Article

Social Factors Related to the Follow-Up Status of Opioid Addicts

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

The present findings concerning social and environmental factors that might affect follow-up outcomes offer tentative support for several major theoretical themes. These findings may be interpreted in terms of their practical implications for treatment and other intervention strategies for opioid addicts (such as emphasizing compensatory experiences, appropriate reference group identifications and social readjustment of clients), but the results are not definitive and lack precision in causal interpretations. Hopefully, subsequent research will benefit from these preliminary findings and will develop improved procedures for identifying and measuring the important variables in these and other theoretical models for greater precision in establishing predictive relationships with outcomes.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... Most field studies of relapse to date have focused on measuring the frequency of relapse or its timing (e.g., O'Donnell 1965;Hunt and Bespalec 1974). A much smaller number of empirical studies have sought to discover the predictors and causes of relapse (e.g., Alksne 1955;Ball and Snarr 1969;Brill et al. 1972;Brown et al. 1971;Joe and Simpson 1983;Jorques 1983;McAuliffe 1982;Stephens and Cottrell 1972;Vaillant 1969;Waldorf 1973Waldorf . 1979Wikler and Pescor 1967;Willie 1983;Winick 1962Winick , 1964. ...
... Other statistical studies of relapse have used multivariate methods but have often employed exploratory or predictionoriented model specification methods, such as step-wise regression, that select variables solely on statistical rather than theoretical for testing theoretical models. The recent study by Jose and Simpson (1983) represents an important early attempt to investigate relapse using multivariate statistical models specified theoretically, although the authors apparently had to rely on existing measures as indicators rather than on measures specifically designed for this purpose. ...
... Most field studies of relapse to date have focused on measuring the frequency of relapse or its timing (e.g., O'Donnell 1965;Hunt and Bespalec 1974). A much smaller number of empirical studies have sought to discover the predictors and causes of relapse (e.g., Alksne 1955;Ball and Snarr 1969;Brill et al. 1972;Brown et al. 1971;Joe and Simpson 1983;Jorques 1983;McAuliffe 1982;Stephens and Cottrell 1972;Vaillant 1969;Waldorf 1973Waldorf . 1979Wikler and Pescor 1967;Willie 1983;Winick 1962Winick , 1964. ...
... Other statistical studies of relapse have used multivariate methods but have often employed exploratory or predictionoriented model specification methods, such as step-wise regression, that select variables solely on statistical rather than theoretical for testing theoretical models. The recent study by Jose and Simpson (1983) represents an important early attempt to investigate relapse using multivariate statistical models specified theoretically, although the authors apparently had to rely on existing measures as indicators rather than on measures specifically designed for this purpose. ...
... Drug abusers also showed overall improvement in the number of days worked, with the VA hospital and the private treatment center showing significant results (McLellan et al., 1986). Joe and Simpson (1983) examined employment among opiate addicts over a 6-year period from 1972-1973 through 1978-1979. These addicts were divided into five types: those who became abstinent before entry into treatment, those whose abstinence followed entry into treatment or incarceration, those whose abstinence was delayed but who did not enter treatment or jail, those who continued their use of opiates, and those who substituted other nonopioid drugs (including alcohol) for their opiate use. ...
Article
Full-text available
Employment has been identified as an important element in the rehabilitation of drug abusers and, together with abstinence from illicit drugs and criminal involvement, is frequently used as a criterion of treatment outcome. The research literature for the last 20 years on variables affecting employment and the vocational rehabilitation of drug abusers is reviewed with an emphasis on (a) the identification of variables influencing the employment of drug abusers and (b) the evaluation results of interventions that have been developed for this purpose. It is concluded that a number of programs have been demonstrated to have had some success in the vocational rehabilitation of drug abusers. Specific recommendations are made concerning both the direction of further research in this area and the application of existing knowledge in current practice.
... Within the substance abuse treatment literature, much attention has been paid to contact with substance using network members and to which people in the network also use substances. For example, a number of studies have focused on the adverse effects of network member drug use on recovery (Davis & O'Neil, in press;Harris, Fallot, & Berley, in press;Hawkins & Fraser, 1987;Rhoads, 1983;Joe & Simpson, 1983;Ellis, Bernichon, Roberts, & Herrell, 2004) and involvement in crime (Best, Hernado, Gossop, Sidwell, & Strang, 2003). Likewise, the importance of non-using social network ties has been stressed in maintenance of sobriety (Gordon & Zrull, 1991;Harris, Fallot, & Berkley, in press), treatment adherence (Hawkins & Fraser, 1983;Galanter, 1999) and relapse prevention (Daley & Marlatt, 1992). ...
