***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: We evaluated a case management intervention to increase treatment entry among injecting drug users referred from a needle exchange program ( NEP ) . A r and omized trial of a strengths based case management ( intervention ) versus passive referral ( control ) was conducted among NEP attenders requesting and receiving referrals to subsidized , publicly funded opiate agonist treatment programs in Baltimore , MD . Logistic regression identified predictors of treatment entry within 7 days , confirmed through treatment program records . Of 247 potential subjects , 245 ( 99 % ) participated . HIV prevalence was 19 % . Overall , 34 % entered treatment within 7 days ( intervention : 40 % versus control : 26 % , p=0.03 ) . In a multivariate " intention to treat " model ( i.e. , ignoring the amount of case management actually received ) , those r and omized to case management were more likely to enter treatment within 7 days . Additional " as treated " analyses revealed that participants who received 30 min or more of case management within 7 days were 33 % more likely to enter treatment and the active ingredient of case management activities was provision of transportation . These findings demonstrate the combined value of offering dedicated treatment referrals from NEP , case management and transportation in facilitating entry into drug abuse treatment . Such initiatives could be implemented at more than 140 needle exchange programs currently operating in the United States . These data also support the need for more accessible programs such as mobile or office-based drug abuse treatment ABSTRACT Using a sample of 453 veterans who received substance abuse treatment and were r and omly assigned to case management and non-case management  , this study examined both proximal ( aftercare participation ) and distal ( severity of legal problems ) measures of treatment outcomes . Multivariate analyses reveal that case-managed subjects stay longer in aftercare services than non-case managed clients . The longer post-treatment aftercare was related to better outcomes in criminality . The length of aftercare participation was also significantly associated with employment and readiness for treatment Integrated mental health and substance abuse treatment within an assertive community treatment ( ACT ) approach was compared to that within a st and ard case management approach for 223 patients with dual disorders over three years . ACT patients showed greater improvements on some measures of substance abuse and quality of life , but the groups were equivalent on most measures , including stable community days , hospital days , psychiatric symptoms , and remission of substance use disorder In many treatment systems , adolescents referred to residential treatment have the most serious alcohol or other substance use disorders and are at high risk of relapse . Upon discharge , these adolescents are typically referred to continuing care services , however , linkage to these services is often problematic . In this study , 114 adolescents ( 76 % male ) who stayed at least 7 days in residential treatment were r and omly assigned to receive either usual continuing care ( UCC ) or UCC plus an assertive continuing care protocol ( ACC ) involving case management and the adolescent community reinforcement approach . ACC participants were significantly more likely to initiate and receive more continuing care services , to be abstinent from marijuana at 3 months postdischarge , and to reduce their 3-month postdischarge days of alcohol use . Preliminary findings demonstrate an ACC approach design ed for adolescents can increase linkage and retention in continuing care and improve short-term substance use outcomes The present study was design ed to explore the relative efficacy of three types of service delivery intervention models for homeless men with alcohol and /or drug problems :  integrated comprehensive residential services provided at one site ( Group 1 ) ; on-site shelter-based intensive case management with referrals to a community network of services ( Group 2 ) ; and usual care shelter services with case management ( Group 3 ) . In addition to assessing the relative efficacy of these approaches in terms of drug and alcohol use , residential stability , economic and employment status , the project also sought to examine what personal factors best predicted successful outcomes for clients . Clients were assessed at baseline and approximately six months following discharge . All three treatment groups improved significantly over time in terms of reduced alcohol and cocaine use , increased employment , and increased stable housing , but no differential improvement was found among groups . Successful outcomes were predicted by lower recent and lifetime substance use , fewer prior treatment episodes , more stable housing at baseline , fewer incarcerations , and less social isolation Examining the correlates of aftercare participation is critical to program development and successful relapse prevention . This study assesses retention in an aftercare program of case management and peer support for formerly homeless recovering mothers .  