Katrina and Rita—Who got treated? J. C. Maxwell, University of Texas at Austin, Gulf Coast Addiction Technology Transfer Center D. Podus, University of California at Los Angeles, Integrated Substance Abuse Programs David Walsh, Texas Department of State Health Services This poster reports on the effects of Hurricanes Katrina and Rita on substance abuse treatment in Texas. Findings are based on a Percentage of Katrina and Rita Admissions secondary analysis of the Texas Department of State Health Services’ client treatment data on 711 hurricane-related admissions by Treatment Program Location (567 unduplicated) and on interview data from a sample of 20 staff in 11 treatment programs. Data on 17 clients displaced by both Katrina and Rita were excluded from this analysis. Some 66% of the Katrina clients were from out-of-state, and 71% of these non- residents had been born in New Orleans. All but 2% of the Rita clients were Texas residents, with 66% being residents of the Beaumont-Port Arthur area and 15% living in the Houston metropolitan area. 3% 8% Characteristics of Katrina and Rita Disaster Clients DISCUSSION Admitted to Treatment between 9/1/05 and 1/31/06 9% 20% Katrina Rita 1. Katrina and Rita clients differed in primary drugs of abuse 52% and treatment modalities. 5% Number 369 181 Average Age (years) 38.9 34.1 2. Katrina clients were more likely to leave treatment quickly Avg. # Months Employed Past Year 3.7 4.0 (modal length of stay of 3 days vs. Rita bi-modal length of 1% Average Education (years) 11.5 11.7 stay of 6 or 28 days). Of those who did not drop out, mean % Male 71.0 55.2 length of stay was 34.8 days for Katrina and 23.5 days for Rita. % History IV Use 67.8 29.3 Primary Problem Substance of Katrina % African American 58.3 29.8 3. Both groups had low socioeconomic status and education and Rita Admissions levels, so counseling and training is needed to help them % Anglo 37.7 60.8 adjust to work environments. % Hispanic 3.3 6.1 4. Because of short stays, most Katrina clients did not receive Katrina Rita mental health screenings, but a consistent proportion of Rita 70% Number of Days of Problems Reported on the 61% clients entered treatment some time after the disaster and 60% Addiction Severity Index in Month Prior to Admission were still reporting mental health problems. As Katrina 50% Katrina Rita clients become settled, the demand for mental health Drug/Alcohol Problems 10.6 15.9 services should increase. 40% Employment Problems 8.8 15.7 5. PTSD is a problem for many clients and counselors need 30% 26% 20% Family Problems 6.0 12.4 training in trauma and PTSD. In addition, program staff are 20% 15%14% 16% Psychological Problems 6.2 11.6 also at risk for disaster-related stress. 8% 9% 6. Publicly-funded methadone slots were scarce in Houston 7% 6% Sickness/Health Problems 4.4 5.7 10% 5% 0 1% 1% 3% 2% Social/Peer Problems 5.6 11.8 prior to the hurricanes and the demand has increased 0% Heroin Other Alcohol Amphet Powder Crack Cannabis Other substantially since then. Opiates /Meth Cocaine Cocaine Drugs 7. FEMA should provide funds for substance abuse treatment Status of Clients at Discharge and Services Received as with mental health services. Katrina Rita 8. Programs and clients will have to adapt to changing client % Completed Treatment 19.9 56.9 demographics. Serving the changed client population will % Abstinent in 30 Days Prior to Discharge 45.8 72.6 require cultural competence training for clients and staff. Percentage of Katrina and Rita Clients % Left Against Medical Advice 41.7 15.3 9. Methadone programs were unable to verify status of Admitted to Treatment in Texas by Month % Discharged for Non-Compliance with Rules 7.1 16.1 evacuee patients and off-site secure client records and % Referred to Other Services at Discharge 59.0 90.3 centralized state registries are needed. % Received Methadone Services 68.0 0.04 10. All programs should have memoranda of agreement with 80% 72% Katrina Rita % Received Detoxification Services 9.4 10.6 similar programs in other areas to facilitate rapid transfer of 70% % Received Residential Services 12.8 44.1 patients. % Received Outpatient Drug-Free Services 9.2 38.8 11. Changes in substance use patterns after disasters should be 60% % Received Services for Co-Occurring Disorders 2.5 6.1 monitored. 50% 12. All hazards disaster plans should be implemented now. 40% 27% 30% 21% 23% 24% Presented at the College on Problems of Drug Dependence, 2006 20% 12% Contact Jane Maxwell, Center for Excellence in Epidemiology, Gulf Coast Addiction Technology Transfer Center 5% 6% 5% 5% 10% email@example.com or 512 232-0610. 0% Supported by the Center for Substance Abuse Treatment Grant UD1 TI13423 Sept. Oct. Nov. Dec. Jan.