Article
Objectives: To review and examine the literature on social networks and dual disorders, and the separate literatures on social networks in relation to mental illness and substance abuse respectively, and to consider implications for practice and research. Methods: Papers selected for review included empirical studies of social networks and/or social support of adults with diagnosed substance use and/or mental disorders. Results: Thirty-six studies met the criteria for review which is organized around three themes: structural characteristics of social networks, network composition, and the impact of social networks on treatment and recovery. Conclusions: Social networks function both as a predictor as well as an outcome of mental illness and substance use. Understanding and assessment of social networks is important to understanding addictive behaviors. Further research is needed in the following areas: the role of social networks in readiness for treatment, entry into and participation in treatment, and support for recovery; the impact of treatment and peer support programs on social networks; social networks in relation to a wider range of mental disorders (e.g., depression, anxiety and post traumatic stress disorder); and the impact of race, ethnicity, and gender on social networks of adults with dual disorders. In addition, the role that families play in treatment and recovery as well as the impact of clients' dual disorders upon family members needs examination.
... There is evidence suggesting that various during-treatment process variables (e.g., motivation and treatment engagement) are related to each other and to outcomes (Simpson, Joe, & Rowan-Szal, 1997;Simpson et al., 1995). For example, the social functioning of a client is related to drug use and treatment effectiveness (Joe & Simpson, 1983;. Two dimensions of social functioning that are reliable predictors of drug use and treatment outcome include risk taking and social conformity Stein, Newcomb, & Bentler, 1987;Wood, Pfefferbaum, & Ameklev, 1993). ...
Article
Full-text available
An integrative analytic model was proposed to explain deviance in terms of the family of origin, perceived peer and family relations, psychosocial functioning, motivation for treatment, and treatment engagement. The model was tested by using data from opioid-addicted persons who completed methadone treatment and were interviewed 1 year after discharge. The hypothesized model was shown to fit the data for outcomes at follow-up. A history of poor family relations was related to perceived family dysfunction and peer deviance at treatment entry; these 2 factors in turn predicted poor psychosocial functioning, which was related to higher levels of motivation. Higher motivation was associated with greater treatment engagement, which was associated with reduced opioid use and criminality. The importance of examining associations between family and peer relations and posttreatment outcomes within the context of treatment engagement is discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... Drug abusers also showed overall improvement in the number of days worked, with the VA hospital and the private treatment center showing significant results (McLellan et al., 1986). Joe and Simpson (1983) ...
Article
Employment has been identified as an important element in the rehabilitation of drug abusers and, together with abstinence from illicit drugs and criminal involvement, is frequently used as a criterion of treatment outcome. The research literature for the last 20 years on variables affecting employment and the vocational rehabilitation of drug abusers is reviewed with an emphasis on (a) the identification of variables influencing the employment of drug abusers and (b) the evaluation results of interventions that have been developed for this purpose. It is concluded that a number of programs have been demonstrated to have had some success in the vocational rehabilitation of drug abusers. Specific recommendations are made concerning both the direction of further research in this area and the application of existing knowledge in current practice.
... In general, antisocial behavior has been found to be associated with poorer treatment outcomes (1,2). Specifically, antisocial clients are less likely to value and conform to conventional norms of society, and they demonstrate greater resistance to treatment (3)(4)(5). ...
Article
This study examined the relationship between perceptions of parent-child relations in the family of origin and antisocial tendency in a sample of drug-addicted adults. Data included retrospective accounts of childhood family factors, adolescent antisocial tendency, and self-reported hostility and risk-taking prior to treatment entry. A developmental model was tested that included adolescent antisocial tendency as a mediator of the relationship between childhood parenting factors and adulthood antisocial tendency. The effects of parental support and conflict were found to operate primarily through adolescent measures. Specifically, lower levels of parental support and higher levels of conflict with parents predicted greater adolescent antisocial tendency, which in turn predicted more hostility and risk-taking in adulthood. Thus, parental support appears to serve as a buffer against deviant behavior and drug use.
