James L Sorensen
Biographic Data
| ID | 4088826 |
|---|---|
| NAME | James L Sorensen |
| GIVEN NAMES | James L |
| FAMILY NAME | Sorensen |
| SIGNATURE | SORENSEN J L |
| AFFILIATIONS | University of California, San Francisco |
| ORCID | 0000-0003-1713-9650 |
| VERIFIED | Yes |
| TOTAL WORKS | 42 |
| TOTAL CITATIONS | 76 |
| AUTHOR COUNT | 42 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1978 |
| LATEST PUBLICATION YEAR | 2025 |
| H-INDEX | 5 |
Barriers to Buprenorphine Treatment Among People Experiencing Homelessness
People experiencing homelessness (PEH) face a high risk of opioid-related deaths, yet there is limited qualitative data on the barriers encountered when accessing buprenorphine treatment for opioid use disorder (OUD). To address this gap, we interviewed 28 clinicians, outreach workers, and administrators from organizations serving PEH with OUD. Our goal was to understand the barriers and facilitators at the patient, clinic, and institutional leve…
Ethical Issues in Treating Substance Use Disorders
Ethical issues arise frequently in the treatment of substance use disorders (SUD). Counselors need guidance to navigate ethical dilemmas but receive limited training in resolving ethical issues. To narrow the gap between the ethical dilemmas counselors face and their training, this qualitative study assessed ethical issues that counselors encounter, how they resolve them, and desired training. We conducted qualitative individual interviews with 2…
Substance use Attitudes, Beliefs, Experience, and Knowledge Among Nursing and Nursing Assistant Students
Stigma is a public health concern. Stigmatizing attitudes toward persons with substance use disorders (SUDs) can adversely impact clinical care and outcomes. Beliefs about SUD, prior experience and familiarity to persons with SUD, and educational curricula drive attitudes among health-care workers. In 2019, nursing and nursing assistant students were recruited through an online survey platform. Participants completed an SUD knowledge test and a s…
Physician Mistrust, Medical System Mistrust, and Perceived Discrimination
Process evaluation of a community outpatient program treating substance use disorders
Addiction treatment can improve its impact by providing evidence‐based care for the variety of problems that accompany substance use disorders. We conducted a retrospective evaluation of a new treatment program in California that aimed at providing multifaceted services through affiliated licensed and certified outpatient providers. The process evaluation used a logic model, focusing on program inputs, activities, and outputs, to understand the s…
Does substance use compromise depression treatment in persons with HIV? Findings from a randomized controlled trial
Depression and substance use are significant obstacles to effective HIV care. Using data derived from a randomized controlled trial of persons with HIV who are homeless or marginally housed, this study assesses the utility of antidepressant treatment among persons with HIV, depression, and active substance use. Participants were diagnosed with depressive disorders and randomly assigned to receive directly observed therapy with fluoxetine or a ref…
Structural factors affecting Asians and Pacific Islanders in community-based substance use treatment
Asians and Pacific Islanders (API) have large disparities in utilization of substance use treatment compared to other racial groups. In this study, we analyzed factors that shape API experiences accessing and engaging in community-based treatment from the perspective of treatment providers. We conducted semi-structured interviews with 40 treatment providers who work with API clients in treatment programs in San Francisco and Los Angeles. We analy…
Temporal Relationship of Sex Risk Behaviors and Substance Use Severity Among Men in Substance Use Treatment
Sex risk behaviors and substance use are intertwined. Many men continue to engage in high-risk sexual behaviors even when enrolled in substance use disorder (SUD) treatment. We hypothesized that changes in sex risk behaviors would coincide with changes in drug/alcohol use severity among men in SUD treatment. During an HIV risk-reduction trial, men in methadone maintenance and outpatient drug-free treatment (N = 359) completed assessments at basel…
Perceived discrimination among racial and ethnic minority drug users and the association with health care utilization
