November 30, 2009

After inpatient drug rehab programs, what support works best?

School of Medicine's Maxine Stitzer receives stimulus grant for research

Maxine Stitzer is a behavioral psychologist whose research focuses on both pharmacologic and behavioral approaches to treating substance abuse. Photo: Will Kirk/Homewoodphoto.jhu.edu

Maxine Stitzer is a behavioral psychologist whose research focuses on both pharmacologic and behavioral approaches to treating substance abuse. Photo: Will Kirk/Homewoodphoto.jhu.edu

This is part of an occasional series on Johns Hopkins research funded by the American Recovery and Reinvestment Act of 2009. If you have a study you would like to be considered for inclusion, contact Lisa De Nike at lde@jhu .edu.

One of the greatest challenges in helping substance abusers recover is ensuring that they have access to—and participate in—follow-up care, counseling and support after their release from inpatient rehabilitation programs.

Using a $959,822 National Institute on Drug Abuse grant funded by the federal stimulus act, Maxine Stitzer, a professor in the Johns Hopkins School of Medicine’s Behavioral Pharmacology Research Unit, will study what programs are most successful in helping encourage people coming out of inpatient treatment centers to enroll in care that will support their recovery.

“Recovery from substance abuse is a long-term process because of the chronic, relapsing nature of the disease. So continuing support is helpful for clients to be successful,” said Stitzer, a behavioral psychologist whose research focuses on both pharmacologic and behavioral approaches to treating substance abuse. “Our goal is to find out what methods will best help patients to enroll in outpatient care.”

In Stitzer’s study, clients leaving a single residential substance abuse program in Baltimore City will be referred to one of eight aftercare outpatient programs, and may be offered one of three added incentives to enroll; some clients will be given only referral to a convenient outpatient program where they can receive counseling and support to maintain their sobriety.

“We will offer some clients a ride directly from the residential treatment center to the outpatient program on the day they are released,” said Stitzer, who came to Johns Hopkins in 1974. “Other clients will be offered gift cards if they enroll and participate in outpatient treatment. Finally, some clients will be able to meet with a counselor from the outpatient program who will introduce them to the program and serve as a personal contact once they get there.”

According to Stitzer, each condition, including the usual care comparison, will be tested several times on a rotating basis during the two-year project, and up to 1,000 residential clients will be able to participate in the project. The main outcome measure is the percentage of clients from each study condition who enroll in the outpatient treatment programs.

Stitzer said she hopes that the study results will help policy-makers identify optimal methods for improving rates of continuing care among those recovering from drug dependence.

Stitzer’s study is one of 320 stimulus-funded research grants totaling nearly $157.4 million that Johns Hopkins has garnered since Congress passed the American Recovery and Revitalization Act of 2009 (informally known by the acronym ARRA), bestowing the National Institutes of Health and the National Science Foundation with $12.4 billion in additional money to underwrite research grants by September 2010. The stimulus package—which provided $550 billion in new spending, including the above grants, and $275 billion in tax relief—is part of President Barack Obama’s plan to kick-start a stagnant economy by doling out dollars for transportation projects, infrastructure building, the development of new energy sources and job creation, and financing research that will benefit humankind.

As of Nov. 18, 86 jobs had been created at Johns Hopkins directly from ARRA funding, including those for research technicians, lab assistants, research nurses, information technology people of various types, exercise physiologists and research administration trainees. In addition, positions have been saved when other grants ran out. Stitzer has hired three full-time research assistants for her project. They will be helping the residential clients with their aftercare planning and working with the outpatient clinics to provide a smooth transition for those who do decide to attend outpatient aftercare.