A Post-Hurricane Katrina Examination of Substance Abuse Treatment Discharges With Co-Occurring Psychiatric and Substance Use Disorders

Monique Shuler, Sumihiro Suzuki, Arwen Podesta, Raquel Qualls-Hampton, Sherrie Flynt Wallington

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

Objectives: There is increasing literature supporting the adverse effects of disasters on substance use and psychiatric disorders. The co-occurrence of psychiatric disorders with substance use intensifies the challenge of treatment delivery. Thus the aim of this study was to examine the prevalence of substance use, treatment characteristics, and demographics of discharges from substance abuse treatment in New Orleans, post–Hurricane Katrina. Trends associated with discharges that have a co-occurring psychiatric and substance use disorder (COD) were also assessed. The secondary aim of this study was to examine the association of successful substance abuse treatment completion among those with a COD post–Hurricane Katrina. Methods: Substance abuse treatment discharge data (N = 16,507) from New Orleans, Louisiana, for years 2006 through 2011 were obtained from the Treatment Episode Data Set–Discharge. Multiple logistic regression analysis was employed to examine the association of discharges with a COD and completion of substance abuse treatment. Demographic, psychiatric, and treatment characteristics of discharges in 2006 were compared to characteristics in 2011. Trends of characteristics were also assessed through the study period. Results: Roughly a third (35.2%) of all discharges in New Orleans from 2006 to 2011 had a COD. After controlling for race, employment, treatment service setting at discharge, primary substance problem, and the discharge's principal source of referral, discharges with a COD were 29% less likely to complete treatment as compared to those with no COD (AOR = 0.71, 95% CI [0.56, 0.90], p =.004). Treatment completion among discharges with a COD has significantly declined from 36.8% in 2006 to 18.7% in 2011 (p <.0001). Notable significant trends in homelessness, criminality, and heroin use were identified among discharges with a COD. Conclusions: Substance abuse treatment undergoes various changes in the event of a natural disaster. These changes may increase challenges for successful treatment completion for vulnerable populations such as those with a COD. Results of this study demonstrate that discharges with a COD are less likely to complete treatment as compared to those with no COD disorder. Unmet treatment needs may also increase odds of criminalization and homelessness.

Original languageEnglish
Pages (from-to)144-156
Number of pages13
JournalJournal of Dual Diagnosis
Volume13
Issue number2
DOIs
StatePublished - 3 Apr 2017

Fingerprint

Cyclonic Storms
Substance-Related Disorders
Psychiatry
Therapeutics
Homeless Persons
Disasters
Demography
Heroin
Vulnerable Populations

Keywords

  • Hurricane Katrina
  • New Orleans
  • Substance use
  • co-occurring
  • disaster
  • psychiatric
  • treatment

Cite this

Shuler, Monique ; Suzuki, Sumihiro ; Podesta, Arwen ; Qualls-Hampton, Raquel ; Wallington, Sherrie Flynt. / A Post-Hurricane Katrina Examination of Substance Abuse Treatment Discharges With Co-Occurring Psychiatric and Substance Use Disorders. In: Journal of Dual Diagnosis. 2017 ; Vol. 13, No. 2. pp. 144-156.
@article{1ee08b59d8354ad893eff8a1571fd930,
title = "A Post-Hurricane Katrina Examination of Substance Abuse Treatment Discharges With Co-Occurring Psychiatric and Substance Use Disorders",
abstract = "Objectives: There is increasing literature supporting the adverse effects of disasters on substance use and psychiatric disorders. The co-occurrence of psychiatric disorders with substance use intensifies the challenge of treatment delivery. Thus the aim of this study was to examine the prevalence of substance use, treatment characteristics, and demographics of discharges from substance abuse treatment in New Orleans, post–Hurricane Katrina. Trends associated with discharges that have a co-occurring psychiatric and substance use disorder (COD) were also assessed. The secondary aim of this study was to examine the association of successful substance abuse treatment completion among those with a COD post–Hurricane Katrina. Methods: Substance abuse treatment discharge data (N = 16,507) from New Orleans, Louisiana, for years 2006 through 2011 were obtained from the Treatment Episode Data Set–Discharge. Multiple logistic regression analysis was employed to examine the association of discharges with a COD and completion of substance abuse treatment. Demographic, psychiatric, and treatment characteristics of discharges in 2006 were compared to characteristics in 2011. Trends of characteristics were also assessed through the study period. Results: Roughly a third (35.2{\%}) of all discharges in New Orleans from 2006 to 2011 had a COD. After controlling for race, employment, treatment service setting at discharge, primary substance problem, and the discharge's principal source of referral, discharges with a COD were 29{\%} less likely to complete treatment as compared to those with no COD (AOR = 0.71, 95{\%} CI [0.56, 0.90], p =.004). Treatment completion among discharges with a COD has significantly declined from 36.8{\%} in 2006 to 18.7{\%} in 2011 (p <.0001). Notable significant trends in homelessness, criminality, and heroin use were identified among discharges with a COD. Conclusions: Substance abuse treatment undergoes various changes in the event of a natural disaster. These changes may increase challenges for successful treatment completion for vulnerable populations such as those with a COD. Results of this study demonstrate that discharges with a COD are less likely to complete treatment as compared to those with no COD disorder. Unmet treatment needs may also increase odds of criminalization and homelessness.",
keywords = "Hurricane Katrina, New Orleans, Substance use, co-occurring, disaster, psychiatric, treatment",
author = "Monique Shuler and Sumihiro Suzuki and Arwen Podesta and Raquel Qualls-Hampton and Wallington, {Sherrie Flynt}",
year = "2017",
month = "4",
day = "3",
doi = "10.1080/15504263.2016.1277816",
language = "English",
volume = "13",
pages = "144--156",
journal = "Journal of Dual Diagnosis",
issn = "1550-4263",
publisher = "Routledge",
number = "2",

}

A Post-Hurricane Katrina Examination of Substance Abuse Treatment Discharges With Co-Occurring Psychiatric and Substance Use Disorders. / Shuler, Monique; Suzuki, Sumihiro; Podesta, Arwen; Qualls-Hampton, Raquel; Wallington, Sherrie Flynt.

