Clients in the national Drug Abuse Treatment Outcome Study reported significant overall improvements in drug use and related measures during a 12-month follow-up period. A quasi-experimental design was used to examine the relationship of treatment duration with outcomes in each of the 3 major modalities represented. Client subsamples with longer retention in long-term residential programs and in outpatient methadone treatment had significantly better outcomes than those with shorter lengths of stay (results were inconclusive for outpatient drug-free programs because of sample limitations). This study used several methodological enhancements and showed general continuity of findings on retention effects from previous national evaluations of treatment effectiveness. It supports the need for more careful study of treatment process in relation to outcomes.

Measures of motivation for drug use change and treatment were examined with respect to psychometric properties and prediction of early dropoutsfrom methadone maintenance (MM). Three scales were used to obtain personal assessments of: Drug Use Problems, Desire for Help, and Treatment Readiness. Each was composed of 7 to 9 items. Data were collected at intake from 311 MM clients admitted to three separate outpatient treatment agencies, of which 24% dropped out of treatment within 60 days. The scales were found to be reliable, and evidence of validity was based on comparisons with other background and pretreatment functioning measures. Social stability (marital status, employment, and fewer prior arrests), previous treatment experience, expectations for reducing Special appreciation is expressed to Ms. Christine B. Meadows and her staff at the Corpus Christi Drug Abuse Council,

Patients with the most severe problems were more likely to enter long-term residential programs, and better outcomes were reported by those treated 90 days or longer. Dimensions of psychosocial problem severity and length of stay are, therefore, important considerations in the treatment of cocaine dependence. Cocaine relapse rates for patients with few problems at program intake were most favorable across all treatment conditions, but better outcomes for patients with medium- to high-level problems were dependent on longer treatment stays.

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