Drug Dependeo,ce

and Alcoholism Volume 2 Social and Behavioral Issues

DRUG DEPENDENCE AND ALCOHOLISM

Volume I Biomedical Issues Volume 2 Social and Behavioral Issues

Drug Dependence and Alcoholism Volume 2 Social and Behavioral Issues

Edited by Arnold J. Schecter Professor, Department of Preventive Medicine Upstate Medical Center, Qinical Campus State University of New York at Binghamton and Director of Health, Broome County Health Department Binghamton, New York

Plenum Press- New York and London

Library of Congress Cataloging in Publication Data

National Drug Abuse Conference, 5th, Seattle, 1978. Drug dependence and alcoholism.

Proceedings of the 1978 NatIOnal Drug Abuse Conference, held in Seattle, Wash., Apr. 3-8, 1978.

Includes index. CONTENTS: v. 1. Biomedical issues.-v. 2. Social and behavioral issues. 1. Drug abuse-Congresses. 2. Alcoholism-Congresses. I. Schecter, Arnold. 11. Tide.

[DNLM: 1. Alcoholism. 2. Drug dependence. WM270.3 D794) RC564.N37 1978 362.2'9 79-24558 ISBN 978-1-4757-0222-4 ISBN 978-1-4757-0220-0 (eBook) DOI 10.1007/978-1-4757-0220-0

These volumes were supported in part by agrant from the Sandoz Foundation designating Dr. Arnold J. Schecter as a Sandoz Fellow. Funds were also received from the National Institute on Drug Abuse to support the National Drug Abuse Conference from which these proceedings were derived.

Second half of the proceedings of the 1978 National Drug Abuse Conference, held in Seatde, Washington, April 3-8, 1978

© 1981 Plenum Press, New York Softcover reprint of the hardcover 1 st edition 1981

A Division of Plenum Publishing Corporation 233 Spring Street, New York, N. Y. 10013

All rights reserved

No part of this book may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the publisher

NATIONAL DRUG ABUSE CONFERENCE

NATIONAL CHAIRPERSON

Arthur Simmons

NATIONAL CO-CHAIRPERSONS

Region 1 Susan Smith Resteghini

Region 2 Ron Gaetano

Region 3 Frank Espada

Region 4 Matt Gissen

Region 5 Rev. Walter Jones

Region 6 Ramon Adame

1978 SPONSORS

National League of Cities

Region 7 Rev. Richard Gilmore

Region 8 George Effman

Region 9 Tommy Chung

Region 10 June Leonard

NASDAPC Co-Chairperson William J. McCord

International Co-Chairperson Ted Schramm

National Federation of Concerned Drug Abuse Workers Joint Commission on Accreditation of Hospitals National Association of State Drug Abuse Program Coordinators National Association of Puerto Rican Drug Abuse Programs National Association on Drug Abuse Problems, Inc. National Institute on Drug Abuse Drug Abuse Council

v

vi NATIONAL DRUG ABUSE CONFERENCE

National Council on Drug Abuse Center for Addiction Services Chicano Alliance of Drug Abuse Programs Washington State Department of Social and Health Services Washington State Council on Crime and Delinquency Therapeutic Communities of America Mental Health Association of San Francisco National Council on Alcoholism National Institute on Alcohol Abuse and Alcoholism Washington State Medical Association Alcohol and Drug Problems Association National Asian-Pacific Substance Abuse Network

SPECIAL ACKNOWLEDGEMENTS

James M. Shulman, program assistance James W. Leigh, program assistance James R. Anderson, program assistance Bradley S. Williamson, program art work Sandy Corkrum Dee Johnson Vern Parrott Richard Singer, C.A.S. Shirley Nelson, C.A.S. Raymond W. Hummel, C.A.S. Norm Johnson, C.A.S. Lois Hansen, C.A.S. Central Breakthrough Larry Gregory, King County Drug Commission Del Schooley, Olympic Hotel Richard Wegscheider, Olympic Hotel Julie Hale, Seattle Convention Bureau Jerry Morrier, Printcraft Kay Henshaw, Quadracolor King County Drug Commission Washington State Office of Drug Abuse Prevention NDAC '77 Staff Washington State Congressional Delegation C.A.S. Staff C.A.S. Board of Directors

