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Motivationally-enhanced group counseling for substance users in a soup kitchen: A randomized clinical trial

Andrew Rosenblum, PhD, Stephen Magura, CSW, PhD, Deborah J. Kayman, CSW, PhD, Cherry B. Gordon, MA, CASAC, Chunki Fong, MS, and Rita Morales. Institute for Treatment and Services Research, National Development and Research Institutes, Inc., 71 West 23rd Street, 8th floor, New York, NY 10010, 212-845-4528, rosenblum@ndri.org

Soup kitchen guests who reported using cocaine, heroin or drinking heavily (4 or more drinks a day) in the past 30 days were voluntarily randomly assigned to either (a) control - information and referral only (n=54) or (b) experimental - a 12-session motivational group followed by a 36-session cognitive-behavioral group (n=55). Outcome measures (5 months after intake) were days heavy drinking, days cocaine use and days heroin use in the past 30 days. Statistical Analysis: Analysis of Covariance. Results: Mean age is 42; 83% male; 71% African American; 73% unstable residence; 15% HIV+. Mean days of drug use in 30 days preceding intake were: cocaine/crack 6.9; heroin 1.6; and alcohol 6.45. Adjusting for the baseline value of the outcome variable, experimentals were significantly more likely than controls to report fewer heavy drinking days (1.9 vs. 5.1, p<.05) at follow-up. A composite standardized (z-score) measure of the 3 drugs was also constructed. Using a median split, subjects were coded as low or high on drug use at baseline: experimentals compared with controls reported significantly less drug use at follow-up (-.04 vs. .27, p<.05). There was also an interaction effect: experimental subjects high in drug or alcohol use at baseline were significantly more likely to show decline in substance use compared with other subjects. These results support the hypothesis that intensive group counseling, provided as a low-threshold outreach intervention at a soup kitchen, can help to reduce drug use. Supported by NIDA R01 DA10188.

Learning Objectives:

Keywords: Special Populations, Out-of-Treatment Drug Users

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Approaches to Substance Abuse Treatment Poster Session

The 132nd Annual Meeting (November 6-10, 2004) of APHA