From: [e--e--s] at [access.digex.net] (enews)
Newsgroups: talk.politics.drugs
Subject: Substance Abuse Report
Date: 6 Sep 1994 16:34:03 -0400

The featured article from the July 15 issue of Substance Abuse Report 
looks at problem drinking. Here is an excerpt from "KAISER HMO AND DUPONT 
MERCK STUDY COST BURDEN OF DRINKING."
______________________________________________________________________________
     Kaiser Permanente wants to find out how costly its 
members' problem drinking is to the health maintenance 
organization. DuPont Merck Pharmaceutical Company is interested 
in positioning its drug, naltrexone, for use in the treatment 
of alcoholism. The two companies, SAR has learned, are 
conducting a joint research project designed to determine the 
costs of drinking in a managed care population. And the study, 
the first to measure the costs of low but problematic levels of 
alcohol use, is likely to have ramifications far beyond the two 
companies which are funding it.

     The purpose of the study from Kaiser's point of view is
to find out how drinking, combined with other lifestyle
behaviors, contributes to a person's health (or lack of it).
Since an HMO assumes financial risks of treatment, it is in an
HMO's interest to keep its members healthy. While much is known
about the burden of alcoholism on medical utilization, very
little is known about the burden of moderate to heavy alcohol
use -- drinking too much or at the wrong time but not being
dependent. This lack of information is of concern to HMOs like
Kaiser which must care for such problems as part of providing
standard care.

     "We're looking at all kinds of drinking, not just
abuse," explains Enid Hunkeler, senior investigator in charge
of the project at Kaiser's division of research in Oakland.
"Then we'll look at utilization and cost of care." The study's
goal is not to single out alcoholics, but to contribute to the
overall health of the HMO's members. "We already have a
well-advertised alcohol and drug program," says Hunkeler. "We
have a clear dedication to those services."

11,000 interviews

     Interviews of the sample -- a whopping 11,000 members
of a Kaiser plan -- are to begin July 25. Chosen randomly, the
plan members will be asked about the amount and frequency of
alcohol use in the last year and in the last month. They will
also be asked about social or medical problems related to their
drinking. Questions will cover seven general areas, according
to an abstract of the research proposal obtained by SAR. These
areas are: medical status, employment, drug use, crime, family
and social relations, psychiatric status, and health services
utilization.

     The interviews will be conducted by Modern Psychiatric
Systems, part of the Philadelphia-based Treatment Research
Institute. "We're expecting to see a direct-line correlation"
between drinking and utilization, says A. Thomas McLellan,
Ph.D., scientific director of the Treatment Research Institute.
The interviewing phase is expected to last through the winter.
How will McLellan's interviewers know they are getting accurate
answers about alcohol use and the other areas of questioning?
"There's no sure way to know," he admits. "But you explain to
them that it has nothing to do with the insurance plan."
_____________________________________________________________________________

So begins this issue's featured article from Substance Abuse Report.

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