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The goal of the present study was to identify the dimensions present in items representing internal barriers to substance abuse treatment and to test their invariance across gender, ethnic, and age groups. Twenty items from the Barriers to Treatment Inventory (BTI) were used to assess the structure and nature of the internal treatment barriers of 518 clients presenting to a central intake unit for a substance abuse assessment. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) revealed that a five factor model provided the best fit to the data. Internal treatment barriers were best described by five dimensions: absence of problem, negative social support, fear of treatment, privacy concerns, and committed lifestyle. Extending the confirmatory factor analysis to test multi-group invariance, there were some differences in measurement and structural relations among the internal barrier dimensions across gender, ethnic, and age groups. However, the lack of invariance was small and practically insubstantial. The findings led to the conclusion that the theoretical constructs measured by the five internal barrier dimensions are equivalent across important characteristics in this population.

The latent growth model (LGM) has drawn increasing attention in behavioral studies using longitudinal data. The LGM captures the level and trajectory of behavior change, variation in both the initial status and the trend of behavior change, as well as the time-ordered covariation between the initial status and change. This study demonstrates how the LGM can be applied in the evaluation of intervention programs targeting HIV risk behavior among drug users. Multigroup piecewise latent growth models were fit to longitudinal data with three repeated response measures.

In a study examining the correspondence between self-reported drug use and drug urinalysis, 128 injection drug users (IDUs), who were subjects in an AIDS prevention research project, were asked to provide urine samples, which would be tested for the presence of the metabolites of opiates and cocaine. Ninety-five IDUs provided samples for testing. Of these, twenty IDUs (21.1%) who reported abstinence from opiates and cocaine for the six months prior to the completion of a follow-up questionnaire had their claims contradicted by urinalysis results. Logit regression analyses revealed that IDUs whose primary drug of choice was both crack and injected cocaine and those who were black were significantly more likely to have misrepresented their current drug use status than other groups. The implications of these findings are discussed.

Research focusing on active users of crack cocaine and how they interact with the health care system—drug abuse treatment in particular—is a new area of inquiry. Much of what is known about the problems associated with the use of crack comes from short-term studies. This article describes implementation and methodological issues related to conducting health services research with a natural history orientation among a population of active crack cocaine users (n = 444) in Dayton and Montgomery counties in Ohio. Data from this study can help define what addiction to crack really means as well as ways to prevent and treat it.