SUBSTANCE ABUSE (also see HEALTH SERVICES)

Adjunct Principal Investigator: Arthur Klatsky, MD
Primary Source of Funding: Kaiser Permanente Community Benefit Programs
Description: This study examines whether a safe limit of drinking for breast cancer risk can be defined, what the drinking and breast cancer relationship is in several ethnic groups, whether the choice of wine, beer and liquor is a factor in breast cancer, if there is a relationship between stage at diagnosis, recurrence or prognosis; and if there is an interaction between alcohol and breast cancer with menopausal status, exogenous hormone usage, estrogen/progesterone receptor status, and folate intake.

Division of Research Principal Investigator: Annette Aalborg, DrPH
Primary Source of Funding: National Institute on Alcohol Abuses and Alcoholism/NIH/DHHS
Description: The major goal of this project is to test two different models of family-based primary care prevention for adolescent substance abuse.

Adjunct Principal Investigator: Arthur Klatsky, MD
Primary Source of Funding: The Wine Institute
Description: This study explores the role of alcoholic beverage choice, wine, liquor and beer, in the risk of death from all causes and specific causes.

Adjunct Principal Investigator: Ameena Ahmed
Primary Source of Funding: Kaiser Foundation Research Institute
Description: The Study of alcohol use and self-care behavior in people with diabetes.

Adjunct Principal Investigator: Arthur Klatsky, MD
Primary Source of Funding: Robert Wood Johnson Foundation
Description: This study explores unresolved issues about the alcohol-hypertension (HTN) relationship, including the roles of beverage choice (wine, liquor, or beer), drinking pattern, time sequence in relation to alcohol intake, confounding by diet or behavioral factors, and the extent to which alcohol-associated HTN results in the usual HTN sequelae.

Division of Research Principal Investigator: Constance M. Weisner, DrPH, MSW
Primary Source of Funding: National Institute on Drug Abuse
Description: This study examines the 3- and 5-year course of problems in an “intent to treat” sample of adolescent intakes in four managed care substance abuse treatment sites, and assesses the relationship of substance abuse problems and treatment to medical utilization and cost.

Division of Research Principal Investigator: Elisabeth Gruskin, DrPH
Primary Source of Funding: Kaiser Permanente Community Benefit Programs
Description: This project compares the rates of smoking and alcohol consumption of gay/bisexual males compared to those of heterosexual men.

Division of Research Principal Investigator: Elisabeth Gruskin, DrPH
Primary Source of Funding: Kaiser Permanente Community Benefit Programs
Description: This study examines addictions of gay/bisexual men. Understanding why gay/bisexual men use substances and the antecedents to these addictive behaviors, along with the relationship between addictive behaviors and stress, will help us to better serve gay men in substance abuse programs and other health care services.

Division of Research Principal Investigator: Joe V. Selby, MD, MPH
Primary Source of Funding: Department of Health and Human Services, Federal Drug Administration
Description: Under this contract, DOR will respond to ad hoc requests from the FDA for reports of medication utilization patterns or the occurrence of specified outcomes in Kaiser Permanente members.

Division of Research Site Principal Investigator: Carlos Iribarren, MD, PhD, MPH
Primary Source of Funding: Tobacco Related Disease Research Program
Description: This project studies whether environmental tobacco smoke (ETS) exposure has harmful effects on adults with asthma by determining how common ETS exposure is in adults with severe asthma, and by examining the impact of ETS exposure on asthma severity, quality of life, and future asthma attacks that require hospitalization.

Division of Research Principal Investigator: Constance Weisner, DrPH, MSW
Primary Source of Funding: National Institute on Alcohol Abuse and Alcoholism
Description: The study examines the medical conditions, utilization, and cost of family members of individuals who have been in chemical dependency treatment.

Division of Research Principal Investigator: Constance Weisner, DrPH, MSW
Primary Source of Funding: National Institute on Alcohol Abuse and Alcoholism
Description: This survey of adults examines differences in drinking patterns between men and women, how gender and drinking patterns interact with health behaviors, attitudes and functioning, and willingness to use different medical services.

Division of Research Principal Investigator: Constance M. Weisner, DrPH, MSW
Primary Source of Funding: National Institute on Drug Abuse
Description: The original Integrated Drug and Medical Care study was a randomized clinical trial comparing outcomes of individuals randomized to the Integrated versus Non-Integrated (Usual Care) medical and substance abuse treatment. This long-term follow-up study uses a conceptual model drawn from the earlier work and from longitudinal literature to identify the trajectory determinants of substance use, medical and mental health outcomes over 7 years.

Division of Research Principal Investigator: Sujaya Parthasarathy, PhD
Primary Source of Funding: National Institute on Drug Abuse
Description: This study undertakes a controlled, random assignment comparison of chemical dependency patients eligible for a new residential recovery program benefit. Subjects are assigned to one of two treatment settings, intensive outpatient or residential recovery — to enable comparison of two types of treatment available at Kaiser Permanente.

Division of Research Principal Investigator: Elisabeth Gruskin, DrPH
Primary Source of Funding: National Institute on Alcohol Abuse and Alcoholism
Description: This federally funded training grant supports research efforts to use qualitative and quantitative methods to study lesbians’ alcohol use and smoking.

