Volume 12, Number 5
Treatment Histories: The Long View of Addiction
Drug Abuse Treatment Outcome Study (DATOS) researchers at the University of California at Los Angeles looked at the treatment histories of addicts in treatment to learn more about the life cycle of addiction and how that influences treatment outcomes. For example, when did patients first enter treatment, and how many times had they been in treatment?
Overall, DATOS patients reported that they first entered
drug abuse treatment about 7 years after they began using their primary drug. In outpatient methadone programs, patients reported having used heroin for an average of 15 years and having undergone various episodes of treatment for about 7 years. In the three other treatment types - outpatient drug-free, long-term residential, and short-term inpatient - patients had been abusing an average of 11 years and had been in some kind of treatment, often not continuously, for 2 to 3 years.
About one-half of the patients had received treatment prior to entering their current treatment episode, and of those, over one-half had received some prior treatment within the previous year. Patients who reported having had prior treatment also had more severe drug dependence and were more involved in criminal activity compared with those who had not had prior drug abuse treatment.
Despite having more severe histories of drug dependence, patients with prior treatment history who received more support services in addition to basic drug abuse treatment - such as help with medical, financial, employment, legal, psychological, and family problems - were more likely to be abstinent at one-year follow-up than those who received fewer support services. Similarly, treatment-experienced patients who spent more time in the current treatment episode had better outcomes than those who spent less time in treatment.
These findings suggest that despite repeated treatment attempts and the multiple problems typically associated with a history of severe drug abuse, patients can be successfully treated with a comprehensive treatment approach of sufficient duration, the researchers say. The scientists are currently comparing treatment histories of men and women to see how they differ and to explore the implications of those differences for effective treatment.
The researchers conclude that treatment providers can improve treatment of drug abuse by:
- engaging addicts in treatment as soon as possible;
- offering support services to address the multiple problems of drug abuse patients; and
- coordinating treatment episodes.
Anglin, M.D.; Hser, Y.; and Grella, C.E. Drug addiction and treatment careers among clients in DATOS. Psychology of Addictive Behavior, in press.
NIDA NOTES - September/October 1997
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