Edward S. Singler, President Geary Simmons, Vice President Nova G. Jones, Secretary Billie J. Caldwell, Treasurer Dr. Albert Black Sunny Brite, R.N. Darrell Fregia

William Hall, Jr. Dr. Virgie L. Harris Edith Hilliard Eddie Rye, Jr. Maryanne Vandervelde Linda B. Wohlers

NATIONAL DRUG ABUSE CONFERENCE

NDAC NATIONAL PLANNING COMMITTEE

Carol Addis Michael Aldrich Harold Alksne James Allen, Jr. Andy Anderson Mirijean Anderson Richard D. Atkins James Bailey David J. Baird Dave Bearman Charles E. Becker Howard Becker David Bentel Karst Besteman Peter Bjorklund Margaret Blasinsky Ken Blum Arytur Bolter Philip C. Bourdette Peter Bourne Gordon Brownell Thomas E. Bryant Terry Buris Albert S. Carlin Lawrence F. Carroll John Chappel Tonnny Chung Ron Clark Allan Y. Cohen Shirley Coletti Mary Beth Collins Joseph Corcoran Harold J. Cornacchia Robert Corrado Grace Dannnann Gerry De Angelis David Deitch Marlene De Rios Risa Dickstein Sara Dowdy-Green Gerry Dubin Robert DuPont Roberta Duron

* Site Selection Committee

George Effman Frank Espada Richard Esposito Mathea Falco James Fausel Beryl Feinglass Sanford J. Feinglass Harvey Feldman Loretta Finnegan Rinna Flour Douglas Foster Helen Foster Herbert J. Freudenberger Ron Gaetano* Dan Garrett Frances Rowe Gearing Richard Gilmore Matthew Gissen* Avram Goldstein Jack Gordon John Griffin Maria Elena Guillen Seymour Halpern William Harvey Tom Hastings Robbie Hayes Carmen Helisten Eileen Henriques Rudy Hernandez* Rayburn Hesse Rae Anne Hickling Rogers Hoffman John E. Imhoff Darryl Inaba Phillip E. Jacobs Norman Johnson Walter Jones* Manny Karell Richard Katon Edward Kaufman Edward Khantzien Benjamin Kissin Ron Kletter

vii

viii

Irving Klompus Gilbert Koda Milan Korcok Day Kuntz John G. Langrod Herbert Leibowitz Frank Lemons June Leonard* David Lewis Ondra Lewis Walter Littrell Roy Eugene Lokey Leroy Looper Sandra Lowe Joyce Lowinson Karin Mack James F. Maddux Ira Marion Jill Marsden Mary Tuma McAdams William J. McCord Harvey Milkman Robert Milkman Lonnie Mitchell Josette Mondanaro Bob Moore Merlyn Moore Bill Morris Ronald Murphy Frank Nelson Marshall Newman John Newmeyer Stuart Nightingale Helen Nowlis Joe Okimoto James Oss Donald Ottenberg Zelba Owens* Abe Pasadaba* Vernon Patch Gary Payer Thomas Payte David Petersen Bianca Podosta Thomas Powers

NATIONAL DRUG ABUSE CONFERENCE

Hale Pringle Mark Quinones Richard Rappolt Richard Rawson Susan Resteghini* Gerry Richardson Anne Salsbury Jordan Scher Ted Schramm* Doris Schwarz Edward Senay Frank Seixas Richard Seymour Arnold Schecter Vernon Short Daniel Joseph Silva Jane Silver David Smith Roger Smith Stuart Snyder Charles B. Starr Arthur Stickgold Shirley Stone R. Keith Stroup Alice Swanson Jose Szapocznik Shani Taha Forest Tennat Harold Trigg Kay Tucker Raoul Tuset Linda Tyon Kathleen Bell Unger J. Thomas Ungerleider April Vandetta William P. Vanquez* Joan L. Wade Ron Wakabayashi* D. Leong Way David Wellisch Oz White Charles Winick Bobby Yoshida Jim L. Young Norman E. Zinberg

