Abstract
Is there a relationship between the characteristics of drug addiction treatment programs and an important correlate of better outcomes, the length of time clients are in treatment? Previous research has consistently shown longer periods in treatment and a range of services each have a salutary effect on client outcomes after treatment. Much of this research has examined the characteristics of clients. Program attributes are another important consideration. Multivariate analysis of data collected from a national survey of outpatient drug addiction treatment programs shows offering a range of services along with several other program characteristics are relevant to the duration of treatment. When a range of services are available, this has a positive association with both the number of months programs report clients are in treatment and with the number of counseling sessions programs report clients receive over the course of treatment. Ultimately, this should lead to better outcomes for clients.
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Office of Applied Studies, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. National survey on drug use and health 2005. Available at: www.oas.samhsa.gov/NSDUH/2k5nsduh/2k5results.htm#7.3.
Anglin MD, Hser YI, Grella CE, et al. Drug treatment careers: conceptual overview and clinical, research, and policy applications. In: Tims FM, Leukefeld CG, Platt JJ, eds. Relapse and Recovery in Addiction. New Haven, CT: Yale University Press; 2001:18–39.
Broome KM, Simpson DD, Joe GW. Relapse to opiod and cocaine use following methadone treatment. In: Tims FM, Leukefeld CG, Platt JJ, eds. Relapse and Recovery in Addiction. New Haven, CT: Yale University Press; 2001:334–354.
Hubbard RL, Flynn PM, Craddock SG, et al. Relapse after drug abuse. In: Tims FM, Leukefeld CG, Platt JJ, eds. Relapse and Recovery in Addiction. New Haven, CT: Yale University Press; 2001:109–121.
McLellan AT, McKay JR. The Treatment of addiction: What can research offer practice. In: Lamb S, Greenlick MR, McCarty D, eds. Bridging the Gap Between Practice and Research. Washington, D.C.: National Academy Press; 1998:147–185.
McLellan AT, Woody GE, Metzger D, et al. Evaluating the effectiveness of addiction treatments: Reasonable expectations, appropriate comparisons. In: Egertson JA, Fox DM, Leshner AI, eds. Treating Drug Abusers Effectively. Malden, MA: Milbank Memorial Fund; 1997:7–40.
Simpson DD. Effectiveness of drug-abuse treatment: A review of research from field settings. In: Egertson JA, Fox DM, Leshner AI, eds. Treating Drug Abusers Effectively. Malden, MA: Milbank Memorial Fund; 1997:41–73.
McKay JR, Weiss RV. A review of temporal effects and outcome predictors in substance abuse treatment studies with long-term follow-ups. Evaluation Review. 2001;25(2):113–161 April.
Brewer DD, Catalano RF, Haggerty K, et al. A meta-analysis of predictors of continued drug use during and after treatment for opiate addiction. Addiction. 1998;93(1):73–92.
Simpson DD, Joe GW, Brown BS. Treatment retention and follow-up outcomes in the Drug Abuse Treatment Outcome Study (DATOS). Psychology of Addictive Behaviors. 1997;11(4):294–307.
Hubbard RL, Craddock SG, Flynn PM, et al. Overview of 1-year follow-up outcomes in the Drug Abuse Treatment Outcome Study (DATOS). Psychology of Addictive Behaviors. 1997;11(4):261–278.
Marsh JC, D’Aunno TA, Smith BD. Increasing access and providing social services to improve drug abuse treatment for women with children. Addiction. 2000;95(8):1237–1247.
McLellan AT, Hagan TA, Levine M, et al. Supplemental social services improve outcomes in public addiction treatment. Addiction. 1998;93(10):1489–1499.
McLellan AT, Arndt IO, Metzger DS, et al. The effects of psychosocial services in substance abuse treatment. Journal of the American Medical Association. 1993;269(15):1953–1959.
Simpson DD, Joe GW, Rowan-Szal GA, et al. Drug abuse treatment process components that improve retention. Journal of Substance Abuse Treatment. 1997;14(6):565–572.
Hser YI, Polinsky ML, Maglione M, et al. Matching clients’ needs with drug treatment services. Journal of Substance Abuse Treatment. 1999;16(4):299–305.
Friedmann PD, Lemon SC, Stein MD, Etheridge RM, D’Aunno TA. Linkage to medical services in the drug abuse treatment outcome study. Medical Care. 2001;39(3):284–295.
Friedmann PD, Alexander JA, D’Aunno TA. Organizational correlates of access to primary care and mental health services in drug abuse treatment units. Journal of Substance Abuse Treatment. 1998;16(1):71–80.
Friedmann PD, Alexander JA, Jin L, D’Aunno TA. On-site primary care and mental health services in outpatient drug abuse treatment units. The Journal of Behavioral Health Services & Research. 1999;26(1):80–94.
Office of Applied Studies, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. National survey of substance abuse treatment services 2005. Available at: http://www.oas.samhsa.gov/DASIS/2k5nssats.cfm.
D’Aunno TA, Price RH. Linked systems: drug abuse and mental health services. In: Scott WR, Black BL, eds. The Organization of Mental Health Services: Societal and Community Systems. Newbury Park, CA: Sage; 1986:277–307.
Wheeler RC, Fadel H, D’Aunno TA. Ownership and performance of outpatient substance abuse treatment centers. American Journal of Public Health. 1992;82(5):711–718 May.
Wheeler RC, Nahra TA. Private and public ownership in outpatient substance abuse treatment: do we have a two-tiered system. Administration and Policy in Mental Health. 2000;27(4):97–209 March.
D’Aunno TA, Vaughn TE. An organizational analysis of service patterns in outpatient drug abuse treatment units. Journal of Substance Abuse. 1995;7:27–42.
Berry WD. Understanding Regression Assumptions. Newbury Park, CA: Sage; 1993.
Berry WD, Feldman S. Multiple Regression in Practice. Newbury Park, CA: Sage; 1985.
Johnson G. Repeated Measures Analysis with Discrete Data Using the SAS System. Cary, NC: SAS Institute, Inc.; 1996.
McCullagh P, Nelder JA. Generalized Linear Models. New York, NY: Chapman and Hall; 1989.
Liang KY, Zeger SL. Longitudinal data analysis using generalized linear models. Biometrika. 1986;73:13–22.
Hardin JW, Hilbe JM. Generalized Estimating Equations. Boca Raton, FL: Chapman and Hall/CRC; 2003.
Lemak, CH. Managed care and outpatient substance abuse treatment: A study of organizational response to external environments. Doctoral dissertation, University of Michigan, Ann Arbor: 1998.
Alexander JA, Lemak CH. Managed care penetration in outpatient substance abuse treatment units. Medical Care and Research Review. 1997;54(4):490–507 December.
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This article was drafted at the Institute for Healthcare Studies of Northwestern University while the author was a postdoctoral fellow in a position funded by the US Department of Education, National Institute on Disability and Rehabilitation Research, Advanced Rehabilitation Research Training Project (H133P030002).
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Walker, M.A. Program Characteristics and the Length of Time Clients are in Substance Abuse Treatment. J Behav Health Serv Res 36, 330–343 (2009). https://doi.org/10.1007/s11414-008-9128-0
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DOI: https://doi.org/10.1007/s11414-008-9128-0