FRN Research Report February 2014: Treatment Outcomes for Adults with Substance Use Disorders

Introduction

Adults aged 26 and older enter substance abuse treatment with different characteristics than younger populations. These adults are more likely to have medical issues, greater severity of psychological issues and greater severity of alcohol use than younger patients. Additionally, life circumstances for adults 26 and older are different from younger patients. Their life situations at entry to treatment may include greater daily social demands, higher levels of responsibilities and greater financial burdens than younger cohorts.

Research from residential populations at Foundations Recovery Network (FRN) shows positive outcomes for adults. Patients in this population exhibit a high level of motivation and engagement in the treatment process, and six month outcomes demonstrate significant positive change following residential treatment at FRN.

Foundations Recovery Network’s Research

The FRN research department evaluates patient data, satisfaction surveys and outcome results, actively incorporating this information in the management and decision-making processes.

This paper discusses patient outcomes for adults 26 years of age and older and offers data collected at three of FRN’s residential facilities: The Canyon at Peace Park, Michael’s House and The Oaks at La Paloma. The information in this report summarizes original research conducted by FRN’s research department and independently verified by a third party consultant. The research was conducted with patients who agreed to participate in a year-long research project. Results reported here represent responses from 76% of 1,972 patients enrolled in research over a two and a half year period.

Mental Illness

Around one in five adults aged 26-49 report having a mental illness in the previous year, the highest rate of all adult groups. Of this age group, 21.2% experienced mental illness. And 15.8% of adults aged 50 or older also report having experienced mental illness. Across all adult age groups, adult women are more likely than men to report a mental health disorder (SAMHSA, 2012).

Adults who report mental illness commonly report substance abuse problems. The relationship between addiction and co-occurring mental illness points to a need for standardized approaches to treat both illnesses at the same time, underlining the importance of integrated treatment.

Age plays a role in the way people respond to mental illness as well as in the way they respond to treatment. The ability to meet patients where they are in their lives—developmentally, by age, professionally and in other ways—is key to effectively motivating and engaging individuals in treatment. The ability to individualize treatment by taking these and other factors into account is an important factor in treatment effectiveness.

Adults’ Substance Use

Approximately 7% of adults over 25 years of age reported illicit drug use in 2012 (Substance Abuse and Mental Health Services Administration, 2013). Adults report the highest drug use rates for two drug categories: marijuana (5.3%) and nonmedical use of prescription drugs (2.1%). Although lower than other age groups, these rates are significant because adults aged 25 and older are the cornerstones of workplace productivity, family life and social responsibility.

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FRN Research Model

Patients who enter treatment at FRN’s residential centers are offered the opportunity to participate in an ongoing study. Participants must sign Institutional Review Board approved consent prior to participation, and the follow-up study includes interviews at intake and again at 30 days, six months and one-year post-discharge.

Data is collected using validated instruments, including the Addiction Severity Index, Treatment Service Review and University of Rhode Island Change Assessment (URICA – Readiness for Change Instrument). Responses from the research instruments are designed to assess several aspects of a person’s mental and physical functioning and all other aspects affecting a person’s life, including alcohol use, drug use, psychiatric symptoms, legal issues, family/social relationships, medical issues and employment issues.

FRN is committed to scientifically-sound research. All results reported herein are independently verified by a third party. Both research enrollment and response rates exceed federal minimum standards, further adding to the validity of findings.

Our Findings: Adults Receiving Treatment at FRN

Adults aged 26 and older make up around 76% of the population receiving treatment at FRN residential facilities. The average age for adults in treatment is 42 years old, and nearly 42% are females. Nearly 55% of adults reported employment in the 30 days prior to treatment, while 5% reported earning money from illegal activities in the same time period. Compared to young adults, adults at FRN report higher rates of alcohol use and lower rates of overall drug use. Adults aged 26 and older reported using alcohol an average of 13.4 days and drugs an average of 11.8 days in the 30 days prior to treatment. The average reported amount of money spent on substance use in the 30 days prior to admission was around $900.

