Drug Treatment Clients Research Articles

Individual, Family, and Contextual Factors Associated with Relapse among Afghan Drug Treatment Clients

The present study explored the family, peer, social, employment, and physiological associations with relapse of clients at treatment centers. A drug treatment center in Balkh, Afghanistan, was studied using a purposive sample of 15 in-depth qualitative interviews. The findings pointed to social pressure, stress coping, accessibility, and social acceptance as reasons behind the use and relapse of clients. The themes within these larger categories involved family factors, work factors, social exposure, collective decision-making, and social reasons as significantly affecting relapse. Individuals used substances to cope with grief, stress at home and work, marriage and family relationships, and to perform work tasks. Practical implications of study findings include the emphasis on multilevel intervention strategies.

Validation of the Australian Treatment Outcomes Profile for use in clients with cannabis dependence

The Australian Treatment Outcomes Profile (ATOP) was developed as a clinical tool for monitoring the substance use, health and wellbeing of clients in alcohol and other drug treatment. This is the first psychometric validation of the ATOP in a cannabis-dependent treatment population. A total of 128 individuals with cannabis dependence enrolled in an outpatient randomised controlled trial were administered the ATOP and gold-standard health and wellbeing questionnaires once by clinicians and once by researchers at baseline. Concurrent validity was assessed by testing ATOP Psychological Health, Physical Health and Quality of Life questions against concurrently administered gold-standard questionnaires: the Short Form 36 Health Survey (SF-36), the 21-item Depression, Anxiety and Stress Scale (DASS-21) and the Sheehan Disability Scale (SDS). Interrater reliability was tested by comparing clinician-administered ATOP items at the medical screening interview to the same ATOP items administered by researchers at baseline. ATOP Psychological Health showed moderate to strong correlations with SF-36 Mental Components, SF-36 Mental Health and DASS-21 scores (r = 0.40-0.52) and ATOP Physical Health with SF-36 Physical Components and SF-36 General Health scores (r = 0.36-0.67). The ATOP Quality of Life scale showed moderate agreement with the SDS and six-dimensional health state short form scales (r = 0.38-0.40). ATOP substance use, employment, education and child care items showed good to excellent interrater reliability (Krippendorff's α = 0.62-0.81), and tobacco use, Psychological Health, Physical Health and Quality of Life showed fair to moderate interrater reliability (Krippendorff's α = 0.42-0.53). The ATOP appears to be valid and reliable when tested in a population with cannabis-dependence, justifying its widespread use in clinical settings.

Using text messages to support recovering substance misusers

Background: The use of digital technology in health and social care is developing rapidly. It is promoted in UK policy and research which suggests varied results surrounding its implementation and outcomes. Introduction: This article aimed to test the implementation and outcomes of a short messaging service sent to a dedicated phone. The target cohort were drug treatment clients in two sites in Northern England. Materials and methods: Through staff focus groups and interviews with a small cohort of clients, the implementation and perceptions of the system were examined. Results: A total of 19 participants were recruited to site 1 (15 male, 4 female, average age=37.7 years) and 12 participants were recruited to site 2 (9 male, 3 female, average age=40.3 years). One outcome that was of interest was wellbeing in treatment which, in this study, was described as an overall sense of feeling better rather than just focusing on the rehabilitation aspect of the programme. Other outcomes included: the successful completion of treatment and for clients to report and instance of a relapse/re-presentation. Discussion: The system shows some evidence of its ‘social actor’ role; however, its implementation was hindered by staff citing that it called for increased resources. For future implementation, the use of clients' own phones may be considered which may help to embed the system more fully in recovery planning and targeting clients at a different treatment stage. Conclusions: Despite some indications of positive results for clients and a perception that the system may have value as an addition to existing clinical interventions, more evaluation is required to determine whether this system can be implemented in a drug treatment setting.

Secondary cannabis use among London drug treatment service clients

Background: Cannabis is the second most commonly used substance after alcohol among people seeking treatment for other drug use, but no statistics are available regarding secondary cannabis use among drug treatment clients.Objectives: To investigate levels of secondary cannabis use among drug treatment clients and perceived need for support addressing this use among clients and staff.Methods: Cross-sectional surveys of clients (N = 295) and staff (N = 33) were conducted in 2015 at four London drug and alcohol treatment services. Client measures included recent drug use, type of cannabis used, Severity of Dependence Scale for cannabis, and views on secondary cannabis use treatment. Staff measures included definition of problem cannabis use, importance and timing for addressing secondary cannabis use.Results: Among clients, 39.7% reported recent secondary cannabis use, with 30.8% of these clients meeting criteria for problem use. Problem users were more likely to be interested in receiving treatment for cannabis use than non-problem users (51.4% versus 10.8%, p < .001). Nearly half of staff (48.5%) thought secondary cannabis use should be addressed early in treatment.Conclusions: Two out of five drug treatment clients used cannabis and a third experienced cannabis-related problems. Many are willing to address cannabis use, but defined treatment pathways are needed.