Article
This systematic review synthesized the literature examining addiction substitution during recovery from substance use or behavioral addictions. A total of 96 studies were included with sample sizes ranging from 6 to 14,885. The most common recovery addictions were opioids (30.21%), followed by cannabis (20.83%), unspecified use (17.71%), nicotine (12.50%), alcohol (12.50%), cocaine (4.17%), and gambling (2.08%). Statistical results were provided by 70.83% of the studies. Of these, 17.65% found support for addiction substitution, whereas 52.94% found support for concurrent recovery. A total of 19.12% found no statistical changes and 10.29% found both significant increases and decreases. The remaining 29.17% of studies provided descriptive data, without statistical tests. Predictors of addiction substitution were provided by 22.92% of the studies and 11.46% included information on impact of addiction substitution on treatment outcomes. Overall, male gender, younger age, greater substance use severity, and presence of mental health disorders were associated with addiction substitution. Addiction substitution was associated with poorer treatment outcomes. A limitation of the present systematic review is the use of significance counting for the quantitative synthesis. More research examining changes in addiction during recovery would aid in the development of more effective treatments for addictive disorders and prevent addiction substitution.
Article
The high rates of substance abuse relapse after participating in treatment programs forces human services professionals to reconsider prevailing addiction theories and treatment approaches. This article first discusses two theoretical orientations: (a) the more traditional and prevalent “disease model,” which emphasizes common, long-standing lifestyle and family background factors which affect addiction development and recovery and (b) the more recent “adaptive perspective,” which emphasizes individual differences in day-to-day stress, cognitive appraisal, and coping processes during recovery. Building on the more innovative adaptive perspective, there is a presentation of research findings that supports the development of a working theoretical model with key variables and causal pathways that affect addiction relapse. The theoretical model incorporates individual-level (behavioral, emotional, cognitive) variables as well as more environmental-level (social involvement, access to community resources) variables. Finally, this paper describes two posttreat-ment, follow-up maintenance programs and their hypothesized effects in the theoretical model's individual-level and environmental-level causal pathways.
Article
Full-text available
This article describes recent developments in a theory of recovery from drug addiction and in the adaptation of Recovery Training and Self Help (RTSH) to cocaine addiction. RTSH is an example of a new element of treatment known as "relapse prevention" (RP), which is an application of the discovery that addiction follows the laws of operant conditioning. We learned, however, that to understand and to treat cocaine addiction, we had to expand upon the conditioning paradigm to include a sociological analysis of the deviant lifestyle from which cocaine addiction stems. The theory presented here postulates three stages of recovery from cocaine addiction. Cocaine addicts can recover as outpatients by (1) initially building "walls" against drug triggers and supplies, (2) extinguishing addiction in the protective community of recovering persons, and (3) gradually lowering the walls and expanding beyond the recovering community to function more fully in conventional society. We have developed an outpatient group treatment system based on this recovery model. The Cocaine Recovery System includes a month-long cessation program, followed by a six-month recovery program, and active participation in the recovering community. A professional and a recovering person colead both the cessation and recovery programs, which feature Recovery Training sessions designed to help cocaine addicts achieve treatment goals and avoid or cope with threats to recovery. Clients in the recovery program also meet weekly for a support session, a weekend recreational activity, and individual counseling. The program also encourages group members to attend 12-step fellowship meetings. Clients achieve difficult lifestyle changes by taking a series of "commitment steps," which increasingly engage the clients in a recovering lifestyle and make relapse more difficult.
Article
The relationship between perceptions of parental absence, support, and conflict during childhood and psychosocial functioning in adulthood was examined for 411 drug user clients in methadone treatment. History of parental support was related to adult psychosocial functioning and parent-child conflict was related to psychosocial functioning only when parental support was low. Findings indicate parental absence is related to the quality of parental support, which in turn predicts psychosocial functioning in adulthood. Implications for treatment intervention are discussed.
Article
The relationship between parental substance use problems (SUPs) and the quality of parental relationships with levels of psychological symptomatology was examined in 155 female and 324 male methadone maintenance patients. Subjects completed the Beck Depression Inventory (BDI), SCL-90, and the Treatment Effectiveness Questionnaire (TEQ), which included questions regarding demographics, drug use, family/social relationships, and substance use in relatives. Of those completing the questionnaire, 40% were randomly selected for an Addiction Severity Index (ASI) interview. As hypothesized, parental SUPs were associated with greater levels of psychological symptomatology, more family/social, and medical problems. Positive parental relationships were associated with significantly lower levels of psychological symptomatology and fewer family/social problems. Males were significantly more likely than females to report positive parental relationships and no parental SUPs. No differences based on race were revealed related to reports of the quality parental relationships or parental SUPs.
