Different Components of Opioid-Substitution Treatment Predict Outcomes of Patients with and Without a Parent with Substance-Use Problems * (Report‪)‬

PARENTAL ALCOHOL AND DRUG PROBLEMS increase children's risk of substance misuse, emotional difficulties, and other problem behaviors (Chassin et al., 1991; Knop et al., 1985; Moos and Billings, 1982; Russell, 1990). The risk for developing an alcohol-use disorder is associated almost equally to genetic and environmental factors (Prescott and Kendler, 1999; Schuckit, 1998; Schuckit and Smith, 2000); however, far less is known regarding the genetic and environmental factors underlying increased vulnerability to misuse of drugs other than alcohol. Within the domain of environmental influences, parental modeling of substance-use behaviors may influence children's beliefs and attitudes concerning the anticipated effects of substance use (i.e., expectancies). For example, adolescents with a heavy-drinking parent anticipate more reinforcement from alcohol than do those with no parental alcohol misuse (Brown et al., 1987). Although it is well established that having a parent with a substance-use problem increases risk for substance-use disorders (SUDs), less is known about the impact of having a substance-misusing parent on SUD treatment needs and outcomes. Limited evidence is available to recommend a particular intervention approach for adolescent substance users who have SUD parents. Nevertheless, family-based approaches have received increased attention in recent years because of consistent evidence for the role of the family factors in adolescent substance use (for a review, see Denton and Kampfe, 1994). Studies of the impact of parental or family SUD history on SUD treatment outcomes in adult patients have found mixed, and apparently conflicting, results (Coviello et al., 2004; Pickens et al., 2001; Poirier et al., 2004). Better understanding of the unique needs of this population may improve treatment planning and outcomes. Here we examine the impact of having a parent with an SUD on treatment process and outcomes in a population of heroin-dependent, polysubstance-using veteran patients entering opioid-substitution treatment (OST).