Longitudinal Outcomes for Treated Opiate Use and the Use of Ancillary Medical and Social Services

Abstract

Using an extended Maudsley Addiction Profile, 404 opiate users entering treatment across Ireland were interviewed at intake and at 1 year and 3 years between 2003 and 2006. At 3 years clients were abstinent, in treatment, or relapsed. Analysis of lifetime use of treatment services revealed that greater proportions of those who were drug free at 3 years had counselling in the past. Multiple regression revealed that the number of previous treatment episodes had a significant positive effect on outcomes. Findings are important during times of financial constraint when treatment providers are under pressure to cut back to core services.

RÉSUMÉ

Résultats longitudinaux pour l’usage d’opiacés sous traitement et le recours aux services ancillaires médicaux et sociaux

En se servant d’une adaptation du Profil de Dépendance de Maudsley, 404 utilisateurs d’opiacés à travers l’Irlande commençant un traitement ont été interrogés au départ puis à 1 et 3 ans d’intervalle entre 2003 et 2006. A 3-ans, les clients étaient abstinents, sous traitement ou avaient rechuté. Une analyse de l’utilisation à vie des services de traitement a révélé qu’une proportion plus importante de ceux qui ne prenaient plus de drogues avait bénéficié d’aide psychosociale dans le passé. La régression multiple a révélé que le nombre d’épisodes de traitement dans le passé avait eu un effet positif considérable sur les résultats. Les conclusions d’analyses sont importantes en temps de contraintes financières lorsque les fournisseurs de services sont sous pression pour réduire leurs services au minimum.

Mots clés: Traitement; usage d’opiacés; services consultés; aide psychosociale, evaluation; résultats longitudinaux; politique.