Advancing Health Services Research

Health Services Research Leads to Exciting Findings

Constance M. Weisner, DrPH, MSW and Stacy A. Sterling, MPH, MSW Researchers know that drug and alcohol dependency cuts a wide path through a chemically dependent person's family. New research from the DOR Drug and Alcohol Research Team (DART) is pinpointing how. The DART study, which looked at the health care costs associated with people who received treatment for chemical addiction, found that family members have higher costs of health care and utilization and are more likely to be diagnosed with a medical or psychiatric condition than those who did not have a family member with alcohol or drug problems.

"The good news is that when chemical dependency is successfully treated, costs for family members also go down," says Constance M. Weisner, DrPH, MSW, investigator and director of DART.

Over the years, DART researchers have published key findings on chemical dependency, including studies showing the benefits of integrating primary care with chemical dependency treatment. Other DART research has found that older women receiving drug and alcohol treatment have particularly good outcomes compared to men. At the same time, adolescents being treated for alcohol and drug problems have better outcomes when they receive even the briefest of psychiatric services at the same time.

Collaborating with Clinicians and Other Regions

From the time DART started in 1993, the program has evolved into one of close collaboration with clinicians in the field, adds Weisner. "In fact, many of our research questions have come from them," she says. "These close partnerships have brought depth to our findings and allowed the research to be more quickly translated into the care setting."

The DART team currently has 14 active studies following several large samples of Kaiser Permanente Northern California adult and adolescent members, most of whom are or were in treatment for substance abuse.

In one study, a collaboration with the Kaiser Permanente Center for Health Research in Portland, Ore., researchers are studying the adoption of buprenorphine, an alternative to methadone, which can be administered to patients who suffer from an opiate addiction. In collaboration with Group Health of Seattle, the group is studying long-term use of opioids for chronic pain and adverse events, including substance abuse.

DART research scientists are also looking closely at the relationship between health care services and treatment for chemical dependency. The research shows a strong link between chemical dependency, mental health, and medical co-morbidities, says Weisner. This has led to a number of changes, adds Weisner, including earlier identification of chemical dependency problems. "Perhaps the most impactful result of the research is that Kaiser Permanente is moving toward a new model of integration."