Article
This article is an initial report from a review of alcohol and drug treatment studies with follow-ups of 2 years or more. The goals of the review are to examine the stability of substance use outcomes and the factors that moderate or mediate these outcomes. Results from 12 studies that generated multiple research reports are presented, and methodological problems encountered in the review are discussed. Substance use outcomes at the group level were generally stable, although moderate within-subject variation in substance use status over time was observed. Of factors assessed at baseline, psychiatric severity was a significant predictor of outcome in the highest percentage of reports, although the nature of the relationship varied. Stronger motivation and coping at baseline also consistently predicted better drinking outcomes. Better progress while in treatment, and the performance of pro-recovery behaviors and low problem severity in associated areas following treatment, consistently predicted better substance use outcomes.
Article
Full-text available
Follow-up data for 1,174 opiate addicts were used to examine leisure reported prior to an interview conducted approximately 6 yrs after admission to treatment for drug abuse. Comparisons of self-reported leisure for the pre- and posttreatment follow-up periods showed an overall shift toward more positive, socially accepted leisure activities at follow-up; more free time was spent with family and with friends who did not use drugs. In addition, positive leisure at follow-up, as well as more positive changes in leisure over time, were related to favorable outcomes on drug use, criminality, and productive activities measures during the year before the follow-up interview. (9 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Follow-up interview data for 1,155 opioid addicts, based on a 4-year period after leaving community-based drug abuse treatment programs, showed that levels of employment and productive activities (a composite measure reflecting employment, school, and homemaking) were generally stable over time. Almost half of the males and females were involved in some type of productive activities in all 12 months of each year examined, and only about one-fourth reported no productive activities at all each year. As expected, males reported higher rates of employment and females were higher in homemaking activities. Employment was associated with lower opioid drug use and criminal involvement during the follow-up period, suggesting the need for continued support and development of community training and employment placement programs as part of a comprehensive treatment system for drug abusers.
Article
• A sample of 1,496 persons admitted to 26 community treatment agencies participating in the Drug Abuse Reporting Program (DARP) during 1972 and 1973 were located and interviewed in 1978 and 1979. Favorableness of one-year posttreatment outcomes with respect to illicit drug use, criminality, and employment and other productive activities was found to increase linearly with the length of time patients stayed in methadone maintenance, a therapeutic community, or outpatient drug-free treatment. In addition, follow-up outcome for persons who spent less than three months in treatment was least favorable, and was not significantly different from that of persons in outpatient detoxification programs or who were admitted but not treated (intake-only). Persons who completed treatment generally stayed in treatment longer, as expected; they also had a more favorable outcome after DARP treatment than did others.
Article
• Long-term behavioral outcome status of 990 daily opioid users, recorded in follow-up interviews about six years after admission to community-based treatment programs, was classified in terms of longitudinal patterns of opioid use. Sixty-one percent of these individuals had achieved abstinence from opioid drugs for a year or longer immediately before the followup interview. Compared with those who continued heavy opioid drug use, and with others who had problems with nonopioid drugs or alcohol over time, persons who achieved abstinence also had significantly better long-term outcomes on criminality, use of nonopioid drugs and alcohol, and productive activities. Except for criminal history, outcome status was generally unrelated to client demographic and background predictors, but behavioral improvements over time were strongly associated with participation in drug abuse treatment.
Article
Marijuana use among recent alumni reflects prior diffusion of a student subculture with a variety of correlated norms and values. Constraints of family and job, and change of associates after graduation, foster cessation of such drug use more often than complete change from the other values of this subculture. Diffusion of norms and values of the student subculture among educated young adults off campus is evident in many alumni not much involved in this subculture as students, especially in those who are late starters at marijuana use. Twice as high a rate of volunteering for interviews was elicited from long-term users as from non-users, suggesting that non-conformity and aberrant behavior foster opposite types of pluralistic ignorance of the prevalence of deviance.