NATIONAL DRUG ABUSE CONFERENCE

CONFERENCE STAFF

Linda Howell Schodt Conference Coordinator

P. Jean D. Williamson Administrator

Jody Bagnariol Staff Assistant

Ken Saunderson Public Relations Director

Carol Strena Administrative Assistant

Don Christensen Program Designer

Dan Kelsch Program Assistant

John Gallant Press Assistant

ix

CONTENTS

VOLUME II SOCIAL AND BEHAVIORAL ISSUES IN DRUG & ALCOHOL ABUSE

PART 1 MINORITIES AND SPECIAL NEEDS

Cultural Variables and the Hispanic Drug Abuser. . .. . .....

Mark A. Quinones and Kathleen M. Doyle

Toward a Model for Alcohol Rehabilitation of Urban Minorities . . . . . . . .

Susan W. Reed

The Drug Treatment Process Among Minorities .....

Paul Phillips and John Phin

Effects of an Affective Drug Abuse Prevention Program on Inner City Black Youths. . ...... .

Ronald L. Nuttall, Michele L. Moreland, and Joan B. Hunter

Symposium on Minorities and Primary Prevention. . . . . .

Carmen R. Maymi

Do Pacific/Asians Have Alcohol Problems? A Preliminary Report . . . . .

Bob Matsushima, Carlos Gonzalez, Curtiss Brown, and Emily Gibson

xi

1

11

15

25

35

39

xii

The Support System of the Alcoholic: Responses and Interventions . .

Mary Ann Holser

Uneroding Enamel: The Stigmatized Sub­Culture in Hawaii . . . . . . . .

The

Fay M. Hidalgo, J. Abraham Pasadaba, and Rodney Morales

Application of a Phase-Level Approach for the Treatment of Young Adult Alcohol and Multiple Substance Abusers in an Urban Community

Jay Fischer and James N. Mitchell

An Alcohol Treatment Model for Use with the Puerto Rican Community

Carlos A. Caste and Jeffrey Blodgett

Consultation to a Puerto Rican Drug Abuse Program . . . . . . . .

Melvin Delgado

The Black Drug Abuser; The Lack of Utilization of Treatment Services

Ethel B. Burks and Tyron S. Johnson

Drug Treatment for the Elderly Abuser J. V. Tamayo and R. M. Haglund

A Drug Education Program for the Elderly. Robert E. Wetter

Treatment of Gays in a Straight Environment: Gay Alcoholics, Drug Addicts Survive a "Straight In-patient Milieu"

Stuart B. Smith and Max A. Schneider

PART 2 RURAL & URBAN ISSUES

Coping with Reluctance to Change in Rural Prevention Programming.

John F. Snyder

Delivery Systems: Drug Abuse Treatment Programs in Rural Setting . . . .

Eliezer A. Rogers

CONTENTS

47

71

89

95

105

113

121

125

131

141

149

CONTENTS

Alcohol and Other Drug Use Among Rural Adolescents: Some Implications for Rural Drug Programming . . . . . .

Bradley M. Larsen, Dale T. Krynak, and Terry F. Pettijohn

Establishing a Rural Substance Abuse Pr.ogram: A First-Hand Report from the Battlefield . .

Tod Johnson

PART 3 PREVENTION

The Family as a Basic Prevention Unit James D. Kazen

Alpha Centers: A Viable Prevention Model for Substance Abuse Agencies and Public Schools ........ .

Hale Pringle, Judi Gregory, Kathy Ginkel, and Carol Cheek

Modules in Prevention: A Flexible Approach to Training . ....... .

Mary Louise Mong and Phillip L. Bandt

Primary Prevention from an "Ecological Perspective". . ...... .

Roger C. Mills

Teaching the Positive Attainment of Altered States of Consciousness as a Prevention and Drug Treatment Approach . . . . . .

Diane D. Livingston and John A. Heuvelman

Approaches for Effective Prevention Work in Public Schools ........... .

