Facilitating Treatment Entry among Out-of-Treatment Injection Drug Users

ArticleinPublic Health Reports 113 Suppl 1:116-28 · July 1998with35 Reads
Impact Factor: 1.55 · Source: PubMed
Abstract

High risk injection practices are common among injecting drug users (IDUs), even following intervention efforts. Moreover, relapse to risk behaviors has been reported among those who initiate risk reduction. Substance abuse treatment offers the potential to reduce or eliminate injecting risk behaviors through drug cessation. We report on the effectiveness of two intervention strategies in facilitating treatment entry among out-of-treatment IDUs: motivational interviewing (MI), and intervention developed to help individuals resolve their ambivalence about behavior change, and free treatment for 90 days. These conditions were compared with an intervention focusing on a hierarchy of safer injecting practice, referred to here as risk reduction (RR), and no free treatment. Nearly 200 out-of-treatment IDUs were randomly assigned to one of four experimental conditions: MI/free treatment, MI/no free treatment, RR/free treatment, and RR/no free treatment. Regardless of assignment, we assisted anyone desiring treatment by calling to schedule the appointment, providing transportation, and waiving the intake fee. Overall, 42% of study participants entered treatment. No significant differences were found between MI and RR; however, 52% of those assigned free treatment entered compare with 32% for those who had to pay. Other predictors of treatment entry included prior treatment experiences, perceived chance of contracting acquired immunodeficiency syndrome (AIDS) greater than 50%, "determination" stage of change, greater frequency of heroin injecting, and fewer drug-using friends. These findings support the importance of removing barriers to treatment entry.

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Available from: Robert E Booth
ROBERT
E.
BOOTH,
PHD
*
CAROL
KWIATKOWSKI,
PHD
MARTIN
Y.
IGUCHI,
PHD
*
FRANCESCA
PINTO,
MPH
DEBBIE
JOHN,
MA
Facilitating
Treatment
Entry
among
Out-of-Treatment
Injection
Drug
Users
Dr.
Booth
is
an
Associate
Professor
in
the
Department
of
Psychiatry
at
the
University
of
Colorado
School
of
Medicine.
Dr.
Kwiatkowski
is
a
Research
Associate
in
the
Department
of
Psychiatry
at
the
University
of
Colorado
School
of
Medicine.
Dr.
Iguchi
is
Co-Director
of
the
Drug
Policy
Research
Center
at
the
RAND
Corporation.
Ms.
Pinto
is
a
Senior
Research
Assistant
in
the
Department
of
Psychiatry
at
the
University
of
Colorado
School
of
Medicine.
Ms.
John
is
a