Length of residential drug treatment , length of sobriety , strong support networks , and concerns about housing and parenting predicted completion of the case management component .  Emotional instability and the severity of problems were found to be correlated with participation in the peer support group . Sociodemographic characteristics were not related to program retention . The findings illustrate the need to tailor aftercare services to the level of clients ' recovery and the need for female-only aftercare groups where women can safely discuss physical and sexual abuse issues related to their misuse of drugs A clinical trial contrasted 2 interventions design ed to link opioid-dependent hospital patients to drug abuse treatment . The 126 out-of-treatment participants were r and omly assigned to ( a ) case management , ( b ) voucher for free methadone maintenance treatment ( MMT ) , ( c ) case management plus voucher , or ( d ) usual care . Services were provided for 6 months .  MMT  enrollment at 3 months was 47 % ( case management ) , 89 % ( voucher ) , 93 % ( case management plus voucher ) , and 11 % ( usual care ) ; at 6 months enrollment was 48 % , 68 % , 79 % , and 21 % , respectively . Case management and vouchers can be valuable in health setting s to link substance abusers with medical problems to drug abuse treatment CONTEXT Although posttraumatic stress disorder ( PTSD ) and alcohol abuse frequently occur among acutely injured trauma survivors , few real-world interventions have targeted these disorders . OBJECTIVE We tested the effectiveness of a multifaceted collaborative care ( CC ) intervention for PTSD and alcohol abuse . DESIGN R and omized effectiveness trial . PARTICIPANTS We recruited a population -based sample of 120 male and female injured surgical in patients 18 or older at a level I trauma center . INTERVENTION Patients were r and omly assigned to the CC intervention ( n = 59 ) or the usual care ( UC ) control condition ( n = 61 ) . The CC patients received stepped care that consisted of ( 1 ) continuous postinjury case management , ( 2 ) motivational interviews targeting alcohol abuse/dependence , and ( 3 ) evidence -based pharmacotherapy and /or cognitive behavioral therapy for patients with persistent PTSD at 3 months after injury . MAIN OUTCOME MEASURES We used the PTSD symptomatic criteria ( PTSD Checklist ) at baseline and 1 , 3 , 6 , and 12 months after injury , and alcohol abuse/dependence ( Composite International Diagnostic Interview ) at baseline and 6 and 12 months after injury . RESULTS R and om-coefficient regression analyses demonstrated that over time , CC patients were significantly less symptomatic compared with UC patients with regard to PTSD ( P = .01 ) and alcohol abuse/dependence ( P = .048 ) . The CC group demonstrated no difference ( -0.07 % ; 95 % confidence interval [ CI ] , -4.2 % to 4.3 % ) in the adjusted rates of change in PTSD from baseline to 12 months , whereas the UC group had a 6 % increase ( 95 % CI , 3.1%-9.3 % ) during the year . The CC group showed on average a decrease in the rate of alcohol abuse/dependence of -24.2 % ( 95 % CI , -19.9 % to -28.6 % ) , whereas the UC group had on average a 12.9 % increase ( 95 % CI , 8.2%-17.7 % ) during the year . CONCLUSIONS Early mental health care interventions can be feasibly and effectively delivered from trauma centers . Future investigations that refine routine acute care treatment procedures may improve the quality of mental health care for Americans injured in the wake of individual and mass trauma OBJECTIVE Clients with co-occurring severe mental and substance use disorders are at high risk of institutionalization and other adverse outcomes . Although integrated mental health and substance abuse treatment is becoming a st and ard clinical approach for such clients , the optimal method for delivering integrated treatment remains unclear . METHOD This study compared integrated treatment delivered within two different models of community-based case management ( assertive community treatment and st and ard clinical case management ) .  A total of 198 clients in two urban sites who had co-occurring disorders and were homeless or unstably housed were r and omly assigned to one of two treatment conditions and were followed for three years . RESULTS Participants in both treatment conditions improved over time in multiple outcome domains , and few differences were found between the two models . Decreases in substance use were greater than would be expected given time alone . At the site that had higher rates of institutionalization , clients who received st and ard case management were more likely to be institutionalized . However , in the site that had lower rates of institutionalization , no differences in the rate of institutionalization were found between the two treatment conditions . CONCLUSIONS Integrated treatment can be successfully delivered either by assertive community treatment or by st and ard clinical case management BACKGROUND People with severe mental illness and substance use disorders ( dual disorder ) often have considerable contact with the criminal justice system . AIMS To test the effects of client characteristics on six criminal justice outcomes among homeless ( at intake ) people with mental illness and substance misuse