The Addiction Severity Index ASI Across Cultures 2005

The Addiction Severity Index (ASI) Across Cultures 2005 NIDA International Forum June 17 th, 2005 Workshop II - The Ireland Room B Thanks to NIDA: Steve Gust & Erin Winstanley TRI science addiction

The Addiction Severity Index (ASI) Across Cultures Today’s Presenters: TRI science addiction

Nasser Loza, Egypt Selection, Modification and Inter-rater Reliability on the use of the ASI in Egypt Sample: Adult Inpatient Hospital Program in Cairo TRI science addiction

Gerasimos Papanastasatos, Greece Elaborating and using the ASI across different national realities and treatment conditions – The Europ. ASI in Greek Treatment Programmes Sample: Adults in 6 Drug-Free Therapeutic Communities in Greece TRI science addiction

Richard Isralowitz, Israel Understanding the Israeli addict population – ASI profiles of former Soviet Union and native Israeli opiate abusers Sample – Adults in detoxification, day treatment and methadone maintenance programs TRI science addiction

Debra Wilson & Pauline Murnin, Ireland Incorporating the ASI: Exploring assessment and outcomes in a residential treatment facility in Northern Ireland Sample: Adult Residential Treatment Facility in Northern Ireland TRI science addiction

Flavio Pechansky, Brazil The Brazilian experience on the implementation of the ASI – where are we right now? Sample: Adult Cocaine Abusers @ HIV clinics in Brazil and a Validity Study of the ASI 6 TRI science addiction

Richard Rawson, USA Experiences using the ASI in different countries. and… TRI science addiction

Deni Carise, USA ASI International Use and Data from 10 Countries TRI science addiction

Introduction The ASI has been translated and modified for use in many countries. In addition to those presenting here, researchers and clinicians in the following countries have used the ASI: TRI science addiction

Countries Introduction Thailand Scotland Hungary Ukraine The Netherlands Sweden Iran Pakistan Spain Italy Belgium Canada The Caribbean Chile Guatemala Morocco Tunisia Portugal Russia Norway TRI science addiction

Deni’s Presentation Introduction Today, data are presented from the US Drug Evaluation Network System and various samples in: Belgium Brazil Greece Ireland Italy Norway Russia Scotland Sweden TRI science addiction

Data Sets TRI science addiction

Introduction Data Sets USA Deni Carise & A. Thomas Mc. Lellan 8, 479 patients from 14 inpatient/ residential, 4 methadone maintenance and 18 out-patient treatment programs Brazil Flavio Pechansky & Felix Kessler 193 cocaine-dependent clients from 3 HIV Clinics TRI science addiction

Introduction Data Sets Greece Gerasimos Papanastasatos & Erianna Daliani 500 clients from 4 residential and 2 OP programs Ireland Debra Wilson & Pauline Murnin 162 clients from 1 inpatient program TRI science addiction

Introduction Data Sets Belgium 1 Joke De Wilde 117 Clients from 4 adult residential drug-free TC’s Belgium 2 Veerle Raes 3, 712 clients from a large drug addiction treatment program

Data Sets Italy Joke De Wilde 101 clients from 5 adult residential drug-free TC’s Norway Edle Ravndal 482 clients from 10 IP, 4 MM, 3 OP youth and 4 youth “collectives”. Russia Evgeny Krupitsky 332 clients from 1 adult hospital detox & treatment program. TRI science addiction

Data Sets Scotland Rowdy Yates 134 clients from 1 adult OP drug treatment program. Sweden Jonas Larsson, David Oberg & Bjorn Sallmen 201 prisoners from 16 SA prison-based treatment programs TRI science addiction

Data Sets TRI science addiction

Data Presented: • Age • Gender • Alcohol & Drug Composite scores • Days heavy drinking • Days used marijuana • Days used cocaine TRI science addiction

Data Presented: • • • Medical, Psychiatric, Family and Legal: Composite Scores Days problems Days conflicts Percent reporting symptoms Illegal behavior Employment variables TRI science addiction

International Data Belgium 1 Brazil Greece Ireland Italy Norway Russia Scotland Sweden U. S. A. Sample N Age (SD) % Male 117 193 500 162 101 482 332 134 201 8429 24 (6) 26 (5) 41 (10) 28 (4) 31 (8) 23 (0) 27 (6) 36 (11) 35 (11) 84 89 84 69 88 67 74 68 95 66

International Data – Drug & Alcohol Alc. CS Drink 5+ Drg. CS Cocaine Cannabis Belgium 1 . 11 (. 19) 2 (5) . 17 (. 13) 1 (5) 5 (8) Brazil . 25 (. 20) 10 (9) . 19 (. 10) 13 (10) 21 (11) Greece - 0 (2) . 21 (. 11) 0 (2) 2 (6) Ireland . 67 (. 26) 16 (10) . 07 (. 14) 0 (1) 3 (8) Italy . 20 (. 27) 6 (11) . 26 (. 17) 2 (6) 8 (12) Norway . 08 (. 14) 2 (6) . 31 (. 13) 0 (3) 10 (12) Russia . 28 (. 00) - . 08 (. 01) - - Scotland . 07 (. 18) 4 (9) . 43 (. 09) 1 (4) 16 (13) Sweden . 52 (. 28) 13 (12) . 05 (. 09) 1 (4) 2 (7) U. S. A. . 21 (. 26) 3 (7) . 12 (. 13) 3 (7) 2 (6)

