treatment and primary medical care to optimize service delivery for HIV risk intervention. Abstract, International Conference on AIDS.
Goldapple, G. C., & Montgomery, D. (1993). Evaluating a behaviorally based intervention to improve client retention in therapeutic community treatment for drug dependency. Research on Social Work Practice, 3, 21-39.
Goldkamp, J. S. (1994). Miami's treatment drug court for felony defendents: Some implications of assessment findings. Prison Journal, 73, 110-116.
Guinan, M. E. (1989). Women and crack addiction. Journal of the American Medical Women's Association, 44, 129.
Gustafson, J. S. (1991). Do more ... and do it better: Staff-related issues in the drug treatment field that affect the quality and effectiveness of services. In R. W. Pickens, C. G. Leukefeld, & C. R. Schuster (Eds.), Improving drug abuse treatment [NIDA Monograph 106] (pp. 53-62). Washington, DC: U.S. Government Printing Office.
Hammett, T. M., Harrold, L., Gross, M., & Epstein, J. (1994). 1992 Update: HIV/AIDS in correctional facilities: Issues and options. Washington, DC: National Institute of Justice.
Hartgers, C., van den Hoek, A., Krijnen, P., & Coutinho, R. A. (1992). HIV prevalence and risk behavior among injecting drug users who participate in "low-threshold" methadone programs in Amsterdam. American Journal of Public Health, 82, 547-551.
Hawkins, J. D., Catalano, R. F., Gillmore, M. R., & Wells, E. A. (1989). Skills training for drug abusers: Generalization, maintenance, and effects on drug use. Journal of Consulting and Clinical Psychology, 57, 559-563.
Hawkins, J. D., Catalano, R. F., & Wells, E. A. (1986). Measuring effects of a skills training intervention for drug abusers. Journal of Consulting and Clinical Psychology, 54, 661-664.
Higgins, D. L., Galavotti, C., O'Reilly, K., Schnell, D. J., Moore, M., Rugg, D. L., & Johnson, R. (1991). Evidence for the effects of HIV antibody counseling and testing on risk behaviors. Journal of the American Medical Association, 266, 2419-2429.
Horner, J. F. (1993). Constitutional issues surrounding the mass testing and segregation of HIV-infected inmates. Memphis State University Law Review, 23, 369-398.
Hubbard, R. L. (1993, July 16). Preliminary findings from DATOS. Paper presented at the Second National Conference on Drug Abuse Research and Practice, Washington, DC.
Hubbard, R. L., Marsden, M. E., Rachal, J. V., Harwood, H. J., Cavanaugh, E. R., & Ginzburg, H. M. (1989). Drug abuse treatment—A national study of effectiveness. Chapel Hill, NC: University of North Carolina Press.
Hughes, P. H. (1977). Behind the wall of respect. Chicago: University of Chicago Press.
Hughes, P. H., & Jaffe, J. H. (1971). The heroin copping area: A location for epidemiological study and intervention activity. Archives of General Psychiatry, 24, 394-400.
Inciardi, J. A. (1996). HIV risk reduction and service delivery strategies in criminal justice settings. Journal of Substance Abuse Treatment, 13, 421-428.
Inciardi, J. A., Chitwood, D. D., & McCoy, C. B. (1992). Special risks for the acquisition and transmission of HIV infection during sex in crack houses. Journal of Acquired Immune Deficiency Syndromes, 5, 951-952.
Inciardi, J. A., Martin, S. S., Lockwood, D., Hooper, R. M., & Wald, B. M. (1992). Obstacles to the implementation and evaluation of drug treatment programs in correctional settings: Reviewing the Delaware Key experience. In C. G. Leukefeld & F. M. Tims (Eds.), Drug abuse treatment in prisons and jails [NIDA Monograph 118] (pp. 176-191). Washington, DC: U.S. Government Printing Office.