People who use drugs (PWUDs) are at increased risk for several medical conditions, yet they delay seeking medical care and utilize emergency departments (EDs) as their primary source of care. Limited research regarding perceived discrimination and PWUDs' use of health care services exists. This study explores the association between interpersonal and institutional racial/ethnic and drug use discrimination in health care settings and health care u…
Development of an Instrument to Characterize Methodological and Collaborative Factors that May Influence Community-Based Clinician Post-Trial Adoption of Clinical Research Interventions
Smoking cessation interventions with female smokers living with HIV/Aids
Smoking among people living with HIV, particularly women living with HIV, is associated with higher morbidity and mortality rates when compared to nonsmoking individuals with HIV. Despite patients' higher risk of adverse health outcomes, in particular preventable smoking-related diseases for smokers living with HIV, few smoking cessation interventions have been examined with this population. The aim of the current study was to test the potential …
Does Effective Depression Treatment Alone Reduce Secondary HIV Transmission Risk? Equivocal Findings from a Randomized Controlled Trial
Directly Observed Antidepressant Medication Treatment and HIV Outcomes Among Homeless and Marginally Housed HIV-Positive Adults
Objectives. We assessed whether directly observed fluoxetine treatment reduced depression symptom severity and improved HIV outcomes among homeless and marginally housed HIV-positive adults in San Francisco, California, from 2002 to 2008. Methods. We conducted a nonblinded, randomized controlled trial of once-weekly fluoxetine, directly observed for 24 weeks, then self-administered for 12 weeks (n = 137 persons with major or minor depressive diso…
A Randomized Trial of a Hepatitis Care Coordination Model in Methadone Maintenance Treatment
Objectives. We evaluated the efficacy of a hepatitis care coordination intervention to improve linkage to hepatitis A virus (HAV) and hepatitis B virus (HBV) vaccination and clinical evaluation of hepatitis C virus (HCV) infection among methadone maintenance patients. Methods. We conducted a randomized controlled trial of 489 participants from methadone maintenance treatment programs in San Francisco, California, and New York City from February 2…
Implementing Rapid HIV Testing With or Without Risk-Reduction Counseling in Drug Treatment Centers
Objectives. We examined the effectiveness of risk reduction counseling and the role of on-site HIV testing in drug treatment. Methods. Between January and May 2009, we randomized 1281 HIV-negative (or status unknown) adults who reported no past-year HIV testing to (1) referral for off-site HIV testing, (2) HIV risk-reduction counseling with on-site rapid HIV testing, or (3) verbal information about testing only with on-site rapid HIV testing. Res…
Evidence-Based Practices, Attitudes, and Beliefs in Substance Abuse Treatment Programs Serving American Indians and Alaska Natives
Substance abuse disproportionately impacts American Indian/Alaska Native (AI/AN) communities in the United States. For the increasing numbers of AI/AN individuals who enter and receive treatment for their alcohol or other drug problem it is imperative that the service they receive be effective. This study used qualitative methodology to examine attitudes toward evidence-based practices, also known as evidence-based treatments (EBTs) in minority-s…
Access to Care for Methadone Maintenance Patients in the United States
This policy commentary addresses a significant access to care issue that faces methadone maintenance patients seeking residential treatment in the United States. Methadone maintenance therapy (MMT) has demonstrated strong efficacy in the outpatient treatment of opiate dependence. However, many opiate dependent patients are also in need of more intensive interventions, such as residential care. Many publically-funded residential treatment programs…
Methadone Maintenance Therapy in Residential Therapeutic Conmmunity Settings
The therapeutic community (TC) and methadone maintenance treatment (MMT) have individually demonstrated consistent positive outcomes yet rarely have been combined. This article describes how a well-established residential therapeutic community integrated methadone maintenance treatment into its activities. Practical recommendations regarding how to incorporate MMT in a residential program are provided including topics for staff (training, coordin…
Housing Patterns and Correlates of Homelessness Differ by Gender among Individuals Using San Francisco Free Food Programs
Gender differences among HIV-positive methadone maintenance patients enrolled in a medication adherence trial
