Substance abuse attitudes and policies in US rehabilitation training programs: A comparison of 1985 and 2000

Jeffrey R. Basford, Daniel E. Rohe, Christopher P. Barnes, Robert W. DePompolo

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective: To assess and compare the attitudes, beliefs, and policies of physical medicine and rehabilitation (PM&R) training programs toward substance abuse and tobacco use over the last 15 years. Design: A blinded questionnaire was sent to all US rehabilitation medicine training program directors. Results were compared with a survey conducted in 1985. Setting: US PM&R residency training programs with inpatient rehabilitation training. Participants: Training directors or their designated agents. Intervention: A 35-item questionnaire was mailed between November 1999 and April 2000 to the 81 US training programs identified by the American Board of Physical Medicine and Rehabilitation as having rehabilitation training programs with inpatient rehabilitation units. Responses were pooled by our Survey Research Center to preserve anonymity. Training programs that did not respond received additional mailings and telephone calls to improve the response rate. Main Outcome Measures: Chi-square analysis to assess changes in responses with time. Results: Forty-six of the 79 (58%) eligible training programs responded (1 program had merged, 1 did not provide inpatient rehabilitation). Programs were located in cities ranging from less than 100,000 (n = 2) to greater than a million inhabitants (n = 18). Eighty percent (37/46) of the respondents were "concerned or very concerned" about their patients' alcohol and drug use, and 69% routinely assessed patients for alcohol and drug use compared with only 25% in 1985 (P < .00001). Almost all respondents (43/46) supported written guidelines to prohibit alcohol and drug use by patients in the rehabilitation unit. Eighty-three percent had a prohibition policy, and 72% had written guidelines. Both of those rates represent increases from the 1985 response rates of 65% and 45%, respectively. Ambivalence persisted about appropriate treatment programs for persons with disabilities: in 1985, 51% of the respondents agreed that a person with a disability could be treated appropriately in a substance abuse program designed for persons without a disability; in 2000, the percentage had increased to 64%. All respondents believed that tobacco use is an addiction, but only 25% of their units offered tobacco cessation services to patients on their rehabilitation unit. Conclusion: The survey results are encouraging. Since 1985, not only have substance abuse issues been recognized, but also systemic institutionalized approaches (eg, regular screening, written guidelines) have increased markedly. Tobacco is now uniformly accepted as an addiction, but screening and access to cessation programs are similar to that available for alcohol and drug treatment programs 15 years ago.

Original languageEnglish (US)
Pages (from-to)517-522
Number of pages6
JournalArchives of Physical Medicine and Rehabilitation
Volume83
Issue number4
DOIs
StatePublished - 2002

Fingerprint

Substance-Related Disorders
Rehabilitation
Education
Alcohols
Inpatients
Physical and Rehabilitation Medicine
Tobacco Use
Guidelines
Disabled Persons
Pharmaceutical Preparations
Tobacco Use Cessation
Surveys and Questionnaires
Internship and Residency
Telephone
Tobacco
Medicine
Outcome Assessment (Health Care)
Therapeutics
Research

Keywords

  • Alcohol
  • Rehabilitation
  • Substance-related disorders
  • Tobacco

ASJC Scopus subject areas

  • Rehabilitation

Cite this

Substance abuse attitudes and policies in US rehabilitation training programs : A comparison of 1985 and 2000. / Basford, Jeffrey R.; Rohe, Daniel E.; Barnes, Christopher P.; DePompolo, Robert W.

In: Archives of Physical Medicine and Rehabilitation, Vol. 83, No. 4, 2002, p. 517-522.

Research output: Contribution to journalArticle

Basford, Jeffrey R. ; Rohe, Daniel E. ; Barnes, Christopher P. ; DePompolo, Robert W. / Substance abuse attitudes and policies in US rehabilitation training programs : A comparison of 1985 and 2000. In: Archives of Physical Medicine and Rehabilitation. 2002 ; Vol. 83, No. 4. pp. 517-522.
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abstract = "Objective: To assess and compare the attitudes, beliefs, and policies of physical medicine and rehabilitation (PM&R) training programs toward substance abuse and tobacco use over the last 15 years. Design: A blinded questionnaire was sent to all US rehabilitation medicine training program directors. Results were compared with a survey conducted in 1985. Setting: US PM&R residency training programs with inpatient rehabilitation training. Participants: Training directors or their designated agents. Intervention: A 35-item questionnaire was mailed between November 1999 and April 2000 to the 81 US training programs identified by the American Board of Physical Medicine and Rehabilitation as having rehabilitation training programs with inpatient rehabilitation units. Responses were pooled by our Survey Research Center to preserve anonymity. Training programs that did not respond received additional mailings and telephone calls to improve the response rate. Main Outcome Measures: Chi-square analysis to assess changes in responses with time. Results: Forty-six of the 79 (58{\%}) eligible training programs responded (1 program had merged, 1 did not provide inpatient rehabilitation). Programs were located in cities ranging from less than 100,000 (n = 2) to greater than a million inhabitants (n = 18). Eighty percent (37/46) of the respondents were {"}concerned or very concerned{"} about their patients' alcohol and drug use, and 69{\%} routinely assessed patients for alcohol and drug use compared with only 25{\%} in 1985 (P < .00001). Almost all respondents (43/46) supported written guidelines to prohibit alcohol and drug use by patients in the rehabilitation unit. Eighty-three percent had a prohibition policy, and 72{\%} had written guidelines. Both of those rates represent increases from the 1985 response rates of 65{\%} and 45{\%}, respectively. Ambivalence persisted about appropriate treatment programs for persons with disabilities: in 1985, 51{\%} of the respondents agreed that a person with a disability could be treated appropriately in a substance abuse program designed for persons without a disability; in 2000, the percentage had increased to 64{\%}. All respondents believed that tobacco use is an addiction, but only 25{\%} of their units offered tobacco cessation services to patients on their rehabilitation unit. Conclusion: The survey results are encouraging. Since 1985, not only have substance abuse issues been recognized, but also systemic institutionalized approaches (eg, regular screening, written guidelines) have increased markedly. Tobacco is now uniformly accepted as an addiction, but screening and access to cessation programs are similar to that available for alcohol and drug treatment programs 15 years ago.",
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