Mary Ellen Marsden

Effectiveness Of Substance Abuse Treatment Programming For Women: A Review

Recent research has shown that women and men differ in substance abuse etiology, disease progression, and access to treatment for substance abuse. Substance abuse treatment specifically designed for women has been proposed as one way to meet womens distinctive needs and reduce barriers to their receiving and remaining in treatment. However, relatively few substance abuse treatment programs offer specialized services for women, and effectiveness has not been fully evaluated. This article reviews the literature on the extent and effectiveness of substance abuse treatment programming for women and provides an overview of what is known about the components of successful treatment programs for women. Thirty-eight studies of the effect on treatment outcomes of substance abuse treatment programming for women were reviewed. Seven were randomized, controlled trials, and 31 were nonrandomized studies. In our review, six components of substance abuse treatment programming for women were examined: child care, prenatal care, women-only programs, supplemental services and workshops that address women-focused topics, mental health programming, and comprehensive programming. The studies found positive associations between these six components and treatment completion, length of stay, decreased use of substances, reduced mental health symptoms, improved birth outcomes, employment, self-reported health status, and HIV risk reduction. These findings suggest that to improve the future health and well-being of women and their children, there is a continued need for well-designed studies of substance abuse treatment programming for women.

Stress and Substance Use Among Military Women and Men

This paper examines the relationship between perceived stress (at work, in family or personal life, and from being a woman in the military) and substance use (heavy drinking, illicit drug use, cigarette smoking) among active-duty military women and men. Data were drawn from over 16,000 respondents to the 1995 Department of Defense Survey of Health Related Behaviors Among Military Personnel. Findings indicated substantial substance use and perceived high stress in the armed forces. Further, the relation between substance use and stress varied by gender. Military women reported substantially lower rates of heavy drinking than men, but had similar rates of illicit drug use and cigarette smoking. Both military women and men were more likely to describe their military duties as more stressful than their family or personal lives; for women, the stress associated with being a woman in the military was second to stress at work. Stress at work or in the family was an important predictor of substance use among military men, but not among military women. For military women, stress associated with being a woman in the military was predictive of illicit drug use and cigarette use. These findings suggest that more effective stress management strategies may need to be implemented for military men to reduce the link between stress and heavy alcohol use, illicit drug use, and smoking.

Progress toward eliminating drug and alcohol abuse among U.S. military personnel

Since 1970, the Department of Defense has set forth a series of policies and programs to combat drug and alcohol abuse among military personnel. The goal of the current policy is one of zero tolerance toward drug and alcohol abuse. Programmatic areas to help attain this goal are assessment, deterrence and detection, treatment and rehabilitation, and education and training. Progress toward eliminating drug and alcohol abuse among military personnel is traced by examining efforts in each of these programmatic areas. The authors conclude that the dramatic decreases in drug use and more stable patterns of alcohol use since 1980 indicate that military policy and programs to eliminate drug abuse have been highly successful, but that military efforts to eliminate alcohol abuse should be intensified.

Trends in alcohol, illicit drug, and cigarette use among U.S. Military personnel: 1980-1992

This paper examines trends in alcohol use, illicit drug use, and cigarette use in the U.S. military. Data are drawn from five worldwide surveys (conducted in 1980, 1982, 1985, 1988, and 1992) of active-duty personnel. All surveys used similar methods and common measures of alcohol, illicit drug, and cigarette use. Findings indicate steady and notable reductions in overall alcohol consumption, illicit drug use, and cigarette use. They show less decrease in heavy alcohol use, however, and the apparent decline from 1980 to 1992 is largely a function of demographic changes in the military. In 1992, during the 30 days before the survey, about 1 in 3 personnel smoked, about 1 in 7 were heavy drinkers, and about 3 in 100 used illicit drugs; rates were higher among certain demographic subgroups. Further reductions in smoking and heavy drinking remain the major substance use challenges for the U.S. military in the 1990s.

Substance use and health among U.S. military personnel: findings from the 1985 Worldwide Survey.

The relationship between substance use (alcohol, drugs, and tobacco) and health (health practices, number of illnesses, number of physician visits, and days hospitalized) was examined using data from the 1985 Worldwide Survey of Alcohol and Nonmedical Drug Use Among Military Personnel. Substance users, particularly heavy users, were less likely than nonusers to engage in health practices and were more likely to experience illness, physician visits, and hospitalizations. Significant effects on the number of illnesses were observed for heavy drinkers compared with abstainers, drug users other than marijuana only users compared with nonusers, and those who smoked one or more packs of cigarettes per day compared with nonsmokers. The potential of substance use programs in improving health status and health promotion programs in reducing substance use among military personnel is discussed.

What works when: Rational-choice theory and offender rehabilitation

Abstract The currently fashionable statement that “nothing works” overstates the case against rehabilitation. Rehabilitation efforts may be effective if addressed to specific offender populations delineated on the basis of causal theory. Causal theory can specify the mechanisms and conditions under which treatment can work. The utility of rational-choice theory in improving the effectiveness of rehabilitation efforts is discussed. Rational-choice theory describes an “economically motivated offender” to whom income-enhancing treatment, such as skills training, can be most effectively applied. The mechanism by which income-enhancing treatment works is through improving the offenders taste for income or his/her taste for work.