UCSF Psychiatry Department receives grant to study innovative drug and substance abuse treatments

December 16, 1999

The UCSF Department of Psychiatry will use a $7.9 million grant to study creative ways to treat complex, substance abusing patients in community settings, such as hospital emergency rooms and mental health programs.

The grant, awarded by the National Institutes of Health, spans over five years and will focus on four areas. The study is unique in that it deals with patients who are doubly diagnosed, such as someone who is mentally ill and also smokes or a person who is HIV positive and addicted to heroin, said principal investigator Sharon Hall, PhD, professor of psychiatry and vice-chair of the UCSF Department of Psychiatry.

"Not a lot of research is done with this complicated population, " she said. "And when it is done, it's not in community settings."

Hall's research involves working on a computer-based intervention program for smokers who are also depressed and seeking treatment for that disorder. The computer program is built around the "stages of change" theory: pre-contemplation, contemplation, preparation, action and maintenance. The program is designed to encourage people to think about what stage they're in and gives them indications of what things to think about in order to move onto the next stage until they reach the action stage, when they do something concrete to quit smoking such as buy a nicotine patch.

Hall is recruiting 400 people who come to UCSF's Langley Porter Psychiatric Institute for treatment of depression. They will be tracked for 18 months. Many people who are at risk for depression are also nicotine addicted, she said, and people who have come in for counseling might be an ideal population to work with to quit smoking.

"These are people who have started to make a major change in their life, so perhaps this is a good time to help change their behaviors," she said. "What we want to see is a decrease in smoking rates."

Another area of study will look at the effectiveness of linking heroin addicts who come into San Francisco General Hospital Medical Center's emergency room to methadone maintenance treatments by either assigning them to a case manager who will move them into treatment or by giving them a voucher good for six months at an area methadone clinic. This isn't treatment as usual: doctors or nurses noticing needle marks on a patient's arms, treating them and giving them a referral to a treatment program, said James Sorensen, PhD, adjunct professor of psychiatry and co- principal investigator who is based at the UCSF-affiliated San Francisco General Hospital Medical Center.

"This kind of outreach isn't usually done," he said. "Usually, treatment programs wait for the patients to come to them."

The goal is to get addicts into treatment right away, he said. "The emergency room is a great place to catch them," Sorensen said. "Otherwise, they are out there living on the streets and in parks and we never see them. It's a way we can have access to this group of people who would be better off if we got them into treatment."

The study will enroll 120 participants who will be followed for a year and a half to see if they go into methadone treatment, what other kinds of services they use and what kinds of problems were they having with their addiction.

Sorenson also is overseeing another study that will test voucher based incentives to encourage HIV/AIDS positive patients enrolled in San Francisco General's methadone program to take their medicine on schedule and stay drug free. Patients can receive vouchers redeemable for goods and services, such as groceries, if their urine samples turn out drug free or if they take their medicine. Doctors can tell if patients have been taking their medication by having information downloaded off a computer chip placed on the cap of the medicine bottle that indicates when and how often the bottle has been opened.

The grant will also be used to train case managers on how to treat their client's drug abuse-while meeting all of their basic needs such as finding them shelter, food and making sure they are safe. The case managers work in mental health programs run by the City and County of San Francisco. After receiving the training, the case managers will teach their clients (people suffering from serious mental illnesses such as schizophrenia) how to cope with stress and other social skills in an effort to get them off drugs. Increasingly, more mentally ill people are also drug addicted and this can exacerbate their condition, said co-principal investigator Barbara Havassy, PhD, adjunct professor of psychiatry based at San Francisco General Hospital Medical Center. For example, drugs can cause patients to forget to take their medicine.

"Missing a dose or two means you are in a lot of trouble," Havassy said. "Whatever stability you have has been destroyed."

Havassy is recruiting 300 patients for treatment for six months and will follow them for a year after that. "This study not only meets scientific criteria in that it is a well designed trial. It will also yield a lot of information that could influence how services are being organized and lead to policy decisions," she said. "It's part of the larger issue of we have people who are mentally ill and drug addicted. Where and how is the best way to take care of them."

University of California - San Francisco

Related Health Articles from Brightsurf:

The mental health impact of pandemics for front line health care staff
New research shows the impact that pandemics have on the mental health of front-line health care staff.

Modifiable health risks linked to more than $730 billion in US health care costs
Modifiable health risks, such as obesity, high blood pressure, and smoking, were linked to over $730 billion in health care spending in the US in 2016, according to a study published in The Lancet Public Health.

New measure of social determinants of health may improve cardiovascular health assessment
The authors of this study developed a single risk score derived from multiple social determinants of health that predicts county-level cardiovascular disease mortality.

BU study: High deductible health plans are widening racial health gaps
The growing Black Lives Matter movement has brought more attention to the myriad structures that reinforce racial inequities, in everything from policing to hiring to maternal mortality.

Electronic health information exchange improves public health disease reporting
Disease tracking is an important area of focus for health departments in the midst of the COVID-19 pandemic.

E-health resource improves men's health behaviours with or without fitness facilities
Men who regularly used a free web resource made significantly more health changes than men who did not, finds a new study from the University of British Columbia and Intensions Consulting.

Mental health outcomes among health care workers during COVID-19 pandemic in Italy
Symptoms of posttraumatic stress disorder, depression, anxiety and insomnia among health care workers in Italy during the COVID-19 pandemic are reported in this observational study.

Mental health of health care workers in china in hospitals with patients with COVID-19
This survey study of almost 1,300 health care workers in China at 34 hospitals equipped with fever clinics or wards for patients with COVID-19 reports on their mental health outcomes, including symptoms of depression, anxiety, insomnia and distress.

Health records pin broad set of health risks on genetic premutation
Researchers from the University of Wisconsin-Madison and Marshfield Clinic have found that there may be a much broader health risk to carriers of the FMR1 premutation, with potentially dozens of clinical conditions that can be ascribed directly to carrying it.

Attitudes about health affect how older adults engage with negative health news
To get older adults to pay attention to important health information, preface it with the good news about their health.

Read More: Health News and Health Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.