Harry Kressler

An Existing School Program as a Model for Prevention Work in Public School

xiii

153

171

177

183

191

197

205

217

Systems . . . . . . . . . . . . . . . . . . . . .. 223 Harry Kressler

xiv

An Environmental Intervention Approach to Prevention and Treatment of Youthful Drug Abusers . . . . . .

Kenneth B. Jacob, Janet Silverstein, and Richard P. Neuner

Predictive accountability for Development, Implementation and Evaluation of Prevention Programs ..... .

Richard Ingraham, Michael Winer-Cyr, and Roger Kuhrt

Developing a Comprehensive Community Based Prevention Program - A Multi-System Planning Model .

Margaret E. Hanna and Phyllis L. Hirschfield

PART 4 TRAINING, EDUCATION, AND CREDENTIALING

Substance Abuse Education in the D.C. Public Schools . . .. •.........

Edward White, Jr.

Professional Nursing Education About the Alcohol and Drug Dependent Person

Kathleen Smith-DiJulio and Nada J. Estes

The Pharmacology of Drug Abuse: Drug Education at San Quentin

William K. Schmidt and Alvin J. Greenberg

The Holistic Classroom Model Eric Hatch

Providing Skills Training to Former Drug Abusers in Treatment . .

Joan Randell, Robert Yankowitz, Susan Schatz, and Barbara Johnson

Work Habits Training - Basic Skills for Employment Success in Drug Abuse Clients . . . . . . . . . . . . •

Janice A. Popick

CONTENTS

229

237

247

257

261

269

275

285

289

CONTENTS

Credentialing: Issues and Considerations for the Front Line Worker . . . . . . . . .

Paul C. Purnell

Training and Organizational Development -Married or Just Living Together .

John Sample

Establishing Minimum Standards in Evaluating Drug Education .

Steven B. Robbins, Michael D. Decaria, and Terri Holleran

Continuing Medical Education in Alcoholism and Drug Abuse: A Formula for Success . . .

Michael R. Liepman and Suzanne S. Gilbert

A Management System for the Training and Supervision of Psychology, Social Work, and Nursing Trainees in a Substance Abuse Treatment Facility.

Larry J. Lantinga and Jennie Baarz

"Learn by Doing" - A Model for Community Health and Drug Education . . . . .

Nesha Z. Haniff

Pre training Screening: How to Pick the Winners . .. .....

Bruce E. Fischer and Dennis A. Armstrong

A Meaningful Credentialing for Senior Non­Degreed Drug Workers

Joseph Ershun and James Leake

A Look at the Three Masters Programs: The Lincoln-Eagleville Masters Program, Biscayne College and the Institute of Experiential Training

Joseph Ershun, Judy Case, and Frank Brown

The Interface Between Training and Education . . . . . . . . . .

Joseph Ershun and Marvin Dichter

xv

299

303

315

325

339

345

349

359

365

375

xvi

The Effectiveness of Short-term Counselor Training in Vocational Rehabilitation Implemented from a Corporate Perspective

Doreen Donen and Nancy Reardon

Clinical Staff Training for Treatment of Both Drug and Alcohol Dependent Patients ...•......

Stewart L. Baker and Charles J. Koerber

The Institute of Experiential Training: A Training Program for Drug Abuse Counselors . . . . . . . . • . .

Frank K. Brown and Moses Rabb, Jr.

An Evaluation of a Comprehensive Training for Drug Treatment Services Staff.

Kwame Ackason, Alicia K. Miller, arid Thomas G. Spiritoso

Program

Competency Based Assessment Approach for Training and Job Performance. . • . .. .... .. ' . . .

Dennis A. Armstrong and Howard M. Ottenheimer

PART 5 VOCATIONAL REHABILITATION

Behavioral Treatment of Test Anxiety in a Drug Abuse Vocational Rehabilitation Day Program. . . . . . . . . . . . .

Harvey Weiner, William L. Padgett, and Edward L. Miller

Vocational Training for Drug Abusers: Identifying the Early Dropout

Robert A. Steer and Edward L. Miller

Vocational Rehabilitation for Substance Abusers: A Model Program. . . . . . . • . . .

