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CRAFT has been found to be superior in engaging treatment-resistant substance-abusing individuals compared with the traditional programmes.

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Substance use disorders (SUDs) have a serious impact on several life areas, including family functioning. This study examined problem areas that patients with SUDs and their family members experience in terms of quality of relations, psychological problems, physical distress, and quality of life. A sample of 32 dyads--persons with SUDs and a family member--were recruited from a substance abuse treatment program, and completed the Maudsley Addiction Profile health symptoms section, EuroQol-5D, Relationship Happiness Scale, Dyadic Adjustment Scale, and the Dedication Scale. Family members reported that four significant others were directly affected by patients' addiction-related problems, while patients reported that less than three family members were affected by their addiction. Consistently, family members indicated that they were less content with their relationship than patients and evaluated the consequences of patients' SUDs as more negative and severe than the patients themselves. Furthermore, patients and their family members reported comparable levels of physical and psychological distress and quality of life scores. These systematically obtained findings support the notion that relationships of patients and family members are disrupted and both need help to improve their physical and psychological well-being.

In this multi-center, naturalistic study, the effectiveness of naltrexone maintenance combined with the Community Reinforcement Approach (CRA) was investigated in detoxified, opioid-dependent patients (N ¼ 272). Patients were recruited from methadone maintenance programs. With intention-to-treat analysis, 10 months of treatment yielded abstinence rates of 28% and 32% at 10 and 16 months after detoxification. The cumulative abstinence rate at 16 months was 24%. Quality of life, craving, general psychopathology, use of other psychoactive substances, and addiction severity of the abstinent group significantly improved when compared to the relapsed group. This abstinence-oriented approach appears to be a feasible goal, and remains an important option next to long-term methadone maintenance in the management of opioid dependence. (Am J Addict 2007;16:124-130)

About 4% of all prisoners can be diagnosed with a psychotic disorder, but it is largely unknown how these prisoners function during imprisonment. The present study aimed to describe symptoms of psychotic prisoners during imprisonment and incidents caused by them as well as care provided to these prisoners. A total of 61 prisoners were observed for a maximum of 12 weeks. Results show that poverty of speech and blunted affect significantly decreased over time. The largest group of psychotic prisoners either did not suffer from positive psychotic symptoms or the encountered positive psychotic symptoms exhibited a steady or decreasing pattern during their imprisonment. Reasons for these findings still remain unclear.

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