Division of Research Principal Investigator: Elisabeth Gruskin, DrPH
Primary Source of Funding: American Cancer Society
Description: Using qualitative interviews and electronic diaries, this study seeks to better understand the relationship between stress, negative affect, and smoking relapse.

Division of Research Principal Investigator: Elisabeth Gruskin, DrPH
Primary Source of Funding: Tobacco-Related Disease Research Program
Description: This project compares the tobacco use, cessation, and second hand smoke of the lesbian, gay, bisexual, and transgender population in California to that of the general population.

Division of Research Principal Investigator: Constance M. Weisner, DrPH, MSW
Primary Source of Funding: National Institute on Drug Abuse
Description: This study examines determinants of 11-year substance abuse treatment readmission, substance use, and medical services cost and utilization. The effects of treatment and other hypothesized influences, such as personal characteristics, on long-term outcomes of these patients are being studied.

Adjunct Principal Investigator: Charles Moore, MD, MBA, MS
Primary Source of Funding: National Institute on Alcohol Abuse and Alcoholism
Description: This training grant examines pre-treatment medical services utilization, medical conditions and medications, and their impact on medical services utilization and outcome at one year as well as longer-term trajectories.

Division of Research Principal Investigator: Stephen Sidney, MD, MPH
Primary Source of Funding: Tobacco-Related Disease Research Program
Description: This retrospective cohort study examines whether mentholated cigarette smokers have a higher risk than smokers of non-mentholated cigarettes for myocardial infarction, all coronary heart disease, and stroke.

Division of Research Principal Investigator: Constance M. Weisner, DrPH, MSW
Primary Source of Funding: National Institute of Alcoholism and Alcohol Abuse
Description: This study compares the effects of day hospital treatment and traditional outpatient treatment for post-treatment outcome and improvement rates in the areas of alcohol consumption, levels of psychosocial functioning, and medical care utilization of the two regimens at five and seven years after treatment entry. This study includes supplemental examinations of ethnic disparities in treatment access and outcomes, and the impact of childcare services on women in treatment.

Division of Research Principal Investigator: Stacy Sterling, MSW, MPH
Primary Source of Funding: Robert Wood Johnson Foundation and Center for Substance Abuse Treatment
Description: This study examines access to and utilization of substance abuse services by adolescents. Specifically describing those identified as substance abusers, identifying successful system pathways and potential barriers to treatment access, describing pretreatment patterns of health service utilization that may facilitate identification, and characterizing who enters and remains in treatment, thus identifying those at risk for early dropout and the factors related to dropping out.

Site Principal Investigator: Stacy Sterling, MSW, MPH
Primary Source of Funding: Robert Wood Johnson Foundation
Description: This study seeks to better understand how private, managed care systems can develop treatment policy leading to dual treatment and continuity of care, and how such treatment impacts utilization and cost.

Division of Research Principal Investigator: Carol Conell, PhD
Primary Source of Funding: National Institute on Alcohol Abuse and Alcoholism
Description: This study uses chart review to validate and find gaps in the electronic identification of alcohol abuse and dependence in 3 Kaiser Permanente regions.

Division of Research Principal Investigator: Constance M. Weisner, DrPH, MSW
Primary Source of Funding: National Institute on Drug Abuse
Description: This study assesses the prevalence of alcohol and drug problems, by gender and age, within primary care clinics in the Cape Town, South Africa Metropolitan area, and also develops a screening methodology that can operate successfully in busy clinics.

Division of Research Site Principal Investigator: Nancy Gordon, ScD
Primary Source of Funding: Tobacco-Related Disease Research Program
Description: This study identifies predictors of smoking cessation and assesses the effect of smoking cessation on medical care use and costs using data from the 1996, 1999, and 2002 Member Health Surveys linked to automated cost and utilization databases for 12 months following each survey.

Division of Research Site Principal Investigator: Elisabeth Gruskin, DrPH
Primary Source of Funding: American Cancer Society, Inc.
Description: To understand the process of smoking relapse among lesbians and heterosexual women with a focus on the effects of stress and negative affect, in order to improve smoking cessation programs.

Division of Research Site Principal Investigator: Connie Weisner,DrPH, MSW
Primary Source of Funding: Kaiser Foundation Research Institute
Description: To assess the effect of the implementation of a new Kaiser Permanente (KP) deductible benefit plan on access to, retention in, and cost of Chemical Dependency services. Using KP databases, we will examine treatment access (intake and initiation rates) before and after implementation of the benefit plan at all CD programs in the KP Northern California (KPNC) region and compare intake rates, retention (number of visit days), and KP costs between patients with the deductible plan and those without, after the introduction of deductible plans.

Division of Research Site Principal Investigator: Stephen K. Van Den Eeden, PhD
Primary Source of Funding: National Institute of Neurological Disorders and Stroke
Description: This study investigates selected mechanisms that may explain the inverse association observed between smoking and Parkinson’s Disease.

Division of Research Site Principal Investigator: Mary Anne Armstrong, MA
Primary Source of Funding: National Institute on Alcohol Abuse and Alcoholism
Description: The purpose of this study is to evaluate the performance of a new alcohol and drug use screening instrument for pregnant women, the 4Ps Plus, against a standardized diagnosis of substance abuse, dependence, or problem use, based on DSM-IV criteria, in a population of pregnant women who receive prenatal care through Kaiser Permanente Northern California.