Alcohol and Pregnancy: Benefits and Harms of State-Level Policies
Funding: NIH R01AA023267
In collaboration with UCSF’s Advancing Standards in Reproductive Health, the aims of this mixed methods project are to: 1) examine intended and unintended consequences of state-level pregnancy-specific alcohol policies and general population alcohol policies on harms from use during pregnancy; 2) assess whether benefits (intended) and negative (unintended) consequences of pregnancy-specific and general population alcohol policies are distributed equitably across race/ethnicity and socioeconomic status; 3) examine possible mechanisms through which policies contribute to the outcomes; and 4) inform new policy approaches that are more likely to reduce harms by exploring experiences and perspectives of women who drink heavily before and/or during pregnancy and the clinicians and professionals who care for them.
An Evaluation of Sober Living Houses
Sober Living Houses are alcohol and drug free residences for individuals attempting to establish or maintain sobriety. Although they do not offer formal treatment, some individuals enter them after completing residential treatment or while engaged in outpatient treatment. Most sober houses require attendance at AA and compliance with basic house rules, such as abstinence from alcohol and drugs and paying rent on time. This repeated measures study assess 300 individuals residing in 18 different sober living houses at intake, 6 months, one year and 18 months.
Measuring Confrontation During Recovery
The Alcohol and Drug Confrontation Scale (ADCS) is a new 72-item instrument that measures a construct of confrontation specified as warnings to an individual about potential harm if she/he does not make changes to establish or maintain abstinence from drugs and alcohol. Unlike most examinations of confrontation, the ADCS assesses confrontation from sources beyond treatment staff, such as recovering peers, family, friends, and professionals in ancillary roles (e.g., criminal justice and social welfare staff). A qualitative component will undertake new in-depth interviews on a targeted sample of 40 participants to help explain why participants’ experiences of confrontation vary over time.
Moderators of Motivation to Maintain Sobriety Over 18 Months
This project will study how motivation to maintain sobriety is associated with abstinence and reduced substance use over 18 months. Rather than yet another study of motivation within a formal treatment program, this project will study it among a population of individuals entering sober living recovery homes. Hypothesis suggest 1) motivation will be associated with alcohol and drug use within and across time points and 2) moderators of the impact of motivation on alcohol and drug use will include measures of supportive confrontation and drinking and drug use, in the social network.
Reducing Offenders HIV Risk: MI Enhanced Case Management with Drug-Free Housing
HIV risk among criminal justice offenders is high. Rates of infection are up to 10 times higher than the general population and 25% of all HIV infected persons have contact with the criminal justice system. Overcrowding of jails and prisons puts offenders at increased risk for HIV as does a failure to successfully transition from prison or jail into the community. Overcrowding of criminal justice institutions has reached crisis proportions in the U.S. and nowhere is the problem worse than in California.
Randomized Trial of Intensive MI to Improve Drinking Outcomes Among Women
An unexpected yet important finding from our ongoing study of Intensive Motivational Interviewing (IMI) for methamphetamine (MA) dependence is women with alcohol problems (N=87) are reducing their drinking significantly more if they are assigned to the IMI condition as opposed to a standard MI (SMI) comparison condition. Reduction of alcohol problems has been larger for women in the IMI condition at 4- and 6-month follow-up. Interestingly, trajectories show continuing declines in drinking problems during and after treatment, and differences between study conditions grow larger between 4-month (p<.05) and 6-month (p<.01) follow-up. Treatment effects at 6 months are medium to large, Cohen’s d=0.63. There are no drinking differences by study condition for men. An important limitation of the current sample in terms of studying the intervention’s effects on drinking is the current study targets persons with MA dependence. Alcohol problems are therefore secondary and typically participants enter with relatively low severity of alcohol problems and limited room for improvement.