title: Determinants of successful treatment outcomes among a sample of urban American Indians/Alaska Natives: the role of social environments.
abstract: Very few studies have analyzed the role of social environments on substance abuse treatment outcomes among urban American Indians/Alaska Natives (AI/ANs). This study examined a measure of positive treatment response-abstinence from substance use at treatment discharge-among urban AI/ANs in Los Angeles County. The sample included all AI/ANs in outpatient drug-free (e.g., no methadone) treatment and residential treatment from 2004 to 2008 (N = 811). Predictors of abstinence at discharge were (a) having recovery-oriented social support and (b) not having a difficult living situation (i.e., experiencing family conflict and/or living with someone who uses alcohol and/or drugs). Higher levels of recovery-oriented social support in the past 30 days predicted abstinence during outpatient treatment. In residential treatment, retention of 90 days or more, high recovery-oriented social support, and not experiencing difficult living situations predicted abstinence. Suggestions for optimizing treatment outcomes among AI/ANs and areas of further research are provided.
authors.affiliation: School of Social Work, University of Southern California, 1149 S. Hill Street, Suite 320, Los Angeles, CA 90015-2245, USA. spearse@usc.edu
authors.forename: Suzanne E
authors.initials: SE
authors.lastname: Spear
authors.forename: Desiree
authors.initials: D
authors.lastname: Crevecoeur-MacPhail
authors.forename: Loretta
authors.initials: L
authors.lastname: Denering
authors.forename: Daniel
authors.initials: D
authors.lastname: Dickerson
authors.forename: Mary-Lynn
authors.initials: ML
authors.lastname: Brecht
mesh_terms: D000413:Alaska; D006801:Humans; D007198:Indians, North American; D015141:Los Angeles; D012114:Residential Treatment; D012307:Risk Factors; D012931:Social Environment; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D014505:Urban Population