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Research Methods

LaShanda McMahon

University of Phoenix

Formulating the Problem Statement and the Purpose Statement

Over the past decade, there have been several changes in drug addiction treatment that has shown results that show reduced associated health and social costs by more than the cost of the treatments. It has been found that treatments cost much less that the alternatives, such as incarcerating people with addictions. There are many savings related to healthcare, which includes, total savings that can exceed costs with a ratio of 12 to 1. Major savings to the individual and to society also stems from fewer interpersonal conflicts; greater workplace productivity; and fewer drug-related accidents, including overdoses and deaths (Woody, M.D., 2018).

Problem Statement

A common misperception is detoxification cures the addiction, yet addiction is a chronic disorder requiring long term multimodal treatment (Korsmeyer et al., 2009. Long-term treatment for substance abuse and co-occurring disorders might reduce recidivism rates and lessen costs for rehabilitation. Goldstein, A. (1997). examined the benefits of long-term substance abuse and posited the benefits. Goldstein further suggested not treating addiction appropriately or at all contributes to the high costs associated with substance use in the United States.

Insurance companies are reluctant to support long term substance abuse treatment; however, Weisner, Ray, Mertens, Satre and Moore (2003) noted patients receiving a minimum of six months substance treatment abstained from drug and alcohol use at least five years after treatment yet abusers of alcohol were less likely to remain sober for lengthy periods of time after treatment (Weisner et al., 2003).

According to the National Drug Institute (2012), every dollar invested in substance abuse treatment yields a return of $5.50 in reduced drug-related crime, costs associated with criminal justice, and theft. Healthcare savings can exceed costs by a 12 to 1 ratio. Therefore, drug addiction treatment reduces costs associated with primary care and is less costly than incarceration. Addressing addiction also contributes to the more positive aspects of life, such as increase in work productivity, and fewer incidents related to drug use, fewer overdoses and deaths.

Purpose Statement

The purpose of this correlational study is to see if a relationship exists among periods of sobriety and four levels of substance abuse treatment. The research will examine substance abuse treatment throughout various levels of care:  higher levels (detox, Inpatient (IP), and Residential (RTC) and lower levels (partial hospitalization (PHP), Intensive Outpatient (IOP), and routine Outpatient (OP). Current trends in substance abuse treatment provides evidence that length of treatment is inadequate contributing to more frequent relapses among substance abusers. Longer treatment options for addiction may reduce the number of relapses, reduce costs associated with additional episodes of treatment, thereby providing health insurance providers options in coverage. Interviews will be conducted to gather personal information from patients and why they feel the need for drug usage.

Research Questions

The purpose of this correlational study is to see if a relationship exists among periods of sobriety and four levels of substance abuse treatment. The research will examine substance abuse treatment throughout various levels of care: higher levels (detox, Inpatient (IP), and Residential (RTC) and lower levels (partial hospitalization (PHP), Intensive Outpatient (IOP), and routine Outpatient (OP). Current trends in substance abuse treatment provide evidence that length of treatment is inadequate contributing to more frequent relapses among substance abusers. Longer treatment options for addiction may reduce the number of relapses; reduce costs associated with additional episodes of treatment, thereby providing health insurance providers options in coverage. Interviews will be conducted to gather personal information from patients and why they feel the need for drug usage.

RQ1:  Is there a relationship between longer stays and costs associated with those stays?

 

RQ2:  Is there a relationship between higher levels of substance abuse treatment and length of sobriety?

Method Selection and Justification

The chosen research method for this paper is a mixed methodology that combines quantitative and qualitative research in a single study. Research question RQ1 asked, determine the relationship between levels of multimodal substance abuse treatment and periods of sobriety? The data gathered from RQ1 will be collected by means of interviews, data from clinics and research conducted by National Institute of Health (NIH). The same survey will address RQ2, determine current trends in substance abuse treatment provides evidence that length of treatment is inadequate contributing to more frequent relapses among substance abusers. The qualitative data gathered will determine the opinions, information from insurance companies and feelings of the research participants.

