Slide 1 of 20 Overview of Overview of National National Treatment Outcome Treatment Outcome Studies Studies Charts Prepared & Released for Public Charts Prepared & Released for Public Use by Use by Dwayne Simpson (TCU), Robert Hubbard Dwayne Simpson (TCU), Robert Hubbard (NDRI-NC), Douglas Anglin (UCLA), & (NDRI-NC), Douglas Anglin (UCLA), & Bennett Fletcher (NIDA) Bennett Fletcher (NIDA) Drug Abuse Treatment Drug Abuse Treatment Outcome Studies Outcome Studies (Funded by NIDA) (Funded by NIDA)
Overview of National Treatment Outcome Studies
Jan 28, 2016
Drug Abuse Treatment Outcome Studies (Funded by NIDA). DATOS. Overview of National Treatment Outcome Studies. Charts Prepared & Released for Public Use by Dwayne Simpson (TCU), Robert Hubbard (NDRI-NC), Douglas Anglin (UCLA), & Bennett Fletcher (NIDA). - PowerPoint PPT Presentation
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Slide 1 of 20
Overview of Overview of National National
Treatment Treatment Outcome StudiesOutcome Studies
Charts Prepared & Released for Public Use by Charts Prepared & Released for Public Use by Dwayne Simpson (TCU), Robert Hubbard (NDRI-NC), Dwayne Simpson (TCU), Robert Hubbard (NDRI-NC),
Douglas Anglin (UCLA), & Bennett Fletcher (NIDA)Douglas Anglin (UCLA), & Bennett Fletcher (NIDA)
Drug Abuse Treatment Drug Abuse Treatment Outcome StudiesOutcome Studies(Funded by NIDA)(Funded by NIDA)
Slide 2 of 20
DDrug rug AAbuse buse TTreatment reatment OOutcome utcome SStudiestudiesThird National Evaluation of Treatment Effectiveness
Over Over 60 Studies Published60 Studies Published – – Psychology of Addictive BehaviorsPsychology of Addictive Behaviors (Dec 97) (Dec 97)Drug and Alcohol DependenceDrug and Alcohol Dependence (Dec 99) (Dec 99) Archives of General PsychiatryArchives of General Psychiatry (June 99) (June 99)
Funded by the Funded by the National National
Institute on Institute on Drug AbuseDrug Abuse
1991-93
11 Cities
96 Programs
~10,000 Patients
All treatment types
Follow-up: 1 & 5 Yrs
Slide 3 of 20
DATOS Research DATOS Research CentersCenters
Treatment Selection, Treatment Selection, Access, and UtilizationAccess, and UtilizationRobert Hubbard, Ph.D.
NDRI, Inc.Raleigh, North Carolina
Addiction and Addiction and Treatment CareersTreatment CareersDouglas Anglin, Ph.D.
University of CaliforniaLos Angeles, California
Treatment Engagement Treatment Engagement and Retentionand RetentionDwayne Simpson, Ph.D.
Texas Christian UniversityFort Worth, Texas
Applications and Policy Applications and Policy DevelopmentDevelopmentBennett Fletcher, Ph.D.
NIDARockville, Maryland
Slide 4 of 20
Reasons for Field-based Reasons for Field-based Treatment Outcome Treatment Outcome
StudiesStudies 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 5 of 20
Changes in Drug Use Patterns Changes in Drug Use Patterns altersalters Treatment Systems Treatment Systems
85
3339
82
1970s (DARP) 1990s (DATOS)
% Using Opiates
% Using Cocaine
Slide 6 of 20
CJ System Involvement and CJ System Involvement and ReferralsReferrals
to Community Programs (DATOS) to Community Programs (DATOS)
64
33
57
42
27
2
0
20
40
60
80
100
Long-TermResidential(n=2,774)
Outpatient Drug-Free (n=2,574)
Outpatient Methadone (n=1,540)
% Legally Involved % Criminal Justice Referral
Craddock, Rounds-Bryant, Flynn, & Hubbard, 1997 (AJDAA)
Slide 7 of 20
DATOS: Overview of Sampling DATOS: Overview of Sampling Plan Plan
Longitudinal Data Collection Intakes (1991-93) During treatment (1-3 mos) Year 1 posttreatment Year 5 posttreatment
Sampled from 11 Cities across the U.S.
