Favorable outcomes linked to treatment compliance

November 04, 2002

A study supported by the National Institute on Drug Abuse (NIDA) assessing patient outcomes following treatment for cocaine dependence found that long-term outcome was related to the severity of the patients¡¦ drug problem upon entering treatment and to their level of involvement in treatment. The severity of the patients¡¦ drug problem was gauged by several measures, including multiple drug use, alcohol dependence, criminal activity, employment status, level of family support, socioeconomic status, and diagnosis of depression or anxiety.

Subjects were drawn from the NIDA-funded Drug Abuse Treatment Outcome Study (DATOS) that followed more than 10,000 patients admitted to 96 drug treatment programs during 1991 to 1993 in 11 cities. The present study looked specifically at a subgroup of cocaine-dependent patients included in the DATOS study of outcomes after the first year following treatment. Interviews were conducted one and five years after treatment with 708 subjects from 45 treatment programs in eight cities.

The patterns of outcomes after five years were similar to those reported for the first year after treatment. Cocaine-dependent patients with comparatively less severe problems at the beginning of treatment generally had the most favorable outcomes, regardless of the type or duration of treatment provided. The patients who were back in treatment at the five-year followup had the worst outcomes. These patients typically had more severe drug problems to start with and had left their DATOS treatment program before completion. In contrast, patients with severe problems who met or exceeded DATOS therapeutic treatment thresholds maintained significant improvements on all outcome measures.

WHAT IT MEANS: Although severity of drug and psychosocial problems at the onset of treatment was predictive of long-term recovery, outcomes improved in direct relation to the level of exposure to treatment, reinforcing the importance of compliance with treatment

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Dr. D. Dwayne Simpson and colleagues from Texas Christian University reported the study in the June 2002 issue of the journal Archives of General Psychiatry.

NIH/National Institute on Drug Abuse

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