Inciardi, J. A., & McBride, D. C. (1991). Treatment Alternatives to Street Crime: History, experiences and issues. Rockville, MD: National Institute on Drug Abuse.
Innes, C. A. (1988). Profile of state prison inmates, 1986. Washington, DC: National Institute of Justice.
Jackson, J. F., Rotkiewicz, L. G., Quinones, M. A., & Passannante, M. R. (1989). A coupon program, drug treatment, and AIDS education. International Journal of the Addictions, 24, 1035-1051.
Joe, G. W., Knezek, L., Watson, D., & Simpson, D. D. (1991). Depression and decision-making among intravenous drug users. Psychological Reports, 68, 339-347.
Jolin, A., & Stipak, B. (1992). Drug treatment and electronically monitored home confinement: An evaluation of a community-based sentencing option. Crime and Delinquency, 38, 158-170.
Kaplan, E. H. (1993). Federal response to needle-exchange programs: Part II: B. Needle-exchange research: The New Haven experience. Pediatric AIDS and HIV Infection: Fetus to Adolescent, 4 (2), 92-96.
Karon, J. M., Rosenberg, P. S., McQuillan, G., Khare, M., Gwinn, M., & Petersen, L. R. (1996). Prevalence of HIV infection in the United States, 1984 to 1992. Journal of the American Medical Association, 276, 126-131.
Kidwell, D. (1993, August 24). Florida plans "AIDS-care" facility for all inmates. Washington Post, p. A5.
Lampinen, T. M. (1991). Cost-effectiveness of drug abuse treatment for primary prevention of AIDS: Epidemiological considerations. In W. S. Cartwright & J. M. Kaple (Eds.), Economic costs, cost-effectiveness, pricing, and community based drug treatment [NIDA Monograph 113] (pp. 114-128). Washington, DC: U.S. Government Printing Office.
Leshner, A. I. (1995). February 22 letter to investigators.
Leukefeld, C. G., & Tims, F. M. (Eds.). (1992). Drug abuse treatment in prisons and jails [NIDA Monograph 118]. Washington, DC: U.S. Government Printing Office.
Liebman, J., Knezek, L. D., Coughey, K., & Hua, S. (1993). Injection drug users, drug treatment and HIV risk behavior. In B. S. Brown, G. M. Beschner, & National AIDS Research Consortium (Eds.), Handbook on risk of AIDS–Injection drug users and sexual partners (pp. 355-373). Westport, CT: Greenwood Press.
Lillis, J. (1993). Dealing with HIV/AIDS-positive inmates. Corrections Compendium, 18, 1-3.
Ling, W., & Blaine, J. D. (1979). The use of LAAM in treatment. In R. L. DuPont, A. Goldstein, & J. O'Donnell (Eds.), Handbook on drug abuse (pp. 87-96). Washington, DC: U.S. Government Printing Office.
Ling, W., Charuvastra, V. C., Kaim, S. C., & Klett, C. J. (1976). Acetylmetadol and methadone as maintenance treatment for heroin addicts. A Veterans Administration cooperative study. Archives of General Psychiatry, 33, 709-720.
Ling, W., Klett, C. J., & Gillis, R. D. (1978). A cooperative clinical study of methadyl acetate. I. Three-times-a-week regimen. Archives of General Psychiatry, 35, 345-353.
Longshore, D., Hsieh, S., Danila, B., & Anglin, M. D. (1993). Methadone maintenance and needle/syringe sharing. International Journal of the Addictions, 28, 983-996.
Lurie, P., Reingold, A. L., Bowser, B., Chen, D., Foley, J., Guydish, J., Kahn, J. G., Land, S., & Sorensen, J. (1993). The public impact of needle exchange programs in the United States and abroad. Volume 1. San Francisco, CA: University of California.
Maddux, J. F., Parihoda, T. J., & Desmond, D. P. (1994). Treatment fees and retention in methadone maintenance. Journal of Drug Issues, 24, 429-443.
