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Outcomes for:
Outpatient Methadone Treatment (OMT)

Long-Term Residential Treatment (LTR)
Outpatient Drug-Free Treatment (ODF)
Short-Term Inpatient Treatment (STI)


Overview of 1-Year Follow-up

Clients treated in all four modalities studied in DATOS – that is, OMT, LTR, ODF, and STI – showed large and significant improvements during the 1-year follow-up (N= 2,966; Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997). Overall, major outcome indicators for drug use, illegal activities, and psychological distress were each reduced on average by about 50%. However, there were notable distinctions between clients admitted to different types of treatment (and there were further variations even between programs of the same general type) as well as in the length of time they remained in treatment. For these reasons, the general findings summarized below are useful for addressing overall questions about "treatment effectiveness," but they do not indicate who benefits most from which treatment, and why. These are among the special topics of other studies now in progress.

Outpatient Methadone Treatment (OMT)

Chart: Outpatient Methadone Treatment (OMT) Outcomes

  • Admissions to OMT were 60% male, 52% African American or Hispanic, and 82% were over 30 years of age. In addition, 67% had graduated from high school (or had a GED), 40% were married or living as married, 3% were referred to treatment by the criminal justice system, and 10% had private health insurance. Previous drug treatments were reported by 77%; of these, 92% had accumulated more than 3 months in treatment.
     
  • Principal indicators of problems in pretreatment functioning (affecting more than 1 of 5 OMT admissions) were weekly heroin use (89%), weekly cocaine use (42%), no full-time work (85%), and illegal activity (29%).
     
  • Follow-up outcomes (see OMT Outcomes Chart) showed a 69% drop in the number of weekly heroin users and a 48% decline in weekly cocaine users.
     
  • Unemployment did not change significantly, but illegal activity declined 52%. Further tabulations showed a drop from 63% to 21% in those jailed in the year before versus after treatment.
     
  • Further treatment during follow-up was reported by 74% of the OMT sample, suggesting the need for a longer follow-up period in order to describe posttreatment outcomes for this sample of OMT clients.

 

Long-Term Residential (LTR) Treatment

Chart: Long-Term Residential Treatment (LTR) Outcomes

  • Admissions to LTR were 65% male, 60% African American or Hispanic, and 50% were over 30 years of age. In addition, 59% had graduated from high school (or had a GED), 22% were married or living as married, 35% were referred to treatment by the criminal justice system, and 4% had private health insurance. Previous drug treatments were reported by 60%; of these, 62% had accumulated more than 3 months in treatment.
     
  • Principal indicators of problems in pretreatment functioning (affecting more than 1 of 5 LTR admissions) were weekly cocaine use (66%), heavy alcohol use (40%), no full-time work (88%), suicidal ideation (24%), and illegal activity (41%).
     
  • Follow-up outcomes (see LTR Outcomes Chart) showed a 67% drop in the number of weekly cocaine users, and a 53% decline in heavy drinkers.
     
  • Unemployment dropped 13%, suicidal ideation fell by 46%, and illegal activity declined 61%. Further tabulations showed a drop from 77% to 35% in being jailed in the year before versus after treatment, and those with any arrests decreased from 56% to 31%.
     
  • Further treatment during follow-up was reported by 29% of the LTR sample.

 

Outpatient Drug-Free (ODF) Treatment

Chart: Outpatient Drug-Free Treatment (ODF) Outcomes

  • Admissions to ODF were 66% male, 66% African American or Hispanic, and 59% were over 30 years of age. In addition, 60% had graduated from high school (or had a GED), 27% were married or living as married, 42% were referred to treatment by the criminal justice system, and 16% had private health insurance. Previous drug treatments were reported by 50%; of these, 58% had accumulated more than 3 months in treatment.
     
  • Principal indicators of problems in pretreatment functioning (affecting more than 1 of 5 ODF admissions) were weekly cocaine use (42%), weekly marijuana use (25%), heavy alcohol use (31%), no full-time work (82%), suicidal ideation (19%), and illegal activity (22%).
     
  • Follow-up outcomes (see ODF Outcomes Chart) showed a 57% drop in the number of weekly cocaine users, a 64% reduction in the number of weekly marijuana users, and a 52% decline in heavy drinkers.
     
  • Unemployment dropped 7%, suicidal ideation fell by 42%, and illegal activity declined 36%. Further tabulations showed a drop from 69% to 25% in being jailed in the year before versus after treatment, and those with any arrests decreased from 37% to 21%.
     
  • Further treatment during follow-up was reported by 20% of the ODF sample.

 

Short-Term Inpatient (STI) Treatment

Chart: Short-Term Inpatient Treatment (STI) Outcomes

  • Admissions to STI were 67% male, 61% African American or Hispanic, and 64% were over 30 years of age. In addition, 72% had graduated from high school (or had a GED), 38% were married or living as married, 5% were referred to treatment by the criminal justice system, and 38% had private health insurance. Previous drug treatments were reported by 47%; of these, only 9% had accumulated more than 3 months in treatment.
     
  • Compared to LTR and ODF treatments, this specialized treatment modality admitted clients who were 3 to 10 times more likely to have private health insurance, more highly educated and employed, and 7 to 8 times less likely to be a criminal justice referral. STI admissions also had only a small fraction of the treatment exposures reported by LTR and ODF clients. Finally, STI programs as represented in DATOS have largely disappeared as a form of treatment available to the public, and cautions are recommended against making simple (i.e., unadjusted) comparisons of outcomes involving this modality.
     
  • Principal indicators of problems in pretreatment functioning (affecting more than 1 of 5 STI admissions) were weekly cocaine use (67%), weekly marijuana use (30%), heavy alcohol use (48%), no full-time work (67%), suicidal ideation (31%), and illegal activity (26%).
     
  • Follow-up outcomes (see STI Outcomes Chart) showed a 69% drop in the number of weekly cocaine users, a 63% reduction in the number of weekly marijuana users, and a 58% decline in heavy drinkers.
     
  • Unemployment showed no significant change, but suicidal ideation fell by 48% and illegal activity declined 58%. Further tabulations showed a drop from 49% to 20% in being jailed in the year before versus after treatment, and those with any arrests decreased from 26% to 20%.
     
  • Further treatment during follow-up was reported by 25% of the STI sample.

Reference

Hubbard, R. L., Craddock, S. G., Flynn, P. M., Anderson, J., & Etheridge, R. M. (1997). Overview of 1-year follow-up outcomes in the Drug Abuse Treatment Outcome Study (DATOS). Psychology of Addictive Behaviors, 11(4), 261-278.  [Abstract]

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