Study of barriers to referring the at-risk, street outreach population to substance abuse treatment

The Foundation's Substance Abuse Policy Research Program was designed to provide support for investigators to conduct policy research on a variety of subjects directed at helping the country reduce the harm caused by substance abuseMany inner-city, substance abusers use illicit drugs intravenously, share injection paraphernalia, and may have unprotected sex. Transient adaptations limit their contacts with basic health and social services, including referrals to substance abuse (SA) treatment. At high risk for HIV/AIDS, such individuals became targets of a harm-reduction effort by the New York State Office of Alcoholism and Substance Abuse Services (OASAS), which formed a network of seven street outreach programs in 1990, initially, to promote HIV/AIDS testing and coordination among providers. Network activities evolved to include additional harm reduction measures: provision of food, cash, and referrals for benefits; social services; and SA treatment through single encounters of clients in the community and, with some, repeated interactions of a quasi-therapeutic nature. While outreach reduces risky drug use and sexual behavior, SA treatment can enhance HIV/AIDS prevention, especially through cessation of drug use. However, less than 5 percent of network outreach clients are referred and enter SA treatment. The street outreach population's central role in the spread of HIV/AIDS makes it essential to: (1) identify the barriers to SA treatment referral; and (2) elicit proposals for change to remove or reduce the barriers to SA treatment referrals for outreach clients. The purpose of this project is: (1) to identify possible sources of barriers to SA treatment referral such as the outreach client, outreach worker, outreach program, SA treatment programs, Health and AIDS institutions, and OASAS itself, including such concrete disincentives as inability to pay or lack of basic documents; (2) within each identified source, to determine the practices, policies, and attitudes that adversely affect referrals to treatment; and (3) to elicit proposals for change and means of remediation in each barrier domain.

Grant Details

Amount Awarded $348,808.00

Awarded on: 11/2/1999

Time frame: 11/1/1999 - 6/13/2001

Grant Number: 37859


Research Foundation for Mental Hygiene, Inc.

44 Holland Avenue
Albany, 12229-0001


Philip W. Appel
Project Director