Exploring mortality among drug treatment clients: The relationship between treatment type and mortality

AimsStudies consistently identify substance treatment populations as more likely to die prematurely compared with age-matched general population, with mortality risk higher out-of-treatment than in-treatment. While opioid-using pharmacotherapy cohorts have been studied extensively, less evidence exists regarding effects of other treatment types, and clients in treatment for other drugs. This paper examines mortality during and following treatment across treatment modalities. MethodsA retrospective seven-year cohort was utilised to examine mortality during and in the two years following treatment among clients from Victoria, Australia, recorded on the Alcohol and Drug Information Service database by linking with National Death Index. 18,686 clients over a 12-month period were included. Crude (CMRs) and standardised mortality rates (SMRs) were analysed in terms of treatment modality, and time in or out of treatment. ResultsHigher risk of premature death was associated with residential withdrawal as the last type of treatment engagement, while mortality following counselling was significantly lower than all other treatment types in the year post-treatment. Both CMRs and SMRs were significantly higher in-treatment than post-treatment. ConclusionBetter understanding of factors contributing to elevated mortality risk for clients engaged in, and following treatment, is needed to ensure that treatment systems provide optimal outcomes during and after treatment.

Opioid analgesics and heroin: Examining drug misuse trends among a sample of drug treatment clients in Kentucky

BackgroundIn an effort to mitigate Kentucky’s prescription drug misuse, legislative intervention efforts were introduced in 2012 and 2013 to better regulate pain clinics, prescribed use of opioid analgesics, and to expand the monitoring of opioid prescriptions. The focus of this paper is primarily on opioid analgesics and heroin and the relationship of use/misuse patterns of these drugs to state drug policy initiatives. MethodsA secondary data analysis of drug treatment clients (N=52,360) was conducted to project illicit drug use trends in Kentucky. This study describes temporal and geographic trends of self-reported illicit drug use among individuals in state-funded treatment in Kentucky between fiscal year 2010 and fiscal year 2013. ResultsSignificant reductions in the prevalence of illicit opioid use, declined from fiscal year 2010 to fiscal year 2013 (p<.01, CI=−.298 to −.215). However, heroin use rates significantly increased over the years studied, suggesting there may be a transition from prescription opioids to heroin (p<.01, CI=.143 to .178). The analysis suggests these trends may continue. ConclusionsFindings suggest Kentucky’s legislative efforts were effective in reducing illicit prescription opioid use, but heroin use has increased. One possible explanation for this relationship is that as prescription opioids became more difficult to obtain, users turned to heroin as a substitute. The finding of rising heroin use suggests a need for further policy initiatives to reduce heroin use, but the potential effectiveness of this policy remains unclear. Understanding trends may help to guide future policy efforts and pain management treatment strategies to where they might have their greatest impact.

Doing narrative feminist research: Intersections and challenges

This article contributes to social work methodological discussions by examining narrative feminist research in action. Our discussion considers our conceptualization and use of narrative feminist research, which is appreciative of intersectionality. We draw illustrative examples from four projects: (1) In the Name of Love, Women’s Narratives of Love, and Abuse (1998–2008), (2) Helping Alliances with Drug Treatment Clients (2010–2016), (3) In Good Company, Women, Companion Animals, and Social Work (2013–2014), and (4) Distress in Childbirth: A Social Work Perspective (in process). We also consider challenges associated with using narrative feminist research data as evidence. For all of the challenges currently facing narrative feminist researchers, we maintain that the methodology offers social workers many benefits and expansive, praxis-oriented possibilities.

