The author examined follow-up outcomes in the first year after treatment in relation to time spent in treatment in the Drug Abuse Reporting Program. Follow-up interviews were completed with more than 3,000 people admitted to drug abuse treatment during 1969--1972, including clients treated with methadone maintenance, therapeutic communities, outpatient drug-free programs, and outpatient detoxification, as well as a group who completed intake procedures but did not return for treatment. Longer time in treatment was related to better posttreatment outcome, but clients who spent less than 3 months in treatment were not significantly different from the detoxification-only group or the intake-only group.
"One way to explore this issue is by focusing on how clients view their treatment experience. Clients' subjective perceptions constitute a salient variable that is correlated with treatment retention, length of sobriety following treatment (Condelli, 1986; Lemieux, 1998), and the length of stay (Kasarabada, Hser, Boles, & Huang, 2002), which is the largest and most consistent predictor of positive post-treatment outcomes (de Leon, 1984, 1999; Simpson, 1979). Finally, the perceptions of clients are considered a good predictor of risk of relapse (Walton, Blow, & Booth, 2000). "
[Show abstract][Hide abstract] ABSTRACT: Residents’ perceptions of recovery in a therapeutic community (TC) have long been of interest to researchers and addiction practitioners. This study aims to continue this course of research in a TC in Israel. In particular, this study aims to present subjective perceptions of recovery of the clients in Retorno, a Jewish TC, using a qualitative, phenomenological, and retrospective study design. The participants were 21 clients, 11 juveniles, and 10 adults, who were administered an in-depth, semi-structured, individual interview. The findings cover two main themes: (a) the properties of treatment that the clients specified as significant to their recovery and (b) the expressions of change in the clients’ lives during their recovery. The findings highlight the importance of unconditional acceptance and caring during therapy, along with additional spiritual values that might challenge clients. This perspective signifies the “how to” and “how it is perceived” rather than merely the “what to do.” It represents the application of the emerging positive criminology that inspires the separation–unification vector of clients with some progress toward greater unification in the social, individual, and spiritual dimensions.
Addiction Research and Theory 06/2013; 21(4). DOI:10.3109/16066359.2012.721145 · 1.03 Impact Factor
"Poor outcomes in the treatment of opiate dependency using naltrexone relates to the shortened time in treatment; time in treatment has been related to better long-term outcomes.18,19 Moreover, with no after-care counselling, compliance strategy or social support in place, studies have shown predictably poor long-term outcomes.12,20,21 "
[Show abstract][Hide abstract] ABSTRACT: The usefulness of oral naltrexone has been limited by compliance. Sub-cutaneous implants would seem to offer a solution to this problem and improve long-term outcomes. The aim of the present study was to compare levels of blood serum naltrexone of patients who had received a naltrexone implant after detoxification to a number of dependent variables of interest. These dependent variables included drug use including urine screens of each patient, any adverse response to the implant, subjective evaluation of self-esteem, quality of relationships, and changes in social functioning. Sixty six patients received an implant and were surveyed; urine and blood samples were taken at about 1, 3, and 6 months after implantation. Naltrexone levels were on average above 1 ng/mL at 6 months after insertion and patients showed significant improvements on all dependent variables. The preliminary evidence indicates that implants can improve compliance rates and outcomes.
Substance Abuse: Research and Treatment 05/2013; 7:75-84. DOI:10.4137/SART.S10776
"Such treatment can help lower recidivism (Field, 1989; Inciardi, Martin, & Butzin, 2004; Knight & Hiller, 1997; Knight, Wallace, Joe, & Logan, 2001; Marlowe et al., 2003). Treatment effectiveness is weakened, however, if participants fail to remain in treatment for the entire program period (De Leon, 1996; Field, 1989; Inciardi et al., 2004; Simpson, 1979; Simpson, Joe, & Brown, 1997). Understanding the factors related to program completion is therefore pivotal. "
[Show abstract][Hide abstract] ABSTRACT: PurposeAlthough past work connects personal factors to substance abuse treatment retention, most studies have been atheoretical. The current work specifically examines impulsivity/low self-control and retention in substance abuse treatment using the General Theory of Crime (Gottfredson & Hirschi, 1990) which anticipates a relationship between intake scores and retention.Methods
Analyses examined 330 probationers in a modified therapeutic community. Four logistic regression models predicting treatment completion examined four aspects of impulsivity/low self-control. Each model included initial scores, while controlling for unexpected changes after 90 days and demographics. Model-fit was analyzed using the Bayesian Information Criterion (BIC).ResultsTwo best-fitting models emerged: sensation-seeking and volatile tendencies. Higher intake scores for sensation-seeking were related to significantly lower odds of completion. Unexpectedly increasing volatile tendencies was related to a significantly lower odds of completion. Models with impulsivity/low self-control indices provided significantly better fit than models with demographics alone.Conclusions
Both measurement periods of impulsivity/low self-control were found to be associated with substance abuse treatment completion. These findings appear supportive of the General Theory of Crime and are directly applicable to Therapeutic Communities. They also may prove useful in future work examining how personal factors connect with treatment outcomes.
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