Retention in Treatment of Drug Users: 1971–1972 DARP Admissions

Abstract

In this brief summary of results, the “holding power” of different approaches to treatment and how certain patient characteristics are involved were examined. In all treatments, rate of termination prior to completion of treatment was high, particularly for the treatments not involving methadone maintenance. Almost three-fourths of the patients in these treatments terminated prior to treatment completion, and most of the terminations were due to quitting. Furthermore it was found that of the patients who terminated, a large number left within a month after admission and over half were gone within 3 months.

In terms of patient characteristics which were related to retention, older patients in all types of treatment were less likely to terminate than younger patients. Even among patients who terminated during the first 12 months after admission, older ones tended to stay longer before leaving. Thus, age was related in a consistent manner with maintenance as well as drug-free oriented programs. Other more treatment-specific relationships involved the trend for females to have higher rates of termination from therapeutic communities, and the tendency for patients who used opioids daily prior to treatment to be less likely than nondaily users to remain in drug-free programs.

Tenure in treatment, of course, does not represent by itself a sufficient criterion for the evaluation of treatment effectiveness. Nevertheless, most treatment programs consider some minimum period of time in treatment to be necessary before the effects of therapy can be realized. In most cases, it is clear from the present results that the treatments offered by community programs generally represented by the DARP have not been able to retain patients for the desired periods of time. This is evident by the rates of treatment terminations, particularly due to quitting at the patient's choice. The rates of treatment completions and percentages of patients still in treatment after a year were also generally low, indicating that relatively few patients were able to fulfill basic expectations of the treatment regimes. The reasons for this are not easily determined, but findings such as those reported in this study identify certain problem areas concerning retention which are expected to be of interest to treatment personnel and suggest that program changes and development could benefit by taking into account patient characteristics of the clientele being served by the treatment agency.