Overview of. Cocaine Treatment Outcome Study

Transcription

1 Drug Abuse Treatment Outcome Studies (Funded by NIDA) Overview of Cocaine Treatment Outcome Charts Prepared & Released for Public Use by Dwayne Simpson (TCU), Robert Hubbard (NDRI-NC), Douglas Anglin (UCLA), & Bennett Fletcher (NIDA) Slide 1 of 14 Drug Abuse Treatment Outcome Studies Third National Evaluation of Treatment Effectiveness Funded by the National Institute on Drug Abuse Cities 96 Programs ~1, Patients All treatment types Follow-up: 1 & 5 Yrs Over Studies Published Psychology of Addictive Behaviors (Dec 97) Drug and Alcohol Dependence (Dec 99) Archives of General Psychiatry (June 99) Slide 2 of 14 Simpson, Hubbard, Anglin, & Fletcher 1

2 Cocaine Treatment About three-fourths of all admissions to non-methadone treatment programs in the U.S. are for cocaine dependence Managed care pressures are for shorter treatment & outpatient settings Outcomes of cocaine treatment needs to be studied in real-world settings Slide 3 of 14 Cocaine Treatment Outcomes (in Year After Discharge in DATOS) Cumulative Outcome Criteria (N=15) Wkly Coc 23% Half (52%) had relapses to drug use: 23% to weekly cocaine use 19% to occasional cocaine 1% to other drugs Any Trt 11% Alc Prob 4% Any Drug 1% Any Coc 19% 4% had alcohol problems 11% reentered treatment (without relapse) Overall, 67% had problems during follow-up period Slide 4 of 14 Simpson, Hubbard, Anglin, & Fletcher 2

3 Weekly Cocaine Use in Past Year: Changes from Before to After Treatment 1 77 Before 58 After LTR* ODF* STI* *p<.1 DATOS Treatment Modality Slide 5 of 14 Any Jail in Past Year: Changes from Before to After Treatment 1 79 Before 73 After LTR* ODF* STI* *p<.1 DATOS Treatment Modality Slide 6 of 14 Simpson, Hubbard, Anglin, & Fletcher 3

4 Drinking 3+ Days/wk in Past Year: Changes from Before to After Treatment 1 Before After LTR* ODF* STI* *p<.1 DATOS Treatment Modality Slide 7 of 14 Relapse Rates (Drug use & Trt in Yr 1), by Retention in Cocaine Treatments 9 High-Problem Group 81 % in Outpatient Drug Free (n=466) % in Long-Term Residential (n=549) Threshold of minimum stay for effectiveness! >27 Number of Days in DATOS Treatment Slide 8 of 14 Simpson, Hubbard, Anglin, & Fletcher 4

5 Types of Problems at Admission 3+ Drugs Alcohol Dep Criminal Act Unemployed-FT Low Social Sup Dep/Anxiety No Insurance % With Problems in Year Before Admission Slide 9 of 14 Total Number of Problems (Problem Severity Index, PSI) % Low (-3) % Med (4-5) % High (6-7) LTR ODF STI Admissions to Each Treatment Modality Slide 1of 14 Simpson, Hubbard, Anglin, & Fletcher 5

6 Weekly Cocaine Use (in Year After Treatment) Low Medium High Problem Severity at Intake (p<.1) <9 Days 9+ Days Length of Treatment (p<.1) Slide 11of 14 Weekly Cocaine Use (in Year After Treatment) 28 Short-Term Low Problem Patients (ns) Long-Term Short-Term Long-Term Mid-High Problem Patients (p<.1) Slide 12of 14 Simpson, Hubbard, Anglin, & Fletcher 6

7 5 3 1 Weekly Cocaine Use (in Year After Treatment) 15 LTR (9+ Days) 29 ODF (9+ Days) 38 STI (21+ Days) HIGH Problem Patients (p<.1) Slide 13of 14 Home Page About DATOS Background Highlights Special Topics Publications Web Posters What s New CONTENT News and Features Latest DATOS studies have been published in Drug and Alcohol Dependence Treatment process (engagement and participation), retention, and outcomes are the focus of this series of studies, and our first cost-benefit analysis addresses cocaine treatment. The latest DATOS publications and "in press" are listed on the Publications page. Cocaine Treatment Outcome is Released (in June 1999 issue of Archives of General Psychiatry) Findings emphasize the need for "adequate treatment stays," especially when problem severity is moderate-to-high. At least 9 days in intensive residential (TC) programs was indicated for high-severity cases. More information is provided in a new section of Highlights page, "Outcomes for Treatment of Cocaine Dependence. Selected Studies 1-Year Outcomes Treatment Services & Process Cocaine Treatment Selected Web Posters Adolescent Studies Cost Benefits of MM Treatment Readiness for Treatment Slide 14of 14 Simpson, Hubbard, Anglin, & Fletcher 7