The 130th Annual Meeting of APHA

4095.0: Tuesday, November 12, 2002 - Board 5

Abstract #44839

Rhythm of recovery: A two-year follow-up of Medicaid adults in substance abuse treatment

Roy M. Gabriel, PhD, Jeffrey R.W. Knudsen, MA, and Kelly J. Brown, PhD. RMC Research Corporation, 522 S.W. Fifth Avenue, Suite 1407, Portland, OR 97204, 503-223-8248,

Objectives. The chronicity of substance abuse and chemical dependency has long been recognized by clinicians, but relatively few studies of treatment effectiveness include client follow up assessments over two years or more. This study examines the substance use and treatment “careers” of a highly vulnerable population, Medicaid-eligible adults, over a two-year period following their entry into a new treatment episode.

Methods. Structured interviews, featuring the Addiction Severity Index, were conducted at treatment entry (baseline), and at 6-, 12- and 24-month follow-ups. The sample included over 500 adults beginning treatment in publicly funded agencies in Oregon and Washington. Follow-up rates were 74%, 76% and 56%, respectively. Although the attrition rate was markedly higher at the 24-month follow-up, the full analysis sample (clients with all four interviews) was highly representative of the baseline sample.

Results. Significant declines in ASI alcohol use, drug use, and legal involvement composites persisted through the 24-month follow-up, although the majority of the decline was visible after 6 months. Initial declines in mental health and physical health problems visible at the 6-month follow-up were not sustained through the 12-month follow-up. A closer look at the substance-abusing behavior in this sample yielded identifiable patterns over the four points in time of research and clinical significance.

Conclusions. While there is strong evidence of long term effectiveness of substance abuse treatment, reliance on group-level analyses often obscures intra-individual trends that are important to researchers in understanding the outcomes of treatment and to clinicians in improving their service to these individuals.

Learning Objectives:

  • At the end of this session, participants will

    Keywords: Substance Abuse Treatment, Drug Use

    Presenting author's disclosure statement:
    I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

    Changing Treatment Systems and Methods Poster Session

    The 130th Annual Meeting of APHA