Magura, S., Rosenblum, A., & Joseph, H. (1992). Evaluation of in-jail methadone maintenance: Preliminary results. In C. G. Leukefeld & F. M. Tims (Eds.), Drug abuse treatment in prisons and jails [NIDA Monograph 118] (pp. 192-210). Washington, DC: U.S. Government Printing Office.
Mahon, N. (1996). New York inmates' HIV risk behaviors: The implications for prevention policy and programs. American Journal of Public Health, 86, 1211-1215.
Malow, R. M., Corrigan, S. A., Pena, J. M., Calkins, A. M., & Bannister, T. M. (1992). Mood and HIV-risk behavior among drug-dependent veterans. Psychology of Addictive Behaviors, 6, 131-134.
Maslansky, R., & Leguillow, N. (in press). Service delivery strategies appropriate to methadone treatment programs. In B. S. Brown (Ed.), Substance abuse treatment in the era of AIDS. Rockville, MD: Center for Substance Abuse Treatment.
McAuliffe, W. E. (1990). A randomized clinical trial of recovery training and self-help for opiate addicts in New England and Hong Kong. Journal of Psychoactive Drugs, 22, 197-209.
McAuliffe, W. E., & Chien, J. M. N. (1986). Recovery training and self-help: A relapse-prevention program for treated heroin addicts. Journal of Substance Abuse Treatment, 3, 9-20.
McCarty, D., LaPrade, J., & Botticelli, M. (1996). Substance abuse treatment and HIV services: Massachusetts' policies and programs. Journal of Substance Abuse Treatment, 13, 429-438.
McLellan, A. T., Arndt, I. O., Metzger, D. S., Woody, G. E., & O'Brien, C. P. (1993). The effects of psychosocial services in substance abuse treatment. Journal of the American Medical Association, 269, 1953-1959.
McLellan, A. T., Metzger, D. S., Alterman, A. I., Woody, G. E., Durell, J., & O'Brien, C. P. (1996). Evaluating the effectiveness of addiction treatment: Reasonable expectations, appropriate comparisons. Milbank Quarterly, 74, 51-85.
McLellan, A. T., Woody, G. E., Luborsky, L., O'Brien, C. P., & Druley, K. A. (1983). Predicting response to alcohol and drug treatments: Role of psychiatric severity. Archives of General Psychiatry, 40, 620-625.
Metzger, D. S., Woody, G. E., & Druley, P. (1991). Psychiatric symptoms, high risk behaviors, and HIV seropositivity among methadone patients. In L. Harris (Ed.), Problems of drug dependence 1990: Proceedings of the 52nd Annual Scientific Meeting [NIDA Monograph 105] (pp. 490-491). Washington, DC: U.S. Government Printing Office.
Metzger, D. S., Woody, G. E., McLellan, A. T., O'Brien, C. P., Druley, P., Navaline, H., De Philippis, D., Stolley, P., & Abrutyn, E. (1993). Human immunodeficiency virus seroconversion among intravenous drug users in- and out-of-treatment: An 18-month prospective follow-up. Journal of Acquired Immune Deficiency Syndromes, 6, 1049-1056.
Miller, H. G., Turner, C. F., & Moses, L. E. (1990). AIDS–The second decade. Washington, DC: National Academy Press.
Mor, V., Fleishman, J. A., Dresser, M., & Piette, J. (1992). Variation in health service use among HIV-infected patients. Medical Care, 30, 17-29.
Murphy, S., & Irwin, J. (1992). "Living with the dirty secret": Problems of disclosure for methadone maintenance clients. Journal of Psychoactive Drugs, 24, 257-264.
National Institute on Drug Abuse. (1994). The National AIDS Demonstration Research (NADR) Project: Effectiveness of AIDS outreach intervention/prevention research project on out-of-treatment injecting drug users. Washington, DC: U.S. Government Printing Office.
