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Assessment and Treatment of Co-occurring Eating Disorders in Publicly Funded Addiction Treatment Programs

Dr. Gordon is affiliated with the Research Department, Seabrook House, 133 Polk Ln., P.O. Box 5055, Seabrook, NJ 08302-5055 (e-mail: sgordon{at}seabrookhouse org). Dr. Johnson and Dr. Roman are with the Institute for Behavioral Research, University of Georgia, Athens. Dr. Greenfield is with the Department of Psychiatry, Harvard Medical School, Boston, Massachusetts. Dr. Cohen is with the School of Social Work, Columbia University, New York City. Dr. Killeen is with the Clinical Neuroscience Division, Institute of Psychiatry, Medical University of South Carolina, Charleston.

OBJECTIVE: Publicly funded addiction treatment programs were surveyed to increase understanding of treatment options for persons with co-occurring eating and substance use disorders. METHODS: Data were collected between 2002 and 2004 from face-to-face interviews with program directors of a nationally representative sample of 351 addiction treatment programs. RESULTS: Half of the programs screen patients for eating disorders; 29% admit all persons with eating disorders, and 48% admit persons with eating disorders of low severity. Few programs attempt to treat eating disorders. Programs that admit and treat patients with eating disorders are more likely to emphasize a medical-psychiatric model of addiction, use psychiatric medications, admit patients with other psychiatric disorders, and have a lower caseload of African-American patients. CONCLUSIONS: Generally, patients with co-occurring eating and substance use disorders do not appear to receive structured assessment or treatment for eating disorders in addiction treatment programs. These results highlight the need for education of addiction treatment professionals in assessment of eating disorders.

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