This study examined baseline gender differences among HIV-positive methadone maintenance outpatients currently prescribed antiretroviral medications. Participants were enrolled in a larger clinical trial, which included a 4-week observation period using electronic monitors to track medication adherence. Contrary to previous literature, no significant differences were detected between men (n = 42) and women (n = 36) on medication adherence or depr…
Predictors of medical service utilization among individuals with co-occurring HIV infection and substance abuse disorders
This study examined factors affecting medical service use among HIV-infected persons with a substance abuse disorder. The sample comprised 190 participants enrolled in a randomized trial of a case management intervention. Participants were interviewed about their backgrounds, housing status, income, alcohol and drug use problems, health status and depressive symptoms at study entry. Electronic medical records were used to assess medical service u…
Bridging the Gap Between Research and Drug Abuse Treatment
There is a gulf between researchers and practitioners, due in part to conditions that existed before they began training, and partially due to their continued separation during training and practice. This article reviews some of the differences and offers suggestions for institutional and personal changes to bring researchers and practitioners more into accord
A Qualitative Evaluation of an Assisted Self-Help Group for Drug-Addicted Clients in a Structured Outpatient Treatment Setting
Effectiveness of Brief Counseling in Reducing HIV Risk Behavior in Injecting Drug Users
Medication adherence strategies for drug abusers with HIV/Aids
This paper describes two clinical techniques aiming to improve adherence to medications for HIV/AIDS in methadone maintenance patients. The first technique, providing on-site dispensing of antiretroviral medications, enhanced medication adherence but did not produce enduring effects beyond the time of the intervention. To develop a more long-lasting intervention, the programme is experimenting with more individualized medication management, in wh…
Quality of Life and Psychological Well-Being in a Bicultural Latino Community
A telephone survey was made of 270 randomly selected adults of Hispanic origin to determine the characteristics of welladjusted "Latinos" residing within San Francisco's Mission District, a bicultural/bilingual urban milieu. Five areas were investigated: (a) sample demographics, (b) acculturation, (c) quality of life components, (d) psychological well-being, and (e) depression levels. Latinos of 18 national origins were represented. The best-adju…
Prevention of depression with primary care patients
The prevention of major depression is an important research goal which deserves increased attention. Depressive symptoms and disorders are particularly common in primary care patients and have a negative impact on functioning and well‐being comparable with other major chronic medical conditions. The San Francisco Depression Prevention Research project conducted a randomized, controlled, prevention trial to demonstrate the feasibility of implement…
The extent, nature, and utility of evaluating consumer satisfaction in community mental health centers
Evaluating consumer perceptions is a recent development in community mental health. The authors surveyed the 504 federally funded community mental health centers to discover the extent to which they assessed consumer satisfaction, the methods used to collect data, and the utility of the results. Of the 366 centers that responded, 48% had gathered consumer feedback in the previous 18 months, and most others planned to initiate such evaluations wit…
Housing Patterns and Correlates of Homelessness Differ by Gender among Individuals Using San Francisco Free Food Programs
Changes in needle sharing behavior among intravenous drug users
We analyzed data for San Francisco intravenous drug users entering treatment, April 1986-September 1988 (N = 7,660). The proportion of cases reporting any needle sharing in the month preceding treatment decreased from 50 percent in 1986 to 28 percent in 1988. Similar decreases were reported by two longitudinal cohorts (needle sharing by the same individuals) admitted in 1986 and 1987 (n = 303), and in 1986 and 1988 (n = 205). In a multiple logist…
Implementing Rapid HIV Testing With or Without Risk-Reduction Counseling in Drug Treatment Centers