National Institute on Drug Abuse, & National Institute of Alcohol Abuse and Addiction. (1992). State resources and services related to alcohol and other drug abuse problems. Fiscal year 1990. Rockville, MD: Alcohol, Drugs and Mental Health Administration.
Nelson, K. E., Vlahov, D., & Cohn, S. (1991). Sexually transmitted diseases in a population of intravenous drug users: Association with seropositivity to the human immunodeficiency virus (HIV). Journal of Infectious Diseases, 164, 457-463.
Neshin, S. F. (1993). HIV and other infectious diseases. In M. W. Parrino (Ed.), State methadone treatment guidelines (pp. 95-100). Rockville, MD: Center for Substance Abuse Treatment.
Normand, J., Vlahov, D., & Moses, L. E. (1995). Preventing HIV transmission. The role of sterile needles and bleach. Washington, DC: National Academy Press.
North American Syringe Exchange Network. (1994). Surveys, surveys, surveys. Networks, 3, 1.
Novick, D. M., & Joseph, H. (1991). Medical maintenance: The treatment of chronic opiate dependence in general medical practice. Journal of Substance Abuse Treatment, 8, 233-239.
Novick, D. M., Joseph, H., Richman, B., Salsitz, E., Pascarelli, E., Des Jarlais, D., Dole, V., & Nyswander, M. (1988). Medical maintenance: A new model for continuing treatment of socially rehabilitated methadone maintenance patients. In L. S. Harris (Ed.), Problems of drug dependence 1988: Proceedings of the 50th Annual Scientific Meeting [NIDA Monograph 90] (pp. 168-176). Washington, DC: U.S. Government Printing Office.
Novick, D. M., Pascarelli, E. F., Joseph, H., Salsitz, E. A., Richman, B. L., Des Jarlais, D. C., Anderson, M., Dole, V. P., & Nyswander, M. E. (1988). Methadone maintenance patients in general medical practice: A preliminary report. Journal of the American Medical Association, 259, 3299-3302.
O’Connor, P. G., Molde, S., Henry, S., Shockfor, W. T., & Schottenfeld, R. S. (1992). Human immunodeficiency virus infection in intravenous drug users: A model for primary care. American Journal of Medicine, 93, 382-386.
Office of Technology Assessment. (1990). The effectiveness of drug abuse treatment: Implications for controlling AIDS/HIV infection. Washington, DC: Office of Technology Assessment.
Oliver, K., Maynard, H., Friedman, S. R., & Des Jarlais, D. C. (1994). Behavioral and community impact of the Portland syringe exchange program. In National Research Council and Institute of Medicine (Ed.), Proceedings, workshop on needle exchange and bleach distribution programs (pp. 35-46). Washington, DC: National Academy Press.
Paone, D., Des Jarlais, D. C., Caloir, S., Friedmann, P., Ness, I., & Friedman, S. R. (1994). New York syringe exchange: An overview. In National Research Council and Institute of Medicine (Ed.), Proceedings, workshop on needle exchange and bleach distribution programs (pp. 47-63). Washington, DC: National Academy Press.
Peyser, N. P., Newman, R. G., Friedmann, P., & Des Jarlais, D. C. (in press). Strategies for delivery of interim substance abuse treatment services. In B. S. Brown (Ed.), Substance abuse treatment in the era of AIDS. Rockville, MD: Center for Substance Abuse Treatment.
Piette, J. D., Fleishman, J. A., Stein, M. D., Mor, V., & Mayer, K. (1993). Perceived needs and unmet needs for formal services among people with HIV disease. Journal of Community Health, 18, 11-23.
Piette, J. D., Mor, V., Mayer, K., Zierler, S., & Wachtel, T. (1993). The effects of immune status and race on health service use among people with HIV disease. American Journal of Public Health, 83, 510-514.