Richard M. Scott and James C. Gardiner

Implications in the Inclusion of Substance Abusers as Handicapped Individuals in Section 504 of the Rehabilitation Act of 1973. . . . . . . . . . . . . . . .

Mel Phillips

CONTENTS

381

389

395

405

417

427

439

445

455

CONTENTS

Vocational Outcome Following Residential Work/ Therapy Program - During High Unemployment and Recession Period . . . . . . . . . . .

Thomas A. Mellon, Jr.

Vocational Rehabilitation: The Key to Rehabilitative Success . . . . .

Vincent Marino

Vocational Services in NIDA-Funded Drug Treatment Programs ............... .

Robert L. Hubbard, Henrick Harwood, Monte C. Maney, S. Lou Mickey, Angela Mitchell, and Judith K. Linn

Vocational Characteristics of Substance Abusers Admitted to a Therapeutic Community ...

James C. Gardiner

Winning Over Employers: A Comprehensive Approach to Job Placement with Substance Abusers . . . . . . . .

James C. Gardiner

Innovations in Vocational RehabilitaL~8n: 1) Brief, Intensive Job Attainment Training . " ....

Victor I. Friesen and Vincent Young

Innovations in Vocational Rehabilitation: 2) Self-Employment Development .

Victor I. Friesen and Vincent Young

Hiring the Ex-Addict - Good Business or Bad. . . . .. . ..... .

H. Daniel Carpenter

PART 6 MANAGERIAL & ADMINISTRATIVE ISSUES

/Regionalization of Substance Abuse Services Utilizing Existing Medical and Substance Abuse Facilities . . . . . .

Joel C. Robertson

xvii

465

479

485

497

505

511

521

529

535

State and Community Cooperation in Addict Offender Treatment: Two Years Later

Leroy Wisdom, Mark Greenwald, and John Henning

Management by Objective and Radical Humanist Perspective as Related to Community Function . • . • •

Frank H. Ware

Needs Assessment for Drug Abuse Treatment Agencies: Four Empirical Approaches

J. Jay Volkert

A Computerized Management Information System and a Unique Funding Mechanism for Outpatient Drug Services in a County Program Network • • • • . . • • • • .

Anthony J. Trifi1etti, Donald Paretchan, and Dorothy A. Klein

Administrative Planning for a Fusion of Systems: Where Prevention and Treatment Must Merge

W. H. Torrence, Jr. and Margaret E. Hanna

Taking Stock: The Development of a Comprehensive Fee-For-Service Network of Drug and Alcohol Services in a Suburban County • • • . • •

W. H. Torrence, Jr. and Robert D. Gorodetzer

The Role of Formal Planning in an Era of No Growth: The Philadelphia Experience •

Thomas K. Smith and Samuel J. Longsworth

The Take Over Cycle • • Carolynn M. Simeone

The Management and the Research System -Is There a Difference? •.•••

John W. Murphy

The War Within the Drug Abuse Program: Problems of Linkage Between Criminal Justice and Health Service Systems

H. Graham McDonald

CONTENTS

541

549

555

567

573

581

587

597

601

609

CONTENTS

Using Management by Objectives as a Tool for Management of Treatment . . . . . . • .

Conrad E. Mauge, Lewis E. Bingham, Howard Luckett, and Virgie Boston

Drug Abuse Case load Management. Reginald L. Locke

Pre-Trial Intervention Among Adult Drug Abusers in the Criminal Justice System. . . .

S. Dennis Hunter and Katherine M. Bilton

Accounting for the Expenditure of Public Funds: An Accountability System for Provincially Funded Treatment Agencies . . . . .

Marcus J. Hollander, Murray A. Martin, and Barbara E. Downs

An Examination of Various Legislative Acts Which Allow for Treatment in Lieu of Incarceration for Drug Related Offenses

Carlos Delgado

Credentialing and Licensing: Community Programs in Crisis? ..... .

William Colon

Third Party Payments Revisited: Everything is Relative ............ .

Richard J. Cohen

Toward a Functional Drug Abuse Program Management Theory . . . . • . . .