Objectives. We examined the effectiveness of risk reduction counseling and the role of on-site HIV testing in drug treatment. Methods. Between January and May 2009, we randomized 1281 HIV-negative (or status unknown) adults who reported no past-year HIV testing to (1) referral for off-site HIV testing, (2) HIV risk-reduction counseling with on-site rapid HIV testing, or (3) verbal information about testing only with on-site rapid HIV testing. Res…
Perceived discrimination among racial and ethnic minority drug users and the association with health care utilization
People who use drugs (PWUDs) are at increased risk for several medical conditions, yet they delay seeking medical care and utilize emergency departments (EDs) as their primary source of care. Limited research regarding perceived discrimination and PWUDs' use of health care services exists. This study explores the association between interpersonal and institutional racial/ethnic and drug use discrimination in health care settings and health care u…
Directly Observed Antidepressant Medication Treatment and HIV Outcomes Among Homeless and Marginally Housed HIV-Positive Adults
Objectives. We assessed whether directly observed fluoxetine treatment reduced depression symptom severity and improved HIV outcomes among homeless and marginally housed HIV-positive adults in San Francisco, California, from 2002 to 2008. Methods. We conducted a nonblinded, randomized controlled trial of once-weekly fluoxetine, directly observed for 24 weeks, then self-administered for 12 weeks (n = 137 persons with major or minor depressive diso…
Outcome evaluation of a referral system for juvenile offenders
Referral systems, among the most recent delinquency prevention programs, have not been evaluated on outcome measures. This paper describes the effectiveness of a referral system for young offenders. The subjects were 239 referred and nonreferred juveniles who were apprehended by the police. Program effectiveness was measured in two areas: diverting youths from court and preventing youths from having further police contact (preventing recidivism).…
Temporal Relationship of Sex Risk Behaviors and Substance Use Severity Among Men in Substance Use Treatment
Sex risk behaviors and substance use are intertwined. Many men continue to engage in high-risk sexual behaviors even when enrolled in substance use disorder (SUD) treatment. We hypothesized that changes in sex risk behaviors would coincide with changes in drug/alcohol use severity among men in SUD treatment. During an HIV risk-reduction trial, men in methadone maintenance and outpatient drug-free treatment (N = 359) completed assessments at basel…
A Randomized Trial of a Hepatitis Care Coordination Model in Methadone Maintenance Treatment
Objectives. We evaluated the efficacy of a hepatitis care coordination intervention to improve linkage to hepatitis A virus (HAV) and hepatitis B virus (HBV) vaccination and clinical evaluation of hepatitis C virus (HCV) infection among methadone maintenance patients. Methods. We conducted a randomized controlled trial of 489 participants from methadone maintenance treatment programs in San Francisco, California, and New York City from February 2…
Mass media as drug users' key information source on overdoses
Mass media as drug users' key information source on overdoses. J L Sorensen, J London, D Tusel, R Wolfe, and A WashburnCopyRight https://doi.org/10.2105/AJPH.82.9.1294 Published Online: October 07, 2011
Evaluating needle exchange
We employed capture-recapture methods as a strategy for evaluating needle exchange. Needles distributed by the exchange at two time periods were marked with color coded bands indicating the date and site of distribution. Half of the marked needles (2,068/4,239) returned within two weeks of distribution, and 61 percent (2,593/4,239) returned during the study period. The rate of return for stationary exchange sites (63 percent) was greater than tha…
Outcome evaluation of a referral system for juvenile offenders
Referral systems, among the most recent delinquency prevention programs, have not been evaluated on outcome measures. This paper describes the effectiveness of a referral system for young offenders. The subjects were 239 referred and nonreferred juveniles who were apprehended by the police. Program effectiveness was measured in two areas: diverting youths from court and preventing youths from having further police contact (preventing recidivism).…
The extent, nature, and utility of evaluating consumer satisfaction in community mental health centers
Evaluating consumer perceptions is a recent development in community mental health. The authors surveyed the 504 federally funded community mental health centers to discover the extent to which they assessed consumer satisfaction, the methods used to collect data, and the utility of the results. Of the 366 centers that responded, 48% had gathered consumer feedback in the previous 18 months, and most others planned to initiate such evaluations wit…