Adult patients 26 and older enter treatment at FRN with fewer legal problems but more medical problems. They also spend less on substance use and report lower use of marijuana, heroin and other opiates, hallucinogens and sedatives when compared to young adults. Adults respond well to treatment and show significant improvement in major life areas, including medical issues, family relationships and psychiatric problems. The group also shows significant improvement in alcohol and drug use rates.

Days-of-Use-Table

Adult patients at FRN facilities showed attitudes and characteristics that were similar to adults in other research studies. As a group, adults 26 and older attending FRN facilities appear to be motivated for treatment and to remain engaged in the treatment process during treatment. Their levels of readiness for change as measured by the URICA were higher than for younger populations, and adults 26 and older showed significant improvement in measures of sobriety and abstinence.

With their openness to participation and transformation, adults aged 26 and older achieved many positive life changes during and after treatment. At six months, former FRN adult patients age 26 and older demonstrated significant improvement in the severity of problems in several important life areas as measured by the Addiction Severity Index Composite Scores.

Reduction in Severity of Problems

FRN’s integrated treatment program, which treats a person’s addictions while also treating any emotional or psychiatric illnesses, follows an evidence-based model that produces better outcomes. FRN’s commitment to providing individualized programs is integral to the system of care.

Overall, FRN sees positive outcomes for its patients and is noted for its evidence-based therapeutic practices. The company is committed to scientific research and is an active participant in the mental health and substance use treatment community. The company’s goal is to conduct further research in order to improve addiction and mental health treatment for all adults.

Foundations Recovery Network is committed to research that improves treatment for all addicted individuals. If you would like to speak with an admissions coordinator today or if you would like to learn more about our research methods and programs, please call us at 615-490-9376.

References

Chan, Y.-F., Dennis, M., & Funk, R. (2008). Prevalence and comorbidity of major internalizing and externalizing problems among adolescents and adults presenting to substance abuse treatment. Journal of Substance Abuse Treatment, 34 (1), 14-24.

Gfroerer, J., Penne, M., Pemberton, M., & Folsom, R. (2003). Substance abuse treatment need among adults in 2020: the impact of the aging baby-boom cohort. Drug and Alcohol Dependence, 69 (2), 127-135.

Han, B., Gfroerer, J., Colliver, J., & Penne, M. (2009). Substance use disorder among adults in the United States in 2020. Addiction, 104 (1), 88-96.

Johnson, B., Cloninger, R., Roache, J., Bordnick, P., & Ruiz, P. (2000). Age of onset as a discriminator between alcoholic subtypes in a treatment-seeking outpatient population. The American Journal on Addictions, 9 (1), 17-27.

Morse, S. A., & MacMaster, S. (2014). Characteristics and outcomes of college-age adults enrolled in private, residential treatment: Implications for practice. Journal of Social Work Practice in the Addictions, 14, 1-21.

Morse, S. A., & MacMaster, S. A. (2013). Characteristics and outcomes of young adult opiate users receiving residential substance abuse treatment. Manuscript submitted for publication.

Satre, D., Mertens, J., Arean, P., & Weisner, C. (2004). Five-year alcohol and drug treatment outcomes of adults versus middle-aged and younger adults in a managed care program. Addiction , 99 (10), 1286-1297.

Substance Abuse and Mental Health Services Administration. (2013). NSDUH Series H-46, HHS Publication No. (SMA) 13-4795. Retrieved January 31, 2014, from Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings: http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindings/NSDUHresults2012.htm

Substance Abuse and Mental Health Services Administration. (2012b). NSDUH Series H-44, HHS Publication No. (SMA) 12-4713. Retrieved from http://www.samhsa.gov/data/NSDUH/2k11Results/NSDUHresults2011.pdf

This white paper is based on the findings reported in Morse, S.A. and MacMaster, S. (in press). Characteristics and Outcomes of College-Age Adults Enrolled in Private Residential Treatment: Implications for Practice. Journal of Social Work Practice in the Addictions volume 14, issue 1.