International Data – Medical & Psychiatric Med. CS Med. Prob. Psy. CS % Dep. Psy. Prob. Belgium 1 . 35 (. 32) 10 (12) . 49 (. 24) 38 13 (12) Brazil . 24 (. 28) 12 (9) . 23 (. 22) 21 15 (11) Greece . 21 (. 29) 4 (8) . 21 (. 18) 21 9 (11) Ireland . 40 (. 41) 11 (13) . 48 (. 26) 59 18 (13) Italy . 17 (. 23) 2 (6) . 38 (. 26) 27 9 (12) Norway . 25 (. 32) 8 (12) . 27 (. 23) 33 11 (13) Russia . 23 (. 01) - . 25 (. 01) - - Scotland . 34 (. 39) 8 (5) . 32 (. 26) 64 11 (12) Sweden . 34 (. 37) 10 (14) . 24 (. 21) 28 9 (13) U. S. A. . 17 (. 30) 5 (10) . 19 (. 23) 30 8 (11)

International Data – Family & Legal Fam. CS Conflicts Leg. CS Illegal Act Work Emp. Prob. Belgium 1 . 20 (. 22) 2 (6) . 34 (. 23) 2 (7) 2 (5) 4 (8) Brazil . 24 (. 21) 10 (10) . 12 (. 17) 8 (9) 22 (9) 9 (10) Greece . 34 (. 20) 5 (9) - 1 (5) 3 (8) 5 (13) Ireland . 29 (. 26) 7 (11) . 09 (. 19) 0 (3) 4 (8) 6 (11) Italy . 36 (. 26) 7 (11) . 30 (. 29) 6 (10) 4 (9) 1 (1) Norway . 16 (. 19) 4 (9) . 31 (. 28) 10 (13) 5 (10) 3 (9) Russia . 41 (. 01) - . 17 (. 02) - - - Scotland . 38 (. 23) 6 (8) . 40 (. 25) 17 (13) 1 (5) 9 (11) Sweden . 18 (. 20) 3 (8) . 28 (. 13) 4 (10) 5 (10) 8 (13) U. S. A. . 16 (. 21) 3 (7) . 18 (. 21) 1 (4) 8 (10) 8 (12)

Larger Belgium Data Set Belgium 2 Veerle Raes Data collected 1998 - 2004 3, 712 interviews 383 Inpatient; 3, 329 Outpatient All collected from a large “illegal drug addiction treatment program” (may under-represent alcohol use). TRI science addiction

USA vs. Belgium Data by Modality U. S. A. (IP) Belgium 2 (IP) U. S. A. (OP) Belgium 2 (OP) Sample N 3, 133 383 3, 885 3, 329 Age (SD) 36 (11) 25 (6) 33 (10) 27 (7) % Male 71 86 77 82 Alc. CS . 33 (. 27) . 1 (. 2) . 16 (. 23) . 1 (. 1) Drink 5+ 5 (9) 2 (5) 2 (6) 3 (6) Drg. CS . 11 (. 14) . 2 (. 1) . 09 (. 11) . 2 (. 1) Cocaine 3 (8) 2 (5) 2 (6) 2 (5) Cannabis 2 (6) 4 (8) 2 (6) 11 (12)

USA vs. Belgium Data by Modality U. S. A. (IP) Belgium 2 (IP) U. S. A. (OP) Belgium 2 (OP) Med. CS . 16 (. 29) . 3 (. 3) . 15 (. 28) . 2 (. 3) 4 (9) 8 (11) 5 (10) 7 (11) Psy. CS . 20 (. 24) . 3 (. 2) . 16 (. 22) . 2 (. 2) % Dep. 31 34 25 30 8 (12) 14 (12) 6 (11) 10 (11) Fam. CS . 15 (. 21) . 3 (. 2) . 13 (. 20) . 1 (. 2) Conflicts 3 (8) 2 (7) 2 (6) Leg. CS . 20 (. 22) . 3 (. 2) . 18 (. 20) . 2 (. 2) Illegal Act 1 (5) 3 (7) 1 (4) 1 (5) Work 8 (10) 1 (5) 9 (11) 8 (11) Emp. Prob. 8 (12) 3 (8) 9 (12) 5 (10) Med. Prob. Psy. Prob.

Conclusions TRI science addiction

Conclusions Data presented just for discussion - No conclusions please! Data were collected from too many different locations (prisons, HIV clinics, in patient, outpatient treatment programs) and from too many different samples (opiate only users, primary alcohol users, an all inpatient sample, an outpatient only sample, etc. ) for valid comparisons to be made. TRI science addiction

Limitations TRI science addiction

The End TRI science addiction