disorders . METHODS The sample was of participants in a r and omized controlled trial comparing st and ard treatment , assertive community treatment ( ACT ) and integrated treatment ( IT ) . Data were analysed using hierarchical logistic regression . RESULTS Half the sample was arrested and a quarter incarcerated during the two-year follow-up period . The regression models explained between 22 % and 35 % of the variance of the following criminal justice measures : ( 1 ) major offences , ( 2 ) minor offences , ( 3 ) substance-use-related offences , ( 4 ) incarcerations , ( 5 ) arrests , and ( 6 ) summons . Prior criminal behaviour was the strongest predictor of all of the dependent variables ; in general , demographic and diagnostic variables were not . Similarly , neither the type nor the amount of mental health treatment received predicted subsequent criminal behaviour . CONCLUSION Elsewhere the authors have shown that ACT and IT had advantages for health and stability of accommodation but these analyses suggest that more specialized interventions are needed to reduce criminal behaviour in dual disorder individuals Faced with many patients with comorbid severe mental illness and substance use disorders , a university-affiliated , inner-city community mental health center and a psychosocial rehabilitation center initiated this clinical trial assessing a program to care for these patients . Fifty-four patients , age 18 to 10 , with either schizophrenia or major affective disorder and a substance use disorder were r and omly assigned to usual community mental health center and rehabilitation services with or without an innovative group and intensive case management program . One-year follow-ups detected no significant advantages on patient outcomes for adding the innovative program to usual services . Failure to engage patients in the experimental program posed a major and enduring barrier to treatment , despite intensive case management . Future efforts must give greater consideration to effective engagement techniques and patients ' readiness for active treatment Early identification of patients with comorbid depression and their subsequent enrollment in an enhanced psychiatric case management ( PCM ) intervention were examined as an effective way to engage depressed substance abuse patients into psychiatric treatment . Depression was screened using the Global Appraisal of Individual Needs ( GAIN ) and a DSM-IV checklist . Patients positive on both evaluations were assigned to PCM ( n = 10 ) or to no case management , or treatment as usual ( TAU ) ( n = 10 ) . An examination of outcomes at six weeks indicated that PCM services are feasible and appear to be effective in encouraging use of psychiatric referral by depressed substance abusers AIMS Children whose parents abuse drugs are exposed to numerous factors that increase the likelihood of future drug abuse . Despite this heightened risk , few experimental tests of prevention programs with this population have been reported . This article examines whether intensive family-focused interventions with methadone treated parents can reduce parents ' drug use and prevent children 's initiation of drug use . DESIGN Parents were assigned r and omly into intervention and control conditions and assessed at baseline , post-test , and 6 and 12 months following the intervention . Children were assessed at baseline , and 6- and 12-month follow-up points . SETTING Two methadone clinics in Seattle , Washington . PARTICIPANTS One hundred and forty-four methadone-treated parents , and their children ( n = 178 ) ranging in age from 3 to 14 years old . INTERVENTION The experimental intervention supplemented methadone treatment with 33 sessions of family training combined with 9 months of home-based case management . Families in the control condition received no supplemental services . MEASUREMENT Parent measures included : relapse and problem-solving skills , self-report measures of family management practice s , deviant peer networks , domestic conflict and drug use . Child measures included self-report measures of rules , family attachment , parental involvement , school attachment and misbehavior , negative peers , substance use and delinquency . FINDINGS One year after the family skills training , results indicate significant positive changes among parents , especially in the areas of parent skills , parent drug use , deviant peers and family management . Few changes were noted in children 's behavior or attitudes . CONCLUSIONS Programs such as this may be an important adjunct to treatment programs , helping to strengthen family bonding and to reduce parents ' drug use This study evaluated the efficacy of 2 brief interventions for cannabis-dependent adults . A multisite r and omized controlled trial compared cannabis use outcomes across 3 study conditions : ( a ) 2 
    Output:
    
A single , large trial of case management with two arms , showed that case management was superior to psychoeducation and drug counselling in reducing drug use .
AUTHORS ' CONCLUSIONS There is current evidence supporting that case management can enhance linkage with other services .
However , evidence that case management reduces drug use or produce other beneficial outcome is not conclusive