Effectiveness of an Outreach Treatment Program for Inner City Crack Abusers: Compliance, Outcome, and Client Satisfaction

Abstract

In a randomized controlled trial the effectiveness of an outreach treatment program (OTP) was compared with standard addiction care services for hard-drug addicts in Rotterdam (The Netherlands). The study aimed at chronic, high-risk crack abusers who were insufficiently engaged in standard addiction treatment services. Data were collected from February 2000 to December 2001. A total of 124 subjects participated in the study at baseline. Follow-up data were available for 94 subjects. Outcome measures included treatment compliance, outcome, and satisfaction. Data were collected by means of monthly registrations, EuropAsi interviews and an evaluation form. There was a high compliance with OTP in the treatment group; the average length-of-stay was 6 months, with visits three times a week. Although both groups were well represented in standard care, participation was mainly based on methadone maintenance. Subjects treated in OTP showed significant improvements in physical health, general living conditions, and psychiatric status, but no change in employment, substance abuse, and legal status. The control group remained almost unchanged. Clients of OTP reported feeling very satisfied with their treatment. On-the-spot incentives and a positive relationship with the care provider were directly associated with treatment retention. An outreach treatment program, as conducted in this study, is associated with high compliance, general improvement, and treatment satisfaction. Characteristics of this treatment modality are (1) assertive outreach, (2) a mixed program with incentives, and (3) a strong focus on individual-bound therapy. Further research is needed with larger groups and similar conditions at baseline assessment.

Increase in brain-derived neurotrophic factor expression in early crack cocaine withdrawal

“…A caveat in drug addiction treatment, especially among crack cocaine users, is the lack of efficacy of the behavioural and pharmacological treatments currently available (Henskens et al, 2008;Dias et al, 2011). Controls lived in poor areas, marked by high violence rates and probably submitted to similar life stressors, except for crack use.…”

Effectiveness of secondary prevention and treatment interventions for crack-cocaine abuse: A comprehensive narrative overview of English-language studies

“…The OTP group indicated stronger physical health, living condition and psychiatric health improvements and higher treatment satisfaction yet no differences in substance abuse, legal or employment indicators; on-the-spot incentives and provider rapport were associated with treatment compliance (Henskens, Garretsen, Bongers, Van Dijk, & Sturmans, 2008).…”

Associations of substance use patterns with attempted suicide among persons who inject drugs: Can distinct use patterns play a role?

“…Rotterdam, Netherlands illustrated that such models can have positive impacts on treatment engagement, and physical and mental health among chronic high-risk crack cocaine users who were previously inadequately engaged in care (Henskens et al, 2008).…”