Price, R. H., & D'Aunno, T. (1992a). Drug abuse treatment system survey—A national study of the outpatient drug-free and methadone treatment system, 1988-1990. In R. H. Price & T. D'Aunno (Eds.), Drug Abuse Treatment System Survey: A national survey of outpatient drug abuse treatment services, 1988-1990. Final report (pp. 27-34). Ann Arbor, MI: Institute for Social Research, University of Michigan.
Price, R. H., & D'Aunno, T. A. (1992b). The organization and impact of outpatient drug abuse treatment services. In R. R. Watson (Ed.), Drug and alcohol abuse reviews. Volume 3. Treatment of drug and alcohol abuse. Totowa, NJ: Humana Press.
Primm, B. (1989, March 17). This fix is too quick. Newsday.
Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change: Applications to addictive behaviors. American Psychologist, 47, 1102-1114.
Rangel, C. B. (1989, March 23). Comments to FDA.
Ravndal, E., & Vaglum, P. (1992). The influence of different intake procedures on treatment start and treatment response—A quasi-experimental study. Journal of Substance Abuse Treatment, 9, 53-58.
Reilly, P. M., Banys, P., Tusel, D. J., & Sees, K. L. (1993). Methadone transition treatment: A treatment model for 180-day methadone detoxification. In L. Harris (Ed.), Problems of drug dependence, 1992: Proceedings of the 54th Annual Scientific Meeting [NIDA Monograph 132] (p. 216). Washington, DC: U.S. Government Printing Office.
Rhodes, F. (1993). The behavioral counseling model for injection drug users: Intervention manual. Rockville, MD: National Institute on Drug Abuse.
Richman, B. (1995). Personal Communication.
Rolfs, R. T., Goldberg, M., & Sharrar, R. G. (1990). Risk factors for syphilis: Cocaine use and prostitution. American Journal of Public Health, 80, 853-857.
Rosenberg, C. M., McKain, N., & Patch, V. (1972). Engaging the narcotic addict in treatment. Drug Forum, 1, 145-152.
Rounsaville, B. J., Tierney, T., Crits-Cristoph, K., Weissman, M. M., & Kleber, H. D. (1982). Predictors of outcome in treatment of opiate addicts: Evidence for the multidimensional nature of addicts' problems. Comprehensive Psychiatry, 23, 462-478.
Rowan-Szal, G., Joe, G. W., Chatham, L. R., & Simpson, D. D. (1994). A simple reinforcement system for methadone clients in a community-based treatment program. Journal of Substance Abuse Treatment, 11, 217-223.
Schilling, R. F., El-Bassel, N., & Gilbert, L. (1993). Predictors of change in sexual behavior among women on methadone. American Journal of Drug and Alcohol Abuse, 19, 409-422.
Schilling, R. F., El-Bassel, N., Schinke, S. P., Gordon, K., & Nichols, S. (1991). Reducing sexual transmission of AIDS: Skills-building with recovering female drug users. Public Health Reports, 106, 297-304.
Schmidt, A. K. (1989). Electronic monitoring of offenders increases. NIJ reports (pp. 2-5). Washington, DC: National Institute of Justice.
Schoenbaum, E. E., Hartel, D., & Friedland, G. G. (1990). Crack use predicts HIV seroconversion. Paper presented at Sixth International Conference on AIDS, San Francisco, California.
Selwyn, P. A. (1996). The impact of HIV infection on medical services in drug abuse treatment programs. Journal of Substance Abuse Treatment,13, 397-410.
Selwyn, P. A., & Batki, S. L. (1995). Treatment for HIV-infected alcohol and other drug abusers. Rockville, MD: Center for Substance Abuse Treatment.
Selwyn, P. A., Hartel, D., Lewis, V. A., Schoenbaum, E. E., Vermund, S. H., Klien, R. S., Walker, A. T., & Friedland, G. H. (1989). A prospective study of the risk of tuberculosis among intravenous drug users with HIV infection. New England Journal of Medicine, 320, 545-550.
Simpson, D. D. (1981). Treatment for drug abuse. Follow-up outcomes and length of time spent. Archives of General Psychiatry, 38, 875-880.
