Evaluation of the predictors of utilization, attrition, and effectiveness of cocaine dependence treatment
Description
Objectives. This study was designed to use data from one site of a nationwide, multiple-site treatment program evaluation to clarify the relationship between completion of cocaine dependence treatment, abstinence from cocaine use, utilization of different treatment modalities for cocaine dependence, and pretreatment patient characteristics Methods. One hundred and thirty eight male veterans who came for alcohol or drug treatment at VAMC, New Orleans, Louisiana between May 1992 and July 1993, and whose Axis I primary. diagnosis of DSM-III-R were cocaine dependence were used as study subjects. Evaluation of the factors associated with both the utilization and the efficacy of the treatment program was the central point of this study. In addition, there were two methodological issues being addressed in the analysis of this data: (1) Response bias was evaluated through the validation of patients self-report data; (2) The most appropriate measurement of treatment re-entry was determined as the outcome variables. Bivariate analyses and logistic regression analyses were the major analytic techniques in this investigation Results. (1) The rate of completing the index inpatient treatment program is 84.1%. The abstinence rate one year after the inpatient program is 34.6%. The rates of readmission and 'continued outpatient treatment'program are 28.8% and 20.2% respectively. (2) Two factors, 'no multiple psychiatric diagnoses' and greater or equal 'non-confidence in self-quitting substance use', are significantly associated with ' completing the index inpatient treatment program'. (3) Three variables: 'having a sponsor of 12-step group', 'completing the index inpatient treatment program', and 'cocaine consumption in a lower frequency (0--3 days) per week', are potential of abstinence. (4) Four variables: 'consuming cocaine in a higher (4--7 days) per week', 'no previous inpatient history', 'usually working greater or equal to 40 hours per week', and 'no multiple psychiatric diagnoses', are important factors of non-readmission. (5) Three variables: 'having previous history of outpatient treatment', 'cocaine consumption in a higher frequency (4--7 days) per week', and 'having previous history of inpatient treatment', are the strongest predictors of ' continued outpatient treatment'. (6) The dichotomous variable of substance use, the frequency of cocaine consumption per week, is a consistently potential factor of these 3 outcome variables: abstinence, non-readmission, and continued outpatient treatment. (7) The variable of substance use (psychopathology), 'no multiple psychiatric diagnoses', is a consistently important predictor of both 'completing the inpatient treatment program' and 'non-readmission'. (8) Patients' re-use of the treatment facility, either inpatient or outpatient treatment, is related to their previous history of treatment experience