Article
The Drug Abuse Reporting Programme (DARP) is a large-scale evaluation project focused on the effectiveness of drug abuse treatment, based on almost 44,000 clients admitted to 52 treatment centres located throughout the United States and in Puerto Rico between June 1969 and March 1973. The present paper summarizes research on post-DARP follow-up data (representing up to six years after DARP) for a sample of 3,131 persons admitted to treatment during 1969 to 1972. Treatments included methadone maintenance (MM), therapeutic community (TC), out-patient drug-free (DF), and out-patient detoxification programmes (DT); a comparison group of intake only (10) clients with no DARP treatment was also followed up. The data showed in general that three treatments, MM, TC and DF, led to favourable results — MM and TC for heroin and other opioid addicts, and DF for non-addicts (users of opioids less-than-daily, usually in conjunction with other non-opioid drugs and users of non-opioids only)
Article
The social psychological antecedents of entry into three sequential stages of adolescent drug use, hard liquor, marihuana, and other illicit drugs, are examined in a cohort of high school students in which the population at risk for initiation into each stage could be clearly specified. The analyses are based on a two-wave panel sample of New York State public secondary students and subsamples of matched adolescent-parent and adolescent-best schoolfriend dyads. Each of four clusters of predictor variables, parental influences, peer influences, adolescent involvement in various behaviors, and adolescent beliefs and values, and single predictors within each cluster assume differential importance for each stage of drug behavior. Prior involvement in a variety of activities, such as minor delinquency and use of cigarettes, beer, and wine are most important for hard liquor use. Adolescents' beliefs and values favorable to the use of marihuana and association with marihuana-using peers are the strongest predictors of initiation into marihuana. Poor relations with parents, feelings of depression, and exposure to drug-using peers are most important for initiation into illicit drugs other than marihuana.
Article
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.
Article
The present study was based on follow-up data on 1,409 persons interviewed 4 to 6 years after admission to drug treatments in the Drug Abuse Reporting Program (DARP). The admissions to DARP occurred in 1969-1971, and for most persons the follow-up data included 3 or more years after termination of DARP treatment. The focus of this study was on illicit drug use of former DARP clients, taking into account if and when they reentered drug treatment after termination of DARP treatment. The results showed that a significant drop in opioid and nonopioid (but not marijuana) drug use generally occurred upon entry into other, post-DARP treatments, and that these beneficial effects of treatment tended to continue beyond the end of treatment. Overall, 42% of the sample had no further drug treatment during the first 3 years after DARP, and almost half (42%) of this group used no opioid or nonopioid drugs at all during this time. Comparisons between DARP treatment groups also indicated that therapeutic community clients had the lowest rate of return to post-DARP treatments.
Article
The present study was based on follow-up data on 1409 persons interviewed 4 to 6 years after admission to drug treatment in the Drug Abuse Reporting Program (DARP). The admissions to DARP occurred in 1969-1971, and for most persons the follow-up data included 3 or more years after termination of DARP treatment. The study focused on variations in alcohol consumption associated with post-DARP drug use and treatment status. The results indicated that use of alcohol and non-opioid drugs (particularly marijuana) tended to be correlated, but that this was not true of opioid drugs. For a small segment of the sample, evidence suggested that substitution of use may have occurred between alcohol and opioid drugs. Also, persons with post-DARP drug treatment tended to use less alcohol than persons without treatment. Interpretations and implications of these findings are discussed.
Article
A system of treatment for heroin addiction is proposed under the acronym STEPS (sequential treatment employing pharmacologic supports). Small steps characterized by decreasing narcotic-induced euphoria and increasing social rehabilitation are expected eventually to bring the addict to an abstinent and well-functioning state, if that is possible. The dichotomous assessment of "success" or "failure" is rejected in favor of the expectation of partial and temporary improvements, as with any chronic relapsing disease.
Article
Post-treatment outcome measures during a four-year follow-up period were examined in relation to readmissions to drug abuse treatment. The sample included 1,174 opioid addicts admitted during 1972-1973 to 26 different treatment programmes throughout the United States that participated in the Drug Abuse Reporting Program (DARP). Admissions to methadone maintenance programmes, therapeutic communities, outpatient drug-free treatments, and outpatient detoxification programmes were studied, as well as a comparison group which completed admission procedures but did not return for treatment at the DARP agency. The examination of temporal patterns of treatment and outcome indicators presenting drug use, criminality, and productive activities during the four-year follow-up period showed that there were beneficial effects associated with treatment.