Simpson, D. D., Knight, K., & Ray, S. (1993). Psychological and cognitive correlates of AIDS-risky behaviors. AIDS Education and Prevention, 5, 121-130.
Smith, P. F., Mild, J., Truman, B. I., Lessner, L., Lehman, J. S., Stevens, R. W., Lord, E. A., Broaddus, R. K., & Morse, D. L. (1990). HIV infection among women entering the New York state correctional system. American Journal of Public Health, 81 (Suppl.), 35-40.
Solomon, L., Frank, R., Vlahov, D., & Astemborski, J. (1991). Utilization of health services in a cohort of intravenous drug users with known HIV-1 serostatus. American Journal of Public Health, 81, 1285-1290.
Sorensen, J., & Lurie, P. (1993). Do NEPs act as bridges to public health services? In P. Lurie & A. Reingold (Eds.), The public health impact of needle exchange programs in the United States and abroad, Vol. I. School of Public Health, University of California, Berkeley, and Institute for Health Policy Studies, University of California, San Francisco. Final report prepared for the Centers for Disease Control and Prevention.
Sorensen, J. L., Batki, S. L., Good, P., & Williamson, K. (1989). Methadone maintenance program for AIDS-affected addicts. Journal of Substance Abuse Treatment, 6, 87-94.
Sorensen, J. L., Constantini, M. F., Gibson, D. R., & Wall, T. L. (1993). Coupons attract high-risk untreated heroin users into detoxification. Drug and Alcohol Dependence, 31, 247-252.
Sorensen, J. L., Constantini, M. F., & London, J. A. (1989). Coping with AIDS: Strategies for patients and staff in drug treatment programs. Journal of Psychoactive Drugs, 31, 435-440.
Sorensen, J. L., DePhilippis, D., & Batki, S. L. (in press). Service delivery for substance abuse patients with AIDS. In B. S. Brown (Ed.), Substance abuse treatment in the era of AIDS. Rockville, MD: Center for Substance Abuse Treatment.
Sorensen, J. L., & Miller, M. S. (1996). Impact of HIV risk and infection on delivery of psychosocial treatment services in outpatient programs. Journal of Substance Abuse Treatment, 13, 387-395.
Stephens, R. C., Simpson, D. D., Coyle, S. L., McCoy, C. B., & The National AIDS Consortium. (1993). Comparative effectivenesss of NADR interventions. In B. S. Brown, G. M. Beschner, & The National AIDS Research Consortium (Eds.), Handbook on risk of AIDS–Injection drug users and sexual partners. Westport, CT: Greenwood Press.
Sterk, C. (1988). Cocaine and HIV seropositivity. Lancet, 1, 1052-1053.
Trapido, E. J., Lewis, N., & Comerford, M. (1990). HIV-1 and AIDS in Belle Glade, Florida: A reexamination of the issues. American Behavioral Scientist, 33, 451-454.
Tusel, D., Reilly, P., Banys, P., Sees, K., & DeLucchi, K. (1993). 180 day methadone detoxification treatment: A six-month follow-up. In L. Harris (Ed.), Problems of drug dependence, 1992: Proceedings of the 54th Annual Scientific Meeting [NIDA Monograph 132] (p. 215). Washington, DC: U.S. Government Printing Office.
Tyon, L. (1988). Baseline management and assessment data project: Final report. Portland, OR: Bureau of Justice Assistance.
Valleroy, L. A., Weinstein, B., Jones, T. S., Groseclose, S. L., Rolfs, R. T., & Kassler, W. J. (1995). Impact of increased legal access to needles and syringes on community pharmacies’ needle and syringe sales—Connecticut, 1992-1993. Journal of Acquired Immune Deficiency Syndromes, 10 (1), 73-81.