Leslie Brown

PART 7 SOCIOLOGY OF DRUG ABUSE

The Polydrug Tree: A Graphical Presentation of Concurrent Multiple Substance Abuse by Clients in Ten Treatment Facilities

Yoav Santo

First Drug Use in Relation to Drug Career Among Youth in Treatment for Drug Abuse. . . •...

Yoav Santo

xix

619

631

641

651

663

673

679

691

705

725

xx

DAEDAC - A National Archive Service Assisting Social Scientists in Drug Abuse Research

Audrey Vanderhoof, LaVerne Knezek, and Marianne Babitch

Prevalence of Interactive Multiple Substance Abuse Among Youth in Drug Treatment.

David W. Speck and Yoav Santo .......

A Socio-Cultural Comparison of Lifestyles and Survival Differences Between Chinese and Black Addicts on Methadone in New York City •..•.••••••..••

John A. Reed

Life Events Leading to Suicide in Drug Abusers . . Steve Saxon, Ernest Kuncel, and Edward Kaufman

VSelf Destructive Behavior Patterns in Male and Female Drug Abusers. •. •.•...

Steve Saxon, Ernest Kuncel, and Edward Kaufman

Differences Between Males and Females in Drug Treatment Programs

Virginia S. Ryan

Drug Treatment Entry Patterns and Socioeconomic Characteristics of Asian American, Native American, and Puerto Rican Clients • . • •

John G. Phin and Paul Phillips

A Longitudinal Study Predicting Heroin and Alcohol Use Among Young Puerto Ricans.

Ronald L. Nuttall and Ena Vazquez Nuttall

A Descriptive Study of Drug Use Among the Hearing Impaired in a Senior High School for the Hearing Impaired • . • • • . • • • . • . • •

Reginald Locke and Shirley Johnson

JFamily Structures of Drug Dependent Individuals. Edward Kaufman and Pauline Kaufmann

Chronobiological Factors in Drug Abuse Mark Hochhauser

Rapidly Developing Psychosis as Complication of Innocent Over-the-Counter Drug Use

Richard C. W. Hall, Earl R. Gardner, and Sondra K. Stickney

CONTENTS

741

747

757

769

779

789

803

819

833

843

855

865

CONTENTS

Drug Abuse of Hallucinogenic Plants: Datura Suaveolens . . . . . . . . . . . . . .

Richard C. W. Hall, Michael K. Popkin, Sondra K. Stickney, and Earl R. Gardner

Multiple Alcohol and Illicit Drug Abuse Considered with Respect to Time Dimensions

Bradford T. Greene

Ethnicity and Transculturality: Its Relevancy in Training Personnel to Work with Clients with Dependency Disorders

Angel Gregorio G6mez

Heroin Prevalence: The Development of a Socioeconomic Model. . . .

Bradford T. Greene and Kareem Nakkash

Chemical Substance Abuse Among the Physically Disabled . . . . . . . . . . . . .

Janet M. Francendese and Alan Glass

Ethnicity and Drug Use Among Urban Junior High School Youths . . . . . . . . . . .

Richard Dembo, William Burgos, Don Des Jarlais, and James Schmeidler

Drug Addicts - Are They All the Same? Arie Cohen and Harriet L. Barr

Cross Cultural Approaches to Working with Addict Families ........•........

Sandra B. Coleman

PART 8 PUBLIC POLICY

Public Policy Recommendations from the National Drug Abuse Conference . . . . .

John E. Riggan

Response to Addiction: A Social Policy of Benign Neglect in Industrial Societies .. . . .

Ann Weick and Arthur Katz

The Impact of Drug Abuse on Organizational Performance and Policy Evaluation

James W. Schreier

xxi

875

881

895

905

915

921

933

941

949

959

969

xxii

PART 9 MISCELLANEOUS

Urine Testing in Parole Offices . . . . Hugh F. Alcott

The Beat of a Different Drummer . . • . . . . • Kenneth S. Russell and Lucinda A. Alibrandi

The PSA Puzzle: Making Media Work .... David G. Schmeling and C. Edward Wotring

Activating Solutions to Alcoholism Among the Hearing Impaired . . . . . . •

Alexander Boros

Index . . . • . • .

CONTENTS

979

987

997

1007

1015