@article{5f8c924606f445ed96ea3d0dd7677f93,
title = "Detoxification centers: Who's in the revolving door?",
abstract = "Data from 443, 812 admissions to publicly funded detoxification centers in Massachusetts (fiscal year 1984 to fiscal year 1996) were analyzed to assess changes in the population served. Substantial increases in admissions of women, African Americans, and Hispanics were apparent. Mean age at admission declined and unemployment increased. A 25% decline in admissions reporting alcohol use was coupled with a twofold increase in reported cocaine use and a fourfold increase in heroin use. Detoxification services have evolved. The older, white, male alcoholic is no longer the primary consumer. Policy initiatives (e.g., increased services for women) and the changing epidemiology of drug abuse (e.g., increased access to heroin) contributed to the changing population served in detoxification centers.",
author = "Dennis McCarty and Yael Caspi and Lee Panas and Milly Krakow and Mulligan, {David H.}",
note = "Funding Information: Federal Legislation. Federal funding for addiction treatment was substantially altered with the passage of the Omnibus Budget Reconciliation Act (OBRA) (P.L. 97-35) in 1981 and the creation of block grants. The Alcohol, Drug Abuse and Mental Health Services (ADMS) Block Grant combined direct project grants and state formula grants from the National Institute of Alcohol Abuse and Alcoholism and the National Institute of Drug Abuser Reauthorizations of the block grant added requirements to serve women (1984, 1988), pregnant women (1992), and injection drug users (1988, 1990, 1992) and in 1992 to support child care, prenatal services, HIV services and medication, TB services and medication, and revolving loan funds that fostered alcohol and drug-free housing) 8T he federal block grant requirements stimulated modifications in service delivery and services for desig- nated populations. Thus, both state (the Uniform Act) and federal (block grants) policies affected the availability of services and the individuals treated. Funding Information: This research was supported by a center grant from the National Institute on Drug Abuse, P50 DA10233, for the Brandeis/Harvard Research Center on Managed Care and Drug Abuse Treatment. Data from this article were included in presentation at the Boston meeting of the National Institute of Drug Abuse's Community Epidemiology Work Group in June 1998. We thank the directors of detoxification centers for their comments and Mayra Rodriguez-Howard (director of substance abuse services for the Massachusetts Department of Public Health) for facilitating access to the Bureau of Substance Abuse Services database. Thanks also to Tom McLellan and Jim Sorenson for helpful comments on earlier drafts.",
year = "2000",
month = aug,
doi = "10.1007/BF02291737",
language = "English (US)",
volume = "27",
pages = "245--256",
journal = "Journal of Behavioral Health Services and Research",
issn = "1094-3412",
publisher = "Springer New York",
number = "3",
}