Includes 10,010 Admissions to 96 Programs 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=1,540 from 29 Outpatient Methadone Treatment (OMT)
PortlandPortland
San JoseSan Jose
PhoenixPhoenix
HoustonHouston
NewNew OrleansOrleans
MiamiMiami
MinneapolisMinneapolis
ChicagoChicago
PittsburghPittsburgh
NewNew YorkYork
NewarkNewark
Flynn, Craddock, Hubbard, Anderson, & Etheridge, 1997 (PAB)
Slide 8 of 20
Long-Term ResidentialLong-Term Residential (LTR)Treatment(LTR)Treatment
Changes from Before to After TreatmentChanges from Before to After Treatment
66
2217
6
40
19
41
16
88
77
24
13
0
20
40
60
80
100
Cocaine (Weekly)*
Heroin (Weekly)*
Heavy Alcohol*
Illegal Activity*
No FTWork*
SuicidalIdeation*
Pre Post
% of DATOS Sample (N=676)*p<.001
Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997 (PAB)
Slide 9 of 20
Outpatient Drug-FreeOutpatient Drug-Free (ODF) (ODF) TreatmentTreatment
Changes from Before to After TreatmentChanges from Before to After Treatment
42
1825
9
31
1522
14
8276
19
11
0
20
40
60
80
100
Cocaine (Weekly)*
Marijuana (Weekly)*
Heavy Alcohol*
Illegal Activity*
No FTWork*
SuicidalIdeation*
Pre Post
% of DATOS Sample (N=764)*p<.001
Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997 (PAB)
Slide 10 of 20
Short-Term InpatientShort-Term Inpatient (STI) (STI) TreatmentTreatment
Changes from Before to After TreatmentChanges from Before to After Treatment
67
21
30
11
48
2026
11
6764
31
16
0
20
40
60
80
100
Cocaine (Weekly)*
Marijuana (Weekly)*
Heavy Alcohol*
Illegal Activity*
No FTWork
SuicidalIdeation*
Pre Post
% of DATOS Sample (N=799)*p<.001
Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997 (PAB)
Slide 11 of 20
42
22
89
28
15 16
29
14
85 82
1713
0
20
40
60
80
100
Cocaine (Weekly)*
Heroin (Weekly)*
Heavy Alcohol
Illegal Activity*
No FTWork
SuicidalIdeation
Pre Post
% of DATOS Sample (N=727)
Outpatient Methadone TreatmentOutpatient Methadone Treatment (OMT)(OMT)
Changes from Before to After TreatmentChanges from Before to After Treatment
*p<.001
Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997 (PAB)
Slide 12 of 20
Drug Abuse Treatment Drug Abuse Treatment CoreCore Components and Components and ComprehensiveComprehensive
ServicesServicesMedicalMedical
Mental Mental HealthHealth
VocationalVocational
EducationalEducational
LegalLegalAIDS / AIDS /
HIV RisksHIV Risks
FinancialFinancial
Housing & Housing & TransportationTransportation
Child Child CareCare
FamilyFamily
Continuing Care
Case Management
Urine Monitoring
Self-Help(AA/NA)
Pharmaco-therapy
Group/Individual Counseling
AbstinenceBasedIntake
Assessment
Treatment Plans
CoreCoreTreatmentTreatment
Etheridge, Hubbard, Anderson, Craddock, & Flynn, 1997 (PAB)
Slide 13 of 20
Changes in Changes in LTRLTR Core Treatment: Core Treatment: 1990s (DATOS1990s (DATOS ) vs.) vs. 1980s (TOPS)1980s (TOPS)
74
33
83
69
41
20
Patient Saw Trt Plan
GroupCounseling
In 12-StepAftercare (FU)
1990s 1980s
% of Long-Term Residential (LTR) Sample
Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997 (PAB)
Slide 14 of 20
Changes in Changes in ODFODF Core Treatment: Core Treatment: 1990s (DATOS1990s (DATOS ) vs.) vs. 1980s (TOPS)1980s (TOPS)
41
22
66
13
31
11
Patient Saw Trt Plan
GroupCounseling
In 12-StepAftercare (FU)
1990s 1980s
% of Outpatient Drug-Free (ODF) Sample
Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997 (PAB)
Slide 15 of 20
Changes in Changes in OMTOMT Core Treatment: Core Treatment: 1990s (DATOS1990s (DATOS ) vs.) vs. 1980s (TOPS)1980s (TOPS)
48
25 22
1
42
6
Patient Saw Trt Plan
GroupCounseling
In 12-StepAftercare (FU)
1990s 1980s
% of Outpatient Methadone Treatment (OMT) Sample
Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997 (PAB)
Slide 16 of 20
Changes in “Wrap-Around” Changes in “Wrap-Around” Services: Services:
1990s (DATOS1990s (DATOS ) vs.) vs. 1980s (TOPS)1980s (TOPS)
50
77
15
60
5
20
LTR ODF OMT
1990s 1980s
% of Sample Receiving 2 or More Services
Etheridge, Craddock, Dunteman, & Hubbard, 1995 (J Sub Abuse)
Slide 17 of 20
Changes in Changes in LTRLTR Comprehensive Comprehensive Services: Services:
1990s (DATOS1990s (DATOS ) vs.) vs. 1980s (TOPS)1980s (TOPS)
55
78
13
59
20
3328
42
MedicalServices
PsycholServices
FamilyServices
EducationalServices
1990s 1980s
% of Long-Term Residential (LTR) Sample
Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997 (PAB)
Slide 18 of 20
Changes in Changes in ODFODF Comprehensive Comprehensive Services: Services:
1990s (DATOS1990s (DATOS ) vs.) vs. 1980s (TOPS)1980s (TOPS)
23 26
10
68
10
43
10
21
MedicalServices
PsycholServices
FamilyServices
EducationalServices
1990s 1980s
% of Outpatient Drug-Free (ODF) Sample
Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997 (PAB)
Slide 19 of 20
Changes in Changes in OMTOMT Comprehensive Comprehensive Services: Services:
1990s (DATOS1990s (DATOS ) vs.) vs. 1980s (TOPS)1980s (TOPS)
2733
1016
10 10 10 10
MedicalServices
PsycholServices
FamilyServices
EducationalServices
1990s 1980s
% of Outpatient Methadone Treatment (OMT) Sample
Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997 (PAB)
Slide 20 of 20
Selected Studies
1-Year Outcomes
Treatment Services
& Process
CocaineTreatment
SelectedWeb Posters
AdolescentStudies
Cost Benefits ofMM Treatment
Readinessfor Treatment
News and FeaturesHome Page
About DATOS
Background
Highlights
Special Topics
Publications
Web Posters
What’s New
CONTENT
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.”
Latest DATOS studies have been published in Drug and Alcohol DependenceTreatment 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.
www.datos.orgwww.datos.org
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