Characteristics and Pretreatment Behaviors of Clients Entering Drug Abuse Treatment: 1969 to 1993

Abstract

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.

Distress Tolerance as a Predictor of Early Treatment Dropout in a Residential Substance Abuse Treatment Facility.

“…Settings vary with regard to single verse mixed gender and distribution of race, while the majority of settings including a wide range of ages (Craddock, Rounds-Bryant, Flynn & Hubbard, 1997). There also exists variability with regard to staff.…”

Influence of Perceived Coercion and Motivation on Treatment Completion and Re-Arrest among Substance-Abusing Offenders

“…For example, the Drug Abuse Treatment Outcome Studies (DATOS), a multisite prospective study of treatment effectiveness, reported that 64% of clients in residential programs and 57% of clients in outpatient (non-methadone) programs were involved in the criminal justice system and that 33% of residential clients and 42% of outpatient clients were in treatment as the result of a referral from a criminal justice agency. 1 Clients referred by the criminal justice system are often assumed to have been admitted to treatment against their will. But evidence from a variety of sources indicates that such clients do not necessarily enter treatment involuntarily.…”

“…Estimates of referrals from the criminal justice system to community-based treatment programs vary but may be as high as 50% of treatment program populations. [1][2][3] Given the large numbers of criminal justice treatment clients, a major policy and clinical issue for the criminal justice and the drug treatment systems is the effectiveness and the appropriateness of coercing substanceabusing offenders to enter and remain in treatment and how such coercion influences or interacts with motivation for treatment.…”

Self-Administered Heroin and Cocaine Combinations in the Rat: Additive Reinforcing Effects—Supra-Additive Effects on Nucleus Accumbens Extracellular Dopamine

“…One study found that 63% of intravenous drug users concurrently used cocaine and heroin and/or their combinations within the past 6 months and 58% within the past 30 days (Schütz et al, 1994). In addition, the incidence of cocaine use in individuals on methadone or LAAM maintenance treatment for opiate abuse is significant (Magura et al, 1998;Craddock et al, 1997). This co-abuse clearly has negative consequences since high levels of cocaine use at intake decreased the likelihood of a positive treatment outcome for opiate addicts (Downey et al, 2000).…”