Length of stay, neuropsychological performance, and aftercare: Influences on alcohol-treatment outcome.

Abstract

This study tested the hypothesis that male veterans who were alcohol abusers (n = 245) grouped according to levels of neuropsychological functioning (based on Reitan's Brain Age Quotient) would have differential outcome following random assignment to 2-week or 7-week hospitalization in a milieu-oriented treatment program. Over the 9 months of posthospitalization follow-up, there was significant improvement for the sample as a whole. However, outcome following 2-and 7-week programs did not differ significantly. Neuropsychological performance was significantly but modestly related to some outcome criteria (e.g., abstinence rates and employment status), but no consistent interaction with length of stay was found. The most salient finding was the strong relationship of aftercare involvement (which was analyzed as a covariate) to most outcome criteria. Patients who attended weekly aftercare groups for 9 months following hospitalization were three times more likely to remain abstinent than patients who dropped out of aftercare (70.2% vs. 23.4% abstinence, respectively). Implications for individualizing alcohol treatment and conducting future research on patient-treatment matching are discussed.

Using buprenorphine short-term taper to facilitate early treatment engagement

“…Retention in treatment is linked to positive outcomes across a wide range of substance abuse problems (Brownell, Marlatt, & Lichtenstein, 1986;Hser, Grella, Hsieh, Anglin, & Brown, 1999;McLellan et al, 1985;Sees et al, 2000;Simpson, Joe, & Brown, 1997;Walker, Donovan, & Kivlahan, 1983). Realizing these benefits for opioiddependent patients following detoxification is particularly challenging given that they have been found to have poor retention in abstinence-based treatment (Paraherakis, Charney, Palacios-Boix, & Gill, 2000).…”

Effectiveness of Dual Focus Mutual Aid for Co-Occurring Substance Use and Mental Health Disorders: A Review and Synthesis of the “Double Trouble” in Recovery Evaluation

“…Comorbidity is highly predictive of negative treatment outcomes (Gonzalez and Rosenheck, 2001;Donat and Haverkamp, 2004). Among substance user patients, the severity of psychiatric symptoms is associated with poorer outcomes (McLellan et al, 1983;Rounsaville et al, 1986;Walker et al, 1983). Among mental health patients, particularly persons manifesting schizophrenia, a comorbid addictive disorder has been associated with increased mental health treatment and more medication, higher rehospitalization and emergency room visits, homelessness, criminality and violence, suicide attempts, increased fluctuation and severity of psychiatric symptoms, legal problems, 2 The DTR program is detailed below.…”

Factors Affecting Long-term Abstinence from Substances Use

“…Other studies, for example, (Fiorentine and Hillhouse 2000) stated that the completion of outpatient treatment and weekly or more frequent attendance at 12-step meetings during and after treatment may assist in the cessation of alcohol and drug-dependent behavior. In addition, Walker et al (1983) found that the abstinent rate was significantly higher for an after-care completer compared to an after-care drop out (70% vs23%). However, Schumacher et al (2000) have postulated that abstinence is a function of treatment attendance and more treatment is associated with greater abstinence.…”

“…This finding supports the idea that ongoing support after completion of an initial program is essential. Walker et al (1983) found that the abstinent rate was significantly higher for an after care completer compared to after care drop out (70% vs. 23). Unexpectedly, some findings (Michael and June 1997) showed that short-term inpatient treatment programs are found to yield a significant decline in drug use.…”