In: Journal of Dual Diagnosis, Vol. 13, No. 2, 03.04.2017, p. 144-156.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - A Post-Hurricane Katrina Examination of Substance Abuse Treatment Discharges With Co-Occurring Psychiatric and Substance Use Disorders

AU - Shuler, Monique

AU - Suzuki, Sumihiro

AU - Podesta, Arwen

AU - Qualls-Hampton, Raquel

AU - Wallington, Sherrie Flynt

PY - 2017/4/3

Y1 - 2017/4/3

N2 - Objectives: There is increasing literature supporting the adverse effects of disasters on substance use and psychiatric disorders. The co-occurrence of psychiatric disorders with substance use intensifies the challenge of treatment delivery. Thus the aim of this study was to examine the prevalence of substance use, treatment characteristics, and demographics of discharges from substance abuse treatment in New Orleans, post–Hurricane Katrina. Trends associated with discharges that have a co-occurring psychiatric and substance use disorder (COD) were also assessed. The secondary aim of this study was to examine the association of successful substance abuse treatment completion among those with a COD post–Hurricane Katrina. Methods: Substance abuse treatment discharge data (N = 16,507) from New Orleans, Louisiana, for years 2006 through 2011 were obtained from the Treatment Episode Data Set–Discharge. Multiple logistic regression analysis was employed to examine the association of discharges with a COD and completion of substance abuse treatment. Demographic, psychiatric, and treatment characteristics of discharges in 2006 were compared to characteristics in 2011. Trends of characteristics were also assessed through the study period. Results: Roughly a third (35.2%) of all discharges in New Orleans from 2006 to 2011 had a COD. After controlling for race, employment, treatment service setting at discharge, primary substance problem, and the discharge's principal source of referral, discharges with a COD were 29% less likely to complete treatment as compared to those with no COD (AOR = 0.71, 95% CI [0.56, 0.90], p =.004). Treatment completion among discharges with a COD has significantly declined from 36.8% in 2006 to 18.7% in 2011 (p <.0001). Notable significant trends in homelessness, criminality, and heroin use were identified among discharges with a COD. Conclusions: Substance abuse treatment undergoes various changes in the event of a natural disaster. These changes may increase challenges for successful treatment completion for vulnerable populations such as those with a COD. Results of this study demonstrate that discharges with a COD are less likely to complete treatment as compared to those with no COD disorder. Unmet treatment needs may also increase odds of criminalization and homelessness.

AB - Objectives: There is increasing literature supporting the adverse effects of disasters on substance use and psychiatric disorders. The co-occurrence of psychiatric disorders with substance use intensifies the challenge of treatment delivery. Thus the aim of this study was to examine the prevalence of substance use, treatment characteristics, and demographics of discharges from substance abuse treatment in New Orleans, post–Hurricane Katrina. Trends associated with discharges that have a co-occurring psychiatric and substance use disorder (COD) were also assessed. The secondary aim of this study was to examine the association of successful substance abuse treatment completion among those with a COD post–Hurricane Katrina. Methods: Substance abuse treatment discharge data (N = 16,507) from New Orleans, Louisiana, for years 2006 through 2011 were obtained from the Treatment Episode Data Set–Discharge. Multiple logistic regression analysis was employed to examine the association of discharges with a COD and completion of substance abuse treatment. Demographic, psychiatric, and treatment characteristics of discharges in 2006 were compared to characteristics in 2011. Trends of characteristics were also assessed through the study period. Results: Roughly a third (35.2%) of all discharges in New Orleans from 2006 to 2011 had a COD. After controlling for race, employment, treatment service setting at discharge, primary substance problem, and the discharge's principal source of referral, discharges with a COD were 29% less likely to complete treatment as compared to those with no COD (AOR = 0.71, 95% CI [0.56, 0.90], p =.004). Treatment completion among discharges with a COD has significantly declined from 36.8% in 2006 to 18.7% in 2011 (p <.0001). Notable significant trends in homelessness, criminality, and heroin use were identified among discharges with a COD. Conclusions: Substance abuse treatment undergoes various changes in the event of a natural disaster. These changes may increase challenges for successful treatment completion for vulnerable populations such as those with a COD. Results of this study demonstrate that discharges with a COD are less likely to complete treatment as compared to those with no COD disorder. Unmet treatment needs may also increase odds of criminalization and homelessness.

KW - Hurricane Katrina

KW - New Orleans

KW - Substance use

KW - co-occurring

KW - disaster

KW - psychiatric

KW - treatment

UR - http://www.scopus.com/inward/record.url?scp=85012245168&partnerID=8YFLogxK

U2 - 10.1080/15504263.2016.1277816

DO - 10.1080/15504263.2016.1277816

M3 - Article

VL - 13

SP - 144

EP - 156

JO - Journal of Dual Diagnosis

JF - Journal of Dual Diagnosis

SN - 1550-4263

IS - 2

ER -