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How long do substance abuse clients stay clean after treatment?

Christopher P Tompkins, PhD, Constance M. Horgan, ScD, Grant A. Ritter, PhD, and Sharon Reif, PhD. Schneider Institute for Health Policy, Heller Graduate School, Brandeis University, 415 South Street, MS 035, Waltham, MA 02454, 781-736-3924, reif@brandeis.edu

A major focus of substance abuse treatment research has been the disposition of clients at periodic intervals following a particular treatment episode. Less is known about how much time transpires before clients return to drug use or to subsequent treatment. This paper uses data from the nationally representative Alcohol and Drug Services Study (conducted during the late 1990s) to understand more about what happens to clients after treatment discharge. Survival analysis is used to determine the proportion of clients who relapse to substance use or return to treatment following discharge, the distributions in time after discharge and time after relapse for these events, and the characteristics and circumstances (in terms of the facility, the treatment, and the client) that predict the likelihood of relapsing or returning to treatment. Preliminary results show that 53% of drug clients relapse and 26% return to treatment within 18 months following treatment discharge, with average times of 58 and 170 days, respectively. About 22% of clients are likely to relapse within the first 20 days post-discharge, after which the probabilities decline and level out by 200 days post-discharge. In addition, relatively few clients return to treatment even after long time intervals following discharge, providing little support for the common stereotype of clients cycling rapidly in and out of substance abuse treatment. Fewer than 15% of clients return to treatment within 6 months of their initial relapse.

Learning Objectives:

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.

Treatment Success and Aftercare

The 132nd Annual Meeting (November 6-10, 2004) of APHA