Article
The Drug Abuse Reporting Programme (DARP) is a large-scale evaluation project focused on the effectiveness of drug abuse treatment, based on almost 44,000 clients admitted to 52 treatment centres located throughout the United States and in Puerto Rico between June 1969 and March 1973. The present paper summarizes research on post-DARP follow-up data (representing up to six years after DARP) for a sample of 3,131 persons admitted to treatment during 1969 to 1972. Treatments included methadone maintenance (MM), therapeutic community (TC), out-patient drug-free (DF), and out-patient detoxification programmes (DT); a comparison group of intake only (IO) clients with no DARP treatment was also followed up. The data showed in general that three treatments, MM, TC and DF, led to favourable results - MM and TC for heroin and other opioid addicts, and DF for non-addicts (users of opioids less-than-daily, usually in conjunction with other non-opioid drugs and users of non-opioids only).
Article
Long-term behavioral outcome status of 990 daily opioid users, recorded in follow-up interviews about six years after admission to community-based treatment programs, was classified in terms of longitudinal patterns of opioid use. Sixty-one percent of these individuals had achieved abstinence from opioid drugs for a year or longer immediately before the follow-up interview. Compared with those who continued heavy opioid drug use, and with others who had problems with nonopioid drugs or alcohol over time, persons who achieved abstinence also had significantly better long-term outcomes on criminality, use of nonopioid drugs and alcohol, and productive activities. Except for criminal history, outcome status was generally unrelated to client demographic and background predictors, but behavioral improvements over time were strongly associated with participation in drug abuse treatment.
Article
A sample of 2,099 Black and White male daily opioid drug users admitted to drug abuse treatment programs located across the United States were followed up 5 to 6 years after admission. Follow-up interviews focused on posttreatment behavioral functioning, including drug and alcohol use, treatment reentry, criminality, and employment. The sample included Black and White males in the nationally oriented Drug Abuse Reporting Program (DARP) who were admitted to methadone maintenance (MM), therapeutic community (TC), outpatient drug-free (DF), and outpatient detoxification (DT) programs; in addition, intake-only (IO) who never returned to receive treatment in the DARP were included as a comparison group. This study examined the status of these former addicts during the year immediately before the follow-up interview. It was found that 60% of the total sample reported no opioid drug use and 78% reported no daily use. Furthermore, over one-third had no illicit drug use at all during the year, as well as no arrests or incarcerations in jail or prison. Long-term status was slightly more favorable for persons treated in DARP, MM, TC, and DF programs, compared to DT and IO clients. Limitations on the interpretations of these results and suggestions for further research are discussed.
Article
In questioning many of the myths in this field, Kaufman has made an important contribution to the literature. Much of the material he presents deserves wider dissemination. However, at least four of his 21 "realities" are overstated, and another four are not well founded or are amenable to alternative explanations. The present paper is generally supportive of Kaufman's presentation while also attempting to place certain of the issues in perspective so as to avoid the creation of new myths. © 1980 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.
Article
Family therapy has become an increasingly important modality in the treatment of substance abuse over the past decade. As knowledge of family patterns and therapy in this area has increased, many myths have evolved. This article examines these myths and presents the realities as perceived by the author at this time.
Article
A sample of 1,496 persons admitted to 26 community treatment agencies participating in the Drug Abuse Reporting Program (DARP) during 1972 and 1973 were located and interviewed in 1978 and 1979. Favorableness of one-year posttreatment outcomes with respect to illicit drug use, criminality, and employment and other productive activities was found to increase linearly with the length of time patients stayed in methadone maintenance, a therapeutic community, or outpatient drug-free treatment. In addition, follow-up outcome for persons who spent less than three months in treatment was least favorable, and was not significantly different from that of persons in outpatient detoxification programs or who were admitted but not treated (intake-only). Persons who completed treatment generally stayed in treatment longer, as expected; they also had a more favorable outcome after DARP treatment than did others.
Article
Heavy drinking following treatment for drug addiction was associated with sex (male), heavy drinking before treatment, a history of alcohol problems, low pretreatment use of opiates and high pretreatment use of nonopiates.
Article
Follow-up interview data for 1,155 opioid addicts showed that about three-fourths of the sample reported some criminal behavior during a 4-year period after leaving drug abuse treatment. Males had a higher prevalence of "major" crimes (including crimes against persons, robbery, mugging, burglary, theft, or dealing drugs) than did females, while females reported a higher percentage engaged in the so-called "victimless" crimes (primarily based on prostitution or pimping). Criminal behavior was primarily profit-related and strongly associated with drug use, especially opioid drugs. Drug users reported more criminal behavior than nonusers, and criminality and drug use increased and decreased together among persons who showed changes in drug use during the follow-up period.