Vlahov, D., Brewer, T. F., Castro, K. G., Narkunas, J. P., Salive, M. E., Ulrich, J., & Munoz, A. (1991). Prevalence of antibody to HIV-1 among entrants to U.S. correctional facilities. Journal of the American Medical Association, 265, 1129-1132.
Watkins, K. E., Metzger, D., Woody, G., & McLellan, A. T. (1994). High-risk sexual behaviors of intravenous drug users in- and out-of-treatment: Implications for the spread of HIV infection. American Journal of Drug and Alcohol Abuse, 18, 389-399.
Watters, J. (1994). Historical perspective on the use of bleach in HIV/AIDS prevention. Journal of Acquired Immune Deficiency Syndromes, 7, 743-746.
Watters, J. K. (1996). Impact of HIV risk and infection and the role of prevention services. Journal of Substance Abuse Treatment, 13, 375-385.
Watters, J. K., Estilo, M. J., Clark, G. L., & Lorvick, J. (1994). Syringe and needle exchange as HIV/AIDS prevention for injection drug users. Journal of the American Medical Association, 271, 115-120.
Webb, A. Y. (1990, February 26). Letter to FDA from Director, New York State Division of Substance Abuse Services.
Weddington, W. W., & Brown, B. S. (1988). Acceptance of HIV-antibody testing by persons seeking outpatient treatment for cocaine abuse. Journal of Substance Abuse Treatment, 5, 145-149.
Weinman, B. (1992). A coordinated approach for drug-abusing offenders: TASC and parole. In C. G. Leukefeld & F. M. Tims (Eds.), Drug abuse treatment in prisons and jails [NIDA Monograph 118] (pp. 232-245). Washington, DC: U.S. Government Printing Office.
Weisner, C., & Schmidt, L. A. (1995). Expanding the frame of health services research in the drug abuse field. Health Services Research, 30, 707-726.
Wenger, L. D., & Rosenbaum, M. (1994). Drug treatment on demand—Not. Journal of Psychoactive Drugs, 26, 1-11.
Wermuth, L. (1995). Strategies for working with sexual partners of substance abuse clients. In B. S. Brown (Ed.), Substance abuse treatment in the era of AIDS (pp. 177-225). Rockville, MD: Center for Substance Abuse Treatment.
Wexler, H. K., Falkin, G. P., Lipton, D. S., & Rosenblum, A. B. (1992). In C. G. Leukefeld & F. M. Tims (Eds.), Drug abuse treatment in prisons and jails [NIDA Monograph 118] (pp. 156-175). Washington, DC: U.S. Government Printing Office.
Wexler, H. K., Magura, S., Beardsley, M. M., & Josepher, H. (1994). ARRIVE: An AIDS education/relapse prevention model for high-risk parolees. International Journal of the Addictions, 29, 361-386.
Wexler, H. K., & Williams, R. (1986). The "Stay'n Out" therapeutic community: Prison treatment for substance abusers. Journal of Psychoactive Drugs, 18, 221-230.
Wiebel, W. W. (1993). The indigenous leader outreach model: Intervention manual. Rockville, MD: National Institute on Drug Abuse.
Wolfe, H., Vranzian, K. M., Gorter, R. G., Cohen, J. B., & Moss, A. R. (1990). Crack use and related risk factors in IVDUs in San Francisco. Poster presented at the Sixth International Conference on AIDS, San Francisco, California.
Woody, G. E., McLellan, A. T., O'Brien, C. P., & Luborsky, L. (1991). Addressing psychiatric comorbidity. In R. W. Pickens, C. G. Leukefeld, & C. R. Schuster (Eds.), Improving drug abuse treatment [NIDA Monograph 106] (pp. 152-166). Washington, DC: U.S. Government Printing Office.
Yancovitz, S. R., Des Jarlais, D. C., Peyser, N. P., Drew, E., Friedmann, P., Trigg, H. L., & Robinson, J. W. (1991). A randomized trial of an interim methadone maintenance clinic. American Journal of Public Health, 81, 1185-1191.
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