Overview of. Treatment Outcome Studies from DATOS
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1 Drug Abuse Treatment Outcome (Funded by NIDA) Overview of Treatment Outcome from DATOS Charts Prepared & Released for Public Use by Dwayne Simpson (TCU), Robert Hubbard (NDRI-NC), Douglas Anglin (UCLA), & Bennett Fletcher (NIDA) Slide 1 of Drug Abuse Treatment Outcome Third National Evaluation of Treatment Effectiveness Funded by the National Institute on Drug Abuse Cities 96 Programs ~10,000 Patients All treatment types Follow-up: 1 & 5 Yrs Over Published Psychology of Addictive Behaviors (Dec 97) Drug and Alcohol Dependence (Dec 99) Archives of General Psychiatry (June 99) Slide 2 of Simpson, Hubbard, Anglin, & Fletcher 1
2 DATOS Research Centers Treatment Selection, Access, and Utilization Robert Hubbard, Ph.D. NDRI, Inc. Raleigh, North Carolina Addiction and Treatment Careers Douglas Anglin, Ph.D. University of California Los Angeles, California Treatment Engagement and Retention Dwayne Simpson, Ph.D. Texas Christian University Fort Worth, Texas Applications and Policy Development Bennett Fletcher, Ph.D. NIDA Rockville, Maryland Slide 3 of Reasons for Field-based Treatment Outcome Effectiveness in real world settings Funding decisions by policy-makers Public information & support Test impact of clinical advancements Changes occur over time in -- Types or trends of patient drug use Treatment services & resources Slide 4 of Simpson, Hubbard, Anglin, & Fletcher 2
3 Changes in Drug Use Patterns alters Treatment Systems 85 % Using Opiates % Using Cocaine s (DARP) (DATOS) Slide 5 of CJ System Involvement and Referrals to Community Programs (DATOS) 100 % Legally Involved % Criminal Justice Referral Long-Term Residential (n=2,774) Outpatient Drug-Free (n=2,574) Outpatient Methadone (n=1,5) Craddock, Rounds-Bryant, Flynn, & Hubbard, 1997, Amer J of Drug Alc Abuse Slide 6 of Simpson, Hubbard, Anglin, & Fletcher 3
4 DATOS: Overview of Sampling Plan Longitudinal Data Collection Intakes ( ) During treatment (1-3 mos) Year 1 posttreatment Year 5 posttreatment Portland Minneapolis San Jose Chicago Phoenix Pittsburgh New Orleans New York Newark Sampled from 11 Cities across the U.S. Includes 10,010 Admissions to 96 Programs Houston N=2,774 from 21 Long-Term Residential (LTR) programs N=2,574 from 32 Outpatient Drug-Free (ODF) programs N=3,122 from 14 Short-Term Inpatient (STI) programs N=1,5 from 29 Outpatient Methadone Treatment (OMT) Miami Slide 7 of Long-Term Residential (LTR)Treatment Changes from Before to After Treatment Pre Post Cocaine Heroin Heavy Alcohol* Illegal Activity* No FT Work* Suicidal Ideation* % of DATOS Sample (N=676) *p<.001 Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997, PAB Slide 8 of Simpson, Hubbard, Anglin, & Fletcher 4
5 Outpatient Drug-Free (ODF) Treatment Changes from Before to After Treatment Pre Post Cocaine Marijuana Heavy Alcohol* Illegal Activity* No FT Work* Suicidal Ideation* % of DATOS Sample (N=764) *p<.001 Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997, PAB Slide 9 of Short-Term Inpatient (STI) Treatment Changes from Before to After Treatment 100 Pre Post Cocaine Marijuana Heavy Alcohol* Illegal Activity* No FT Work Suicidal Ideation* % of DATOS Sample (N=799) *p<.001 Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997, PAB Slide 10 of Simpson, Hubbard, Anglin, & Fletcher 5
6 Outpatient Methadone Treatment (OMT) Changes from Before to After Treatment Pre Post Cocaine Heroin Heavy Alcohol Illegal Activity* No FT Work Suicidal Ideation % of DATOS Sample (N=727) *p<.001 Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997, PAB Slide 11 of Drug Abuse Treatment Core Components and Comprehensive Financial Medical Mental Health Housing & Transportation Child Care Core Treatment Intake Assessment Treatment Plans Group/Individual Counseling Abstinence Based Pharmacotherapy Self-Help (AA/NA) Urine Monitoring Case Management Continuing Care Vocational Educational Family AIDS / HIV Risks Legal Slide 12 of Simpson, Hubbard, Anglin, & Fletcher 6
7 Changes in LTR Core Treatment: Patient Saw Trt Plan Group Counseling In 12-Step Aftercare (FU) % of Long-Term Residential (LTR) Sample Slide 13 of Changes in ODF Core Treatment: Patient Saw Trt Plan Group Counseling In 12-Step Aftercare (FU) % of Outpatient Drug-Free (ODF) Sample Slide 14 of Simpson, Hubbard, Anglin, & Fletcher 7
8 Changes in OMT Core Treatment: Patient Saw Trt Plan Group Counseling In 12-Step Aftercare (FU) % of Outpatient Methadone Treatment (OMT) Sample Slide 15 of Changes in Wrap-Around : LTR ODF OMT % of Sample Receiving 2 or More Etheridge, Craddock, Dunteman, & Hubbard, 1995, J Substance Abuse Slide 16 of Simpson, Hubbard, Anglin, & Fletcher 8
9 Changes in LTR Comprehensive : Medical Psychol Family Educational % of Long-Term Residential (LTR) Sample Slide 17 of Changes in ODF Comprehensive : Medical Psychol Family Educational % of Outpatient Drug-Free (ODF) Sample Slide 18 of Simpson, Hubbard, Anglin, & Fletcher 9
10 Changes in OMT Comprehensive : Medical Psychol Family Educational % of Outpatient Methadone Treatment (OMT) Sample Slide 19 of Home Page About DATOS Background Highlights Special Topics Publications Web Posters What s New CONTENT News and Features Latest DATOS studies have been published in Drug and Alcohol Dependence Treatment process (engagement and participation), retention, and outcomes are the focus of this series of studies, and our first cost-benefit analysis addresses cocaine treatment. The latest DATOS publications and "in press" are listed on the Publications page. Cocaine Treatment Outcome Study is Released (in June 1999 issue of Archives of General Psychiatry) Findings emphasize the need for "adequate treatment stays," especially when problem severity is moderate-to-high. At least 90 days in intensive residential (TC) programs was indicated for high-severity cases. More information is provided in a new section of Highlights page, "Outcomes for Treatment of Cocaine Dependence. Selected 1-Year Outcomes Treatment & Process Cocaine Treatment Selected Web Posters Adolescent Cost Benefits of MM Treatment Readiness for Treatment Slide of Simpson, Hubbard, Anglin, & Fletcher 10
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