The Montreal Cognitive Assessment (MoCA) is Sensitive to Head Injury and Cognitive Impairment in a Residential Alcohol and Other Drug Therapeutic Community

IntroductionRetaining clients in residential alcohol and other drug (AOD) treatment is difficult and cognitive impairment has been identified as a significant predictor of treatment dropout. The application of extensive screening for cognitive impairment is cost-prohibitive for most AOD treatment services. The current study aimed to explore cognitive functioning and impairment-associated factors in a typical sample of residential AOD clients using a free brief screening tool that could be utilised by front-line AOD services. MethodsResidents of an AOD therapeutic community (n=128) and a non-substance using control group (n=37) were administered a brief cognitive screening measure, the Montreal Cognitive Assessment (MoCA). MoCA total and domain scores were compared between these groups and within the AOD group examined in association with primary substance of misuse, severity of dependence, gender, psychological distress, and history of head injury. ResultsAlmost half (43.8%) of the AOD sample were identified as cognitively impaired, compared to 16.2% of the control group. Furthermore, 67.2% of the AOD sample had sustained head injuries and 50% of the sample required hospitalization for head injury. History of head injury was a significant determinant of cognitive impairment, and associated with greater levels of psychological distress. ConclusionsThere are high rates of inter-related cognitive impairment, head injuries, and psychological distress among clients in residential AOD treatment. Routine screening of clients at intake for cognitive impairment by means of a brief screening measure such as the MoCA, in combination with the assessment of history of head injuries and comorbid psychological disorders, could inform treatment modifications or adjunct interventions to increase retention and improve long-term outcomes.

A mixed-methods evaluation of the feasibility, acceptability, and preliminary efficacy of a mobile intervention for methadone maintenance clients.

Despite the recent explosion of behavioral health interventions delivered on mobile devices, little is known about factors that make such applications practical, engaging and useful to their target audience. This study reports on the feasibility, acceptability and preliminary efficacy of a prototype of a novel, interactive mobile psychosocial intervention to reduce problematic drug use among clients in methadone maintenance treatment (MMT). A mixed-methods pilot study with new MMT clients (n = 25) indicated that the mobile intervention approach was feasible, and that participants found the intervention highly acceptable and useful. On 100-point visual analog scale (VAS) items, participants reported high levels of liking the program (M = 75.6), and endorsed it as useful (M = 77.5), easy to use (M = 80.7), and containing a significant amount of new information (M = 74.8). When compared with 25 study participants who received standard MMT alone, pilot participants rated their treatment significantly higher in interestingness and usefulness, and were significantly more satisfied with their treatment. In qualitative interviews, participants reported using the mobile intervention in a range of settings, including during times of heightened risk for substance use, and finding it helpful in managing drug cravings. Additionally, pilot participants showed evidence of increased treatment retention and abstinence from illicit opioids (in terms of effect size) over a 3-month period relative to those in standard MMT, suggesting the application's potential to enhance treatment outcomes. These promising findings suggest that an evidence-based mobile therapeutic tool addressing substance use may appeal to drug treatment clients and have clinical utility as an adjunct to formal treatment.

Reproductive Health Needs Among Substance Use Disorder Treatment Clients.

Individuals with substance use disorders (SUDs) have unique reproductive health needs. The aim of this study was to evaluate these needs and assess the acceptability of family planning service delivery of SUD treatment clients. Reproductive health needs of drug treatment clients were assessed using a cross-sectional anonymous survey in 4 treatment sites in Baltimore City, MD. Surveys were distributed by staff. Contraceptives assessed included sterilization, intrauterine devices, implants, injections, pills, patches, rings, condoms, spermicide, withdrawal, and the rhythm method. Results are stratified by sex and between those using and not using highly effective contraceptive methods. A total of 115 women and 95 men completed the survey (80% younger than 50 years), with 39% of women and 54% of men reporting using condoms, but only 24% of women and 26% of men reporting consistent use. All other methods were used by less than 12% of the sample. Only 20% of sexually active women reported using a highly reliable form of contraception and only 53% were using any form of contraception at all. Contraceptive use correlated inversely with age, but did not correlate with having had sexually transmitted infection testing or other preventive health services. Although more than 90% of participants had access to health care services in the past 3 years, 25% of women and 33% of men reported difficulty accessing health care providers. The majority of respondents said they would likely use family planning services if available at their SUD treatment (83% of women and 58% of men). Men and women in SUD treatment have unmet reproductive health needs. As SUD treatment moves toward greater integration, the programmatic inclusion of family planning services should be considered.