Quality of Life and Psychological Well-Being in a Bicultural Latino Community
A telephone survey was made of 270 randomly selected adults of Hispanic origin to determine the characteristics of welladjusted "Latinos" residing within San Francisco's Mission District, a bicultural/bilingual urban milieu. Five areas were investigated: (a) sample demographics, (b) acculturation, (c) quality of life components, (d) psychological well-being, and (e) depression levels. Latinos of 18 national origins were represented. The best-adju…
From Maintenance to Abstinence in a Therapeutic Community
Presented at the Seventh World Conference of Therapeutic Communities, Chicago, May 1983. This project was supported by NIDA Grant No. 1R01 DA03057
From Maintenance to Abstinence in a Therapeutic Community
This project, “From Maintenance to Abstinence in a Therapeutic Community,” was supported by NIDA Grant No. 1 RO1 DA03057. Notes †This project, “From Maintenance to Abstinence in a Therapeutic Community,” was supported by NIDA Grant No. 1 RO1 DA03057
From Maintenance to Abstinence in a Therapeutic Community
Misunderstandings About Methadone
Dual Diagnosis Patients in the Urban Psychiatric Emergency Room
Substance abuse among the mentally ill has become increasingly prominent. This article describes the problems presented by dual diagnosis patients in the urban, publicly funded, psychiatric emergency room. When such patients become acutely ill, neither the public health system nor the mental health clinician is adequately prepared to provide care. The inability to effectively treat these patients has become strikingly clear in recent years. In 19…
Coping with Aids
HIV infection creates difficulties for patients and staff in drug abuse treatment programs. This article reviews significant problems and coping strategies, drawing on experience in a drug abuse treatment program where a third of the patients are HIV infected. Patient-related problems include denial, anger, depression, and isolation. The coping strategies that patients use can exacerbate their illness. Effective coping strategies may involve the …
Community psychology, drug use, and Aids
Intravenous drug users may hold the key to the future epidemic of AIDS in the United States. Although gay men have changed their social norms to lower the risk of AIDS, such change will be more difficult to bring about in drug users. Several intervention efforts have been developed and are being evaluated. The psychoeducational workshops developed by the authors have shown promise in random-assignment trials with drug abusers in residential treat…
Changes in needle sharing behavior among intravenous drug users
We analyzed data for San Francisco intravenous drug users entering treatment, April 1986-September 1988 (N = 7,660). The proportion of cases reporting any needle sharing in the month preceding treatment decreased from 50 percent in 1986 to 28 percent in 1988. Similar decreases were reported by two longitudinal cohorts (needle sharing by the same individuals) admitted in 1986 and 1987 (n = 303), and in 1986 and 1988 (n = 205). In a multiple logist…
Evaluating needle exchange
We employed capture-recapture methods as a strategy for evaluating needle exchange. Needles distributed by the exchange at two time periods were marked with color coded bands indicating the date and site of distribution. Half of the marked needles (2,068/4,239) returned within two weeks of distribution, and 61 percent (2,593/4,239) returned during the study period. The rate of return for stationary exchange sites (63 percent) was greater than tha…
Conducting Social and Behavioral Aids Research in Drug Treatment Clinics
viewing protocols for research related to HIV infection in the special context of a drug treatment clinic? This article provides background to prepare IRB members for the difficulties of reviewing such protocols, suggesting review procedures and emphasizing the need for investigators to respect clinic patients and staff. Special attention is given to eight problem areas: providing counseling to persons who are seropositive; privacy; community con…
Intervention from family members as a strategy for preventing HIV transmission among intravenous drug users
This exploratory study, undertaken to inform new prevention strategies, assessed the willingness of community members and drug users to advise drug-using relatives about various HIV prevention strategies. Participants were 421 adult community members and 67 adults in treatment for drug abuse in San Francisco, with approximately equal numbers of Hispanics and non-Hispanic Whites in each group. Participants answered questions about whether they wou…