The justification to use this methodology provides philosophical conventions to direct the gathering and analysis of information using a combination of quantitative and qualitative styles in the research progression. The main principle of using both quantitative and qualitative approaches is to obtain a better understanding of the research problems than with either methodology alone (Burke & Onwuegbuzie, 2016).

Design Method and Justification

Although substance abuse is a growing epidemic in the United States there is a disconnect regarding the treatment approach for substance abuse. Perhaps there are inadequacies in treatment plans and the length of treatment. Statistics provided by the Center for Behavioral Health Statistics and Quality (2015), confirm that 21.5 million individuals aged 12 and older were diagnosed with a substance use disorder in 2014, and of that number 80% also engaged in alcoholism. What this means is that one out of eight people were diagnosed with a substance use disorder and alcohol use disorder. These are two different substance classes that warrant modified treatment plans and increased length of treatment. Substance abuse i nationwide issue, and global issue. In fact, the World Health Organization (2016), disclosed that 5.4% of the global population struggle with substance use disorder and alcoholism. Fortunately, substance abuse and alcohol use disorders are treatable diseases and recovery is possible; however, the outcomes vary and is dependent on the length of treatment provided. Unfortunately, many times the course of treatment and length of treatment are determined by third parties, primarily by private insurance companies and even some state funded health plans, such as Medicaid. Medicare has an allotted number of days one can seek treatment for these disorders, and the days allotted are lifetime days and not number of days per treatment episode. For instance, Medicare allots a total of 190 lifetime days for treatment (Medicare, n.d.). Once the days are utilized, the patient will then be financially responsible for future treatment episodes, which is costly and sometimes unattainable. These factors can negatively impact treatment and an individual’s chance of remaining sober or even achieving sobriety. This study will focus on long-term treatment episodes versus short-term treatment episodes and relapse probability, and the costs associated with treatment episodes.

The research design that will be utilized will be the quasi-experimental design, because it is not feasible to assign random therapy to some individuals. It does not have the time and logistical constraints associated with true experimental designs. Reaction to test subjects are more likely to be genuine, it’s useful in identifying general trends, and it reduces the difficulty and ethical concerns. Quasi-experimental reduces the time and resources because pre-screening and randomization is not required and threats to validity are identified and addressed in the research design to minimize impact.

References

Burke, R., & Onwuegbuzie, J. (2016). Mixed methods research: A research paradigm whose time has come. Educational Researcher, 33(7), 14-26. doi:10.3102/0013189X033007014

Center for Behavioral Health Statistics and Quality (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health. HHS Publication No. SMA 15-4927, NSDUH Series H-50. Retrieved from http://www.samhsa.gov/data/

Goldstein, A. (1997). The selfish brain: Learning from addiction. Addiction, 92(12), 1789. Retrieved from https://search-proquest-com.contentproxy.phoenix.edu/docview/199681706?accountid=134061

Korsmeyer, P. & Kranzler, H.R. (2009). Myths about addiction and its treatments. Encyclopedia of Drugs, Alcohol, & Addictive Behaviors (3rd ed). Vol. 3, pp. 93. Detroit: Macmillan References USA.

Medicare (n.d.). Your Medicare coverage: Mental health care (inpatient). Medicare, The Official U.S. Government Site for Medicare. See https://www.medicare.gov/coverage/inpatient-mental-health-care.html

National Institute on Drug Abuse (NIDA) (2012). Principles of Drug Addiction Treatment: A research-based guide, (3rd ed). Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment

National Institute on Drug Abuse. (2017, April 24). Trends & Statistics. Retrieved from https://www.drugabuse.gov/related-topics/trends-statistic

Woody, M.D., G. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). Retrieved from National Institute on Drug Abuse (NIDA) website: https://d14rmgtrwzf5a.cloudfront.net/sites/default/files/675-principles-of-drug-addiction-treatment-a-research-based-guide-third-edition.pdf

World Health Organization (2016). Resources for the prevention and treatment of substance use disorders. Global Health Observatory (GHO) Data. Retrieved from http://www.who.int/gho/substance_abuse/en/