Grant will allow D'Aunno to study drug addiction treatments

One out of every 260 Americans comes to a drug addiction treatment program each year. But are they getting the treatment they need?

Thomas D'Aunno, Associate Professor in the School of Social Service Administration and in Biological Sciences, recently received a $2.7 million grant from NIDA, the National Institutes for Health/National Institute for Drug Abuse, to analyze the extent to which drug addiction treatment providers are using approaches that work.

D'Aunno has studied the structure and performance of health care organizations for more than a decade. But he is particularly excited about his newest research because "It's the only study of its kind-a nationally representative survey over 11 years that will not only reveal whether providers are meeting accepted standards of care, but will also clearly show which providers are delivering the most effective drug addiction treatment."

The study, which will be completed in four years, will analyze data collected from 600 providers around the country in 1988, 1990, 1995 and 1999.

"We had heard anecdotal evidence that some treatment providers weren't meeting standards of care-that they weren't educating clients about HIV prevention, that they were providing too low doses of methadone," D'Aunno said, explaining why he decided to do the survey.

"To analyze the data, we'll use available social science theory to inform our understanding of factors affecting treatment practices, and we may use the results to develop theory as well," he added. When the study is completed, D'Aunno will use the results to identify trouble areas and make policy recommendations to NIDA.

D'Aunno notes that there are several approaches to drug addiction treatment: the Alcoholics Anonymous approach, which advocates a 12-step program and the submission to a higher power; the psycho-social model, which suggests solving underlying emotional problems to treat drug addiction; the medical-biological model, which says that addicts need medical care and medication; and the criminal justice model, which advocates for the criminal punishment of drug addicts.

"That's simplified, of course," D'Aunno says. "There are many other factors involved-treatment duration and intensity; client's use of primary health care, mental health care and social services; HIV prevention practices; methadone dose levels; availability of special services for women and ethnic minorities; and the staffing level, ownership and organization of treatment providers. We'll track all those factors.

"But partly what we want to do is trace the embedded beliefs of providers because their beliefs may affect their practices. We're looking for the combination of beliefs, practices and organizational structure that provides the best results," D'Aunno said.