Mass media as drug users' key information source on overdoses
Mass media as drug users' key information source on overdoses. J L Sorensen, J London, D Tusel, R Wolfe, and A WashburnCopyRight https://doi.org/10.2105/AJPH.82.9.1294 Published Online: October 07, 2011
Cultural Issues in an Outpatient Program for Stimulant Abusers
Cocaine abuse has created widespread problems, especially in poor urban ethnic minority communities. This article discusses the cultural issues in delivering a cocaine treatment program to a predominantly minority patient population. The Stimulant Treatment Outpatient Program (STOP) of San Francisco General Hospital's Substance Abuse Services was established in 1990 as a public service clinic. Many program elements apply equally well to various c…
Prevention of depression with primary care patients
The prevention of major depression is an important research goal which deserves increased attention. Depressive symptoms and disorders are particularly common in primary care patients and have a negative impact on functioning and well‐being comparable with other major chronic medical conditions. The San Francisco Depression Prevention Research project conducted a randomized, controlled, prevention trial to demonstrate the feasibility of implement…
Medication adherence strategies for drug abusers with HIV/Aids
This paper describes two clinical techniques aiming to improve adherence to medications for HIV/AIDS in methadone maintenance patients. The first technique, providing on-site dispensing of antiretroviral medications, enhanced medication adherence but did not produce enduring effects beyond the time of the intervention. To develop a more long-lasting intervention, the programme is experimenting with more individualized medication management, in wh…
Effectiveness of Brief Counseling in Reducing HIV Risk Behavior in Injecting Drug Users
Bridging the Gap Between Research and Drug Abuse Treatment
There is a gulf between researchers and practitioners, due in part to conditions that existed before they began training, and partially due to their continued separation during training and practice. This article reviews some of the differences and offers suggestions for institutional and personal changes to bring researchers and practitioners more into accord
A Qualitative Evaluation of an Assisted Self-Help Group for Drug-Addicted Clients in a Structured Outpatient Treatment Setting
Predictors of medical service utilization among individuals with co-occurring HIV infection and substance abuse disorders
This study examined factors affecting medical service use among HIV-infected persons with a substance abuse disorder. The sample comprised 190 participants enrolled in a randomized trial of a case management intervention. Participants were interviewed about their backgrounds, housing status, income, alcohol and drug use problems, health status and depressive symptoms at study entry. Electronic medical records were used to assess medical service u…
Gender differences among HIV-positive methadone maintenance patients enrolled in a medication adherence trial
This study examined baseline gender differences among HIV-positive methadone maintenance outpatients currently prescribed antiretroviral medications. Participants were enrolled in a larger clinical trial, which included a 4-week observation period using electronic monitors to track medication adherence. Contrary to previous literature, no significant differences were detected between men (n = 42) and women (n = 36) on medication adherence or depr…
Methadone Maintenance Therapy in Residential Therapeutic Conmmunity Settings
The therapeutic community (TC) and methadone maintenance treatment (MMT) have individually demonstrated consistent positive outcomes yet rarely have been combined. This article describes how a well-established residential therapeutic community integrated methadone maintenance treatment into its activities. Practical recommendations regarding how to incorporate MMT in a residential program are provided including topics for staff (training, coordin…
Housing Patterns and Correlates of Homelessness Differ by Gender among Individuals Using San Francisco Free Food Programs
Medicine (40 works) · Psychiatry (32 works) · Psychology (26 works) · Family medicine (16 works) · Nursing (13 works) · HIV/AIDS Research and Interventions (12 works) · Internal Medicine (12 works) · Substance abuse (12 works) · Substance Abuse Treatment and Outcomes (12 works) · Methadone (9 works)