Drug Abuse Treatment Outcome

Etheridge, R. M., Hubbard, R. L., Anderson, J., Craddock, S. G., Elynn, P. M. (1997). Treatment structure and program services in the Drug Abuse Treatment Outcome Study (DATOS). Psycholojiy of Addictive Behaviors, jj, 244-260. 

Fletcher, B.W., Tims, F. M., Brown, B. S. (1997). Drug Abuse Treatment Outcome Study (DATOS) Treatment evaluation research in the United States. Psycholo/iy of Addictive Behaviors,... 

Donovan, D.M. Kivlahan, D.R. and Walker, D.R. Clinical limitations of neuropsychological testing in predicting treatment outcome among alcoholics. Alcoholism Clin Fxp Res 8 470-475, 1984. Fauman, M.A., and Fauman, B.J. Chronic phencyclidine (PCP) abuse A psychiatric perspective. J. Psvchedel ic Drugs 12 307-315,... 

Williamson A, Darke S, Ross J Teesson M (2006). The association between cocaine use and short-term outcomes for the treatment of heroin dependence findings from the Australian Treatment Outcome Study (ATOS). Drug and Alcohol Review, 25, 141-8 Withers NW, Pulvirenti L, Koob GF Gillin JC (1995). Cocaine abuse and dependence. Journal of Clinical Psychopharmacology, 15, 63-78... 

Stanton, M. D., Shadish, W. R. (1997). Outcome, attrition, and family-couples treatment tor drug abuse A meta-analysis and review of controlled, comparative studies. Psycholo/fical Bulletin, 122, 170-191. 

Similar findings resulted from a study sponsored by the National Institute on Drug Abuse of 10,000 clients in nearly 100 treatment programs and in a metaanalysis of 78 separate drug treatment outcome studies. In addition, a summary of 51 published and 17 unpublished reports regarding the costs versus benefits of substance abuse treatment firmly validated the cost-effectiveness of treatment. ... 

It would appear that public-sector treatment has positive eflects on alcohol and other drug use and on the consequence of substance abuse and addiction. Additionally, treatment is cost-effective. These outcomes have occurred in spite of the fact that most public-sector treatment clients do not complete treatment nor do they stay in treatment long enough for the maximum benefits. Even though many federal efforts have not been able to demonstrate effectiveness for specific programs, the treatment outcome studies indicate the NDCS treatment dollars have been much better spent than the prevention dollars. 

In other substance use disorders, the use of 12-step interventions is also popular, and participation in 12-step groups is correlated with better outcomes in cocaine abusers (e.g., McKay et al. 1994). However, a smdy of 128 cocaine abusers found that cognitive-behavioral therapy was more efficacious than 12-step facilitation in engendering cocaine abstinence (Maude-Griffm et al. 1998). Thus, the relative efficacy of 12-step approaches for drug use disorders requires further investigation. No known studies have systematically evaluated the efficacy of 12-step treatments in opioid-dependent patients, either alone or in conjunction with pharmacotherapies. 

In the reviews cited in this chapter there is often some breakdown of findings into those relating to heroin use, criminality, HIV-risk behaviours, social rehabilitation and nonopiate abuse. We have noted that crime was one of the earliest indicators in methadone treatment, while the wider range of outcomes is formalized in drug misuse rating instruments such as the Opiate Treatment Index (Darke et al. 1992a). The main areas in which methadone treatment has been found to be of substantial benefit are indicated in Table 1.3. 

Other drugs of the depressant, antianxiety, antipyschotic, and anticonvulsive types are being investigated as treatments for cocaine abuse. Those which have been or will be covered in this course include the heterocyclic antidepressants desipramine and imipramine, which diminish cocaine use and craving as well as improve the outcome in the first few months of treatment. Buprenorphine (depressant) may augment the reward system (it has been found to suppress self-administration of cocaine in monkeys). Lithium sometimes works for those who are clinically depressives. Carbamazapine, bromocriptine and mazindol are also used as well as fluphenthixol and buspirone. 

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