Drugs-Related Death Soon after Hospital-Discharge among Drug Treatment Clients in Scotland: Record Linkage, Validation, and Investigation of Risk-Factors

We validate that the 28 days after hospital-discharge are high-risk for drugs-related death (DRD) among drug users in Scotland and investigate key risk-factors for DRDs soon after hospital-discharge. Using data from an anonymous linkage of hospitalisation and death records to the Scottish Drugs Misuse Database (SDMD), including over 98,000 individuals registered for drug treatment during 1 April 1996 to 31 March 2010 with 705,538 person-years, 173,107 hospital-stays, and 2,523 DRDs. Time-at-risk of DRD was categorised as: during hospitalization, within 28 days, 29–90 days, 91 days–1 year, >1 year since most recent hospital discharge versus ‘never admitted’. Factors of interest were: having ever injected, misuse of alcohol, length of hospital-stay (0–1 versus 2+ days), and main discharge-diagnosis. We confirm SDMD clients’ high DRD-rate soon after hospital-discharge in 2006–2010. DRD-rate in the 28 days after hospital-discharge did not vary by length of hospital-stay but was significantly higher for clients who had ever-injected versus otherwise. Three leading discharge-diagnoses accounted for only 150/290 DRDs in the 28 days after hospital-discharge, but ever-injectors for 222/290. Hospital-discharge remains a period of increased DRD-vulnerability in 2006–2010, as in 1996–2006, especially for those with a history of injecting.

Reproductive health needs among drug treatment clients

Reproductive health needs among drug treatment clients

Reproductive Health Needs Among Drug Treatment Clients

INTRODUCTION: Substance users are at increased risk of unintended pregnancy and sexually transmitted infections and human immunodeficiency virus (HIV). The objective of this study is to explore the prevalence of contraceptive use and reproductive health care uptake among drug treatment clients. METHODS: Between August 2012 and October 2013, clients of four Baltimore city drug treatment centers completed a one-time survey adapted from the National Survey of Family Growth. χ2 tests and logistic regression assessed associations between demographic variables and contraception use. RESULTS: A total of 95 men and 54 women participated. Most were younger than 50 years (74% women; 72% men), sexually active (68% women; 85% men), and did not desire pregnancy (74% women; 63% men). However, many did not use contraception most of the time (54% women; 39% men) with few women reporting use of a nonbarrier method (7%). Although condoms were the most common method (35% women; 45% men), only one fourth (28% women; 26% men) reported consistent use. Most women (70%) completed an obstetrics–gynecology appointment in the past year, but fewer had received an annual examination (37%), Pap test (53%), mammogram (20%), or HIV (59%) or sexually transmitted infection testing (45%). Contraception use among women was not associated with age (P=.7), parity (P=.7), self-rated health quality (P=.4), HIV (P=1.0), or hepatitis C virus status (P=1.0). Most (74% women; 57% men) stated they would definitely or maybe use family planning services at their treatment site if available. CONCLUSIONS: Drug treatment clients have high unmet reproductive health needs. Tailored family planning interventions are needed and should be incorporated into substance use programs.

Overall Gambling Behaviors and Gambling Treatment Needs Among a Statewide Sample of Drug Treatment Clients in Ohio

Casino gambling in Ohio became available for the first time in May 2012. This gambling expansion led the Ohio substance abuse monitoring (OSAM) Network, Ohio's drug abuse surveillance system that collects drug trend data on an ongoing basis, to amend its protocol in June 2011 to include collection of data related to problem and pathological gambling to inform current treatment and prevention needs. OSAM collected gambling data from July 2011 to June 2012 via focus group interviews of 714 drug users recruited from alcohol and other drug (AOD) treatment programs throughout Ohio. Participants who reported gambling during the past 6 months (N = 412) completed the South Oaks gambling screen. This study found a prevalence estimate of 12.1 % for probable pathological gambling among its statewide sample. Sizeable proportions of participants reported that they gambled more when using AOD (23.5 %) and used more AOD when gambling (19.4 %). A majority of study participants (59.2 %) reported participation in at least one type of gambling during the past 6 months, and of those participants, only 22.2 % reported ever having been asked about gambling while receiving AOD treatment services, with just 12.5 % reporting ever having had gambling treatment services offered to them. Men were 4.1 times more likely to screen positive for probable pathological gambling than women; non-Whites were 61.0 % more likely to screen positive than Whites. Findings presented in this report have the potential to help shape and strengthen problem and pathological gambling prevention and treatment measures in Ohio.

