Kathleen M. Doyle’s research while affiliated with Rutgers New Jersey Medical School and other places

Increasing availability of high quality heroin moving from the Middle East to Western Europe and the United States accounts for the recent rise in heroin abuse in these countries which seems to be reaching almost epidemic proportions. Over the past two decades, a number of treatment techniques have been developed showing varying degrees of 'success' in rehabilitating drug abusers. Drawing from the existing literature, this paper explains the etiology, treatment and rehabilitation of the drug abuser along with an historical development of policies toward drug abuse and the drug abuser in the United States. Also this paper attempts to offer an evaluation model that can easily and inexpensively be instituted by alcohol, drug abuse and other social programs to determine its efficiency and effectiveness in two important parameters: cost containment and client benefits.

Social conflict theory is used as the framework in which the controversy surrounding the establishment of a medical/dental school complex in the heart of the black community of Newark, New Jersey, is examined. The roles of community leaders, medical/dental professionals and state and federal officials are scrutinized. The implications of the outcome of the struggle for understanding conflict theory as a health educational tool are discussed. Language: en

A comparative evaluation outcome model designed to aid in referral of clients to appropriate drug abuse treatment centers was developed for a multimodality drug abuse rehabilitation network in Newark, New Jersey. The model analyzes retention rates and treatment dropout outcome to assess impact, and graduate outcome to assess the effectiveness of the various drug abuse treatment centers. Study of 3,943 addicts found a number of demographic and psychosocial variables that correlated with retention in specific programs; retention of some subgroups in specific treatments was substantially longer than overall retention rates. One year retention rates of 65% in methadone maintenance; 22, 16, and 8.5% in the three therapeutic communities; and less than 5% in two outpatient drug-free programs suggested a study of treatment dropouts outcome. Significant reduction in criminality and drug use were found for all treatment dropouts including a “no-treatment” comparison group; however, significantly larger improvements were noted for dropouts of the methadone maintenance program, two of the three therapeutic communities, and one of the outpatient drug-free clinics when compared with the comparison group in these and other compounded indices designed to assess the effectiveness of treatment. Analysis of graduate outcome showed further reduction in drug use and criminality among methadone maintenance and one of the three therapeutic community graduates. Graduates of this therapeutic community exhibited substantial improvement in employment and productivity. The evaluation model is applicable for treatments for alcohol abuse and offers specific recommendations for improvement in allocation of clients and resources to the various treatments.

During the 1960s, three modalities of treatment aimed at rehabilitation of the drug abuser (methadone maintenance, outpatient drug free treatment, and the residential therapeutic community) were developed. Large amounts of public and private monies have gone to supporting these modalities; little evaluation as to the efficacy of such rehabilitation efforts has been done. This paper attempts to delineate the evaluative research efforts undertaken in the drug abuse field to date. In addition, the findings of an eight-year evaluation of six drug treatment programs in Newark, NJ are presented. The authors propose a paradigm for quick, effective evaluation of drug and alcohol programs at minimal cost.

Two residential therapeutic communities for female addicts--one coeducational and the other all female--encountered serious problems shortly after their formation. The authors found that the male and female staff of the coeducational program had quite different perceptions of the purposes and characteristics of the women's part of the program. In both programs the female staff held such strongly ambivalent feeling toward their roles as women and authority figures that they had difficulty functioning effectively. The authors suggest the need for research that will identify the female addict's special needs, and a restructuring of programs to meet those needs. Further, training programs for female staff must enable them to distinguish between their own ideals and their clients' needs.

Of 802 voluntary patients admitted to the detoxification unit of a comprehensive treatment system, 69% completed detoxification but only 9.6% of thest patients sought long-term treatment. The demographic profile of detoxification patients differed somewhat from that of patients in long-term treatment. The authors suggest that new approaches, including legal pressure, are needed to induce detoxification patients to accept prolonged therapy.