The Drug Abuse Treatment Outcome Study (DATOS) collected 1-year follow-up outcomes for 2,966 clients in outpatient methadone (OMT), long-term residential (LTR), outpatient drug-free (ODF), and short-term inpatient (STI) programs in 1991-1993. LTR, STI, and ODF clients reported 50% less weekly or daily cocaine use in the follow-up year than in the preadmission year. Reductions were greater (p < .01) for clients treated for 3 months or more. Clients still in OMT reported less weekly or daily heroin use than clients who left OMT. Multivariate analysis confirmed that 6 months or more in ODF and LTR and enrollment in OMT were associated with the reductions. Reductions of 50% in illegal activity and 10% increases in full-time employment for LTR clients were related (p < .01) to treatment stays of 6 months or longer. The results replicated findings from 1979-1981 for heroin use in OMT and illegal activity and employment for LTR but not for illegal activity in OMT and ODF.The Drug Abuse Treatment Outcome Study (DATOS) is the third in a series of studies

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The Drug Abuse Treatment Outcome Study (DATOS) is the 3rd in a series of national multisite studies of community-based treatment sponsored by the National Institute on Drug Abuse. The major goal of this prospective cohort study of adult clients entering treatment from 1991 to 1993 is to evaluate treatment effectiveness. The study included 10,010 admissions from 96 programs in 11 cities. Interviews were conducted at admission and during treatment, and 2,966 selected participants completed a 12-month follow-up interview. This article describes the methodological aspects of the study and provides an overview of program and client samples. Data collection procedures and instrumentation are described, and the analytical approach used to attain the research objectives is presented. Future plans for a longer term follow-up are also described, along with the potential contributions of DATOS findings to treatment policy.

Program and client data from the Drug Abuse Treatment Outcome Study (DATOS) were used to examine program structural and treatment characteristics in 1991-1993. Similar data from the Treatment Outcome Prospective Study were used to compare the characteristics of DATOS programs with those in 1979-1981. Drug abuse treatment typically consisted of supportive therapy delivered primarily in groups, emphasizing abstinence from all illicit substances, including alcohol, buttressed by relapse prevention and urine monitoring during treatment. Secondary treatment emphases reflected each modality's unique orientations. Over the 2 eras, comprehensive services declined while many core elements of treatment strengthened, including client awareness of treatment plans and posttreatment involvement in 12-step groups. Some programs began to experience structural changes resulting from cost containment and managed care.Drag abuse treatment is provided in distinct program settings, each having arisen from and being inseparably tied to distinct philosophical

This study summarizes historical changes among clients entering drug treatment in their sociodemographic characteristics and important pretreatment behaviors, such as work activity, criminal behavior, drug use, prior drug treatment, and health insurance. Data are drawn from three major studies of drug abuse treatment clients: the Drug Abuse Reporting Program (DARP), 1969-1972; the Treatment Outcome Prospective Study (TOPS), 1979-1981; and the Drug Abuse Treatment Outcome Study (DATOS), 1991-1993. The mix of drug treatment clients and their interaction with the drug treatment system changed substantially over the past three decades. Because data items are most directly comparable between TOPS and DATOS, the focus of this paper is on changes within the past decade. The most conspicuous change is in types and numbers of drugs used by clients entering treatment. Multiple drug use declined since the late 1970s, while reports of cocaine use since TOPS more than doubled among clients in the long-term residential and outpatient treatment modalities, and increased 1 1/2 times among methadone clients. Other differences in treatment populations include decreases in clients' working full-time and in reports of suicidal ideation and attempts and predatory crime. Data from such studies as DARP, TOPS, and DATOS are valuable in historical, contextual, policy, and evaluative frameworks. The changing nature of the drug treatment client population--from sociodemographics to drug use and multiple treatment problem severities--highlights the complexity of issues and difficulties encountered by those attempting to treat clients or plan treatment strategies.

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