title: Alcohol detoxification completion, acceptance of referral to substance abuse treatment, and entry into substance abuse treatment among Alaska Native people.
abstract: Little is known about factors associated with detoxification treatment completion and the transition to substance abuse treatment following detoxification among Alaska Native people. This study examined 3 critical points on the substance abuse continuum of care (alcohol detoxification completion, acceptance of referral to substance abuse treatment, entry into substance abuse treatment following detoxification).
  
  
  
  The retrospective cohort included 383 adult Alaska Native patients admitted to a tribally owned and managed inpatient detoxification unit. Three multiple logistic regression models estimated the adjusted associations of each outcome separately with demographic/psychosocial characteristics, clinical characteristics, use related behaviors, and health care utilization.
  
  
  
  Seventy-five percent completed detoxification treatment. Higher global assessment functioning scores, longer lengths of stay, and older ages of first alcohol use were associated with completing detoxification. A secondary drug diagnosis was associated with not completing detoxification. Thirty-six percent accepted a referral to substance abuse treatment following detoxification. Men, those with legal problems, and those with a longer length of stay were more likely to accept a referral to substance abuse treatment. Fifty-eight percent had a confirmed entry into a substance abuse treatment program at discharge. Length of stay was the only variable associated with substance abuse treatment entry.
  
  
  
  Services like motivational interviewing, counseling, development of therapeutic alliance, monetary incentives, and contingency management are effective in linking patients to services after detoxification. These should be considered, along with the factors associated with each point on the continuum of care when linking patients to follow-up services.
authors.affiliation: University of Colorado Anschutz Medical Campus, Centers for American Indian and Alaska Native Health, Colorado School of Public Health, Mail Stop F800, Nighthorse Campbell Native Health Building, 13055 E. 17th Avenue, Aurora, CO 80045, United States. Electronic address: Ursula.RunningBear@ucdenver.edu.
authors.forename: Ursula
authors.initials: U
authors.lastname: Running Bear
authors.affiliation: University of Colorado Anschutz Medical Campus, Centers for American Indian and Alaska Native Health, Colorado School of Public Health, Mail Stop F800, Nighthorse Campbell Native Health Building, 13055 E. 17th Avenue, Aurora, CO 80045, United States.
authors.forename: Janette
authors.initials: J
authors.lastname: Beals
authors.affiliation: University of Colorado Anschutz Medical Campus, Centers for American Indian and Alaska Native Health, Colorado School of Public Health, Mail Stop F800, Nighthorse Campbell Native Health Building, 13055 E. 17th Avenue, Aurora, CO 80045, United States; University of Colorado Anschutz Medical Campus, Department of Psychiatry, 13055 East 17th Avenue, Aurora, CO 80045, United States.
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Novins
authors.affiliation: University of Colorado Anschutz Medical Campus, Centers for American Indian and Alaska Native Health, Colorado School of Public Health, Mail Stop F800, Nighthorse Campbell Native Health Building, 13055 E. 17th Avenue, Aurora, CO 80045, United States.
authors.forename: Spero M
authors.initials: SM
authors.lastname: Manson
mesh_terms: D000328:Adult; D000367:Age Factors; D000072957:Alaska Natives; D000437:Alcoholism / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012737:Sex Factors; D016320:Substance Abuse Treatment Centers; D016896:Treatment Outcome
keywords: Alaska Native; Alcohol detoxification; American Indian; Detoxification completion; Substance abuse treatment entry; Substance abuse treatment referral