Factors influencing mortality among alcohol and drug treatment clients in Victoria, Australia: The role of demographic and substance use characteristics

Clinical studies consistently identify alcohol- and drug-related treatment populations as more likely to die prematurely compared with an age-matched general population. However, demographic characteristics and primary drug of concern as predictors of mortality risk following treatment have not been adequately explored. This paper examines relationships between substance use, demographic factors and mortality among alcohol and drug treatment clients. A retrospective cohort incorporating 7 years of data was utilised to examine mortality outcomes in the 2 years following treatment among Victorian clients recorded on the Alcohol and Drug Information Service (ADIS) database by linking partial client identifiers with the National Death Index (NDI). A cohort of 18,686 clients engaged in at least one course of treatment over a 12-month period was included. Analysis was of crude and standardised mortality rates across client groups in terms of the presenting drug of concern for treatment and demographic characteristics. A higher risk of premature death was associated with older age, being male, not being employed, living alone, medical and psychiatric comorbidity, recent injecting, and a history of intensive drug treatment access. Alcohol treatment clients had the worst prognosis. After adjustment for client characteristics, alcohol treatment clients experienced a significantly higher rate of death compared with other clients. Findings from these previously unexplored data highlight the need to increase awareness of the range and magnitude of risks associated with harmful alcohol use, and to identify approaches to enhance treatment effectiveness to reduce negative outcomes following treatment for populations at elevated risk of harm.

A record linkage study of hospital episodes for drug treatment clients in Scotland, 1996–2006

Despite drug users’ high mortality rates, their contacts with hospital and psychiatric treatment have received comparatively little quantification. We provide a comprehensive summary and characterisation of the hospital and psychiatric treatment episodes of a national cohort of drug treatment clients during 1996–2006. Drug treatment records were linked to national registers of deaths, hepatitis C virus (HCV) diagnoses and hospital and psychiatric episodes (hereafter hospital episode). Allowing for overdispersion, we calculated hospital episode rates (HERs) by main diagnosis at discharge; standardised hospital episode ratios (SHERs) during 2001/2002 to 2005/2006 only and Cox regression analyses of time-to-hospital-episode. The Scottish Drug Misuse Database (SDMD) cohort comprised 69,457 individuals and 350,317 person-years (pys) with 107,723 hospital episodes by 27,124 individuals: 70,094 hospital episodes occurred during 229,504 pys in 2001/2002 to 2005/2006. The five discharge-diagnoses with highest SHERs were: mental and behavioural disorders 40.3 (95% CI: 38.6–42.1), circulatory system disease 3.7 (3.5–4.0), infectious and parasitic diseases 3.7 (3.4–4.0), diseases of the skin and subcutaneous tissue 3.5 (3.4–3.7), injury, poisoning and other consequences of external causes 3.4 (3.3–3.5). HCV-diagnosed clients were at over twofold greater risk of hospital episode (hazard ratio (HR), for those without diagnosis, 0.41, 95% CI: 0.39–0.43) and alcohol misuse increased risk (HR: 1.69, 95% CI: 1.60–1.80). HERs and SHERs align with SDMD clients’ cause-specific mortality pattern. Interventions for drug treatment clients might incorporate preventive strategies to address the significantly elevated diagnosis-specific SHERs – in particular, dual diagnoses with mental illness.

Expertise and humanity: the supportive professional relationship from the perspective of clients in drug treatment

Expertise and humanity: the supportive professional relationship from the perspective of clients in drug treatment The importance of the relationship between professional and client is strongly highlighted in research that deals with psychotherapy as well as clinical social work and counselling. The aim of this article is to explore the characteristics of supportive professional relationships. The main question is what, from the clients point of view, constitutes such a relationship in psychosocial drug treatment. The study was performed in Sweden. The empirical data consist of qualitative interviews and focus groups with clients in four residential treatment centres where compulsory treatment takes place. On the basis of this data we identify five interactive and partly overlapping themes that together constitute the supportive professional relationship: (1) “A perfect match” – the professional as a person; (2) Physical and psychological presence; (3) Like friendship – but still not; (4) Trustful cooperation; and (5) Vehicle for flexible and multifaceted support. Expertise en menselijkheid: de ondersteunende professionele relatie in de verslavingszorg vanuit het perspectief van de client In onderzoek op het gebied van psychotherapie en sociaal werk wordt het belang van de relatie tussen professional en client onderstreept. Het doel van dit artikel is om de kenmerken van ondersteunende professionele relaties vanuit het perspectief van clienten binnen de verslavingszorg in kaart te brengen. Het onderzoek vond plaats in Zweden en omvatte kwalitatieve interviews en focusgroepsgesprekken met clienten in vier residentiele instellingen. Uit de analyse van dit kwalitatieve materiaal kwamen vijf interactieve en elkaar deels overlappende thema’s, tezamen kenmerkend voor een ondersteunende professionele relatie, naar voren: (1) “De perfecte match” – de professional als persoon; (2) Fysieke en psychische aanwezigheid; (3) Net als vriendschap – maar toch niet helemaal; (4) Betrouwbare samenwerking; (5) Een voertuig voor flexibele en meervoudige ondersteuning.

Ongoing cocaine and benzodiazepine use: Effects on acquisitive crime committal rates amongst opiate users in treatment

Aims: Research has shown that treatment for opiate use reduces crime, however the extent to which this is maintained is open to question. The objective of this study was to measure the relationship between crime committal rates and ongoing benzodiazepine and cocaine use by clients in opiate drug treatment programs.Methods: A national, prospective, longitudinal, multi-site drug treatment outcome study was conducted, 404 participants were recruited from inpatient and outpatient settings and 97% were located at 3 years. Drug use and crimes committed were ascertained from the Maudsley Addiction Profile of Marsden et al. [Marsden, J., Gossop, M., Stewart, D., Best, D., Farrell, M., Lehmann, P., … Strang, J. (1998). The Maudsley Addiction Profile (MAP): A brief instrument for assessing treatment outcome. Addiction, 93, 1857–1867].Findings: Analysis revealed that of those who had not committed an acquisitive crime at intake, those who used cocaine regularly at 1-year were 6.5 times more likely and those that used benzodiazepines regularly were eight times more likely to commit an acquisitive crime at 1-year. Of those who had committed an acquisitive crime at intake, those who used heroin regularly at 1-year were nine times more likely to commit acquisitive crime at 1-year than those who did not use heroin regularly at 1 year.Conclusions: Treatment must place greater emphasis on reducing substitute drug use if opiate treatment is to effectively sustain crime reduction.

Non-injection drug use and hepatitis C among drug treatment clients in west central Mexico

BackgroundResearch on hepatitis C virus (HCV) prevalence among non-injecting drug treatment clients in the United States, Europe and Asia indicate substantial differences by place. To date, little or no research on HCV and non-injection drug use (NIDU) has been conducted in Mexico. MethodsWe examined the prevalence of HCV, hepatitis B virus (HBV), and HIV among non-injecting drug users (NIDUs) in community-based drug treatment (N=122) and NIDUs in a prison-based drug treatment program (N=30), both located in west central Mexico. ResultsAmong the community clients, prevalence was 4.1% (95% confidence interval [CI]: 1.8–9.2) for HCV, 5.7% for HBV (95% CI: 2.8–11.4), and 1.6% for HIV (95% CI: 0.4–5.8). Among the in-prison clients, prevalence was 40.0% (95% CI: 24.6–57.7) for HCV, 20.0% for HBV (95% CI: 9.5–37.3), and 6.7% for HIV (95% CI: 1.9–21.3). None of the clients were aware of being infected. ConclusionThe HCV prevalence found for the NIDU community treatment clients ranks among the lower HCV estimates published for NIDUs in treatment to date. The prevalence found for the in-prison clients ranks among the higher, raising a concern of possible elevated HCV infection among NIDUs in the west central Mexico prison—one compounded by the finding that none of this study's clients knew they were HCV positive.

Dual diagnosis capability after an AOD workforce initiative

PurposeDissemination of good practice information to practitioners is one of the great challenges of the substance abuse treatment sector. The authors' understanding of the process by which research is translated is limited, but a whole of workforce approach is considered best practice. This paper aims to examine organisational change as a result of a workforce capacity‐building program over six months.Design/methodology/approachA total of 195 staff (nine service managers, 39 supervisors and 147 clinicians) in 13 alcohol and other drug (AOD) services across Australia participated in mental health screening and brief intervention training using PsyCheck. PsyCheck is designed to detect and address common mental health symptoms among drug treatment clients. The Dual Diagnosis Capability in Addiction Treatment (DDCAT) index was used to measure capacity before and after training.FindingsThere was no significant difference between baseline and follow‐up DDCAT scores; however, the level of PsyCheck implementation indicated improvement in DDCAT scores.Practical implicationsThe results show that where organisations implement the program successfully, capacity improves; where the program is not well implemented, capacity reduces. Successful implementers report a number of common elements: the screening tool was implemented into routine assessment; there was a single onsite “champion” supporting the implementation; and they worked with the staff and persisted with the implementation even where there was initial worker resistance.Originality/valueThis paper provides the opportunity to assess workforce capacity building and the feasibility of utilising the DCCAT to measure co‐occurring mental health and substance use disorders in Australian AOD services.