Further Reading

Where can I get data on treatment?

Hi Stanton,

I'm currently wading through a miasma of material in preparation for writing the new edition of A: Cult or Cure? In it, I intend to include a chapter on the treatment industry, and thus far I haven't found answers to a number of questions. If I dig long enough, I'll probably find all of this info, but I'm hoping that you'll be good enough to save me some time by pointing me toward sources. If you could give me any help with sources for info on any of the following, I'd greatly appreciate it. (You address some of these things in Diseasing of America but I'm wondering if you can tell me where I can find more up-do-date info.)

Here's what I'm looking for:

1. # of treatment centers (I've found the 1987 figures, but nothing later)
2. % that use AA (I've found unsubstantiated estimates, and nothing else)
3. % that use anything else
4. Personnel--qualifications or lack thereof, and % who belong to AA
5. Finances--costs to patients, insurers, compensation to staff, profitability, gross dollar volume
6. Effectiveness--I'm specifically looking for controlled studies of inpatient treatment
7. History of for-profit treatment (where it came from, how it developed, etc.)
8. Average number of days in treatment now vs. 5 & 10 years ago
9. Number of patients per year (inpatient & outpatient total for USA)
10. Diagnoses--how many are diagnosed for "alcoholism" and how many for other things? And how do these figures differ from diagnoses five and ten years ago?

Finally, thanks for setting up this online library, it's a real public service.

Best regards,
Chaz Bufe

Charles:

Here are major sources to give you a lot of this information:

For 2,3,5 National Treatment Center Study, January 1997, by Paul Roman and Terry Blum, Institute of Behavioral Research, University of Georgia, phone (706) 542-6090;
FAX (706) 542-6436, E-mail; ajohns@uga.cc.uga.edu.
(Incidentally, the figure is 93% are 12-step programs while 99% are abstinence-oriented.)

For 4: Contact Jeff Schaler, (jschaler@umd5.umd.edu), who has studied the characteristics and belief systems of treatment providers.

For 6: Miller & Hester, "Inpatient alcoholism treatment: Who benefits?" American Psychologist, 41, 794-805, 1986; Miller et al., "What works?: A methodological analysis," in Hester & Miller (Eds.), Handbook of Alcoholism Treatment Approaches, Boston: Allyn and Bacon, 1995; Dawson, "Correlates of past-year status among treated and untreated persons with former alcohol dependence: United States, 1992," Alcoholism: Clinical and Experimental Research, 20, 771-779, 1996.

For 7: Peele, "What we now know about treating alcoholism and other addictions," The Harvard Mental Health Letter, December 1991, pp. 5-7.

For 1,9: Treatment Episode Data Set Advance Report; including "CODAP (1979-1981) to TEDS (1992-1995)," Advance Report # 12; National Drug and Alcoholism Treatment Unit Survey (NDATUS): Data from 1993 and 1980-1993, SAMHSA/OAS, Advance Report Number 9A, August 1995.

For 10: I don't know about those diagnosed in treatment, but in general, alcohol dependence diagnoses are increasing: Helzer, Brunham, & McEvoy, "Alcohol abuse and dependence," in Robins & Regier, Psychiatric Disorders in America, New York: Free Press, 1991; Hilton and Clark, "Changes in American drinking patterns and problems, 1967-1984," in Pittman & White (Eds.), Society, culture, and drinking patterns reexamined, New Brunswick, NJ: Center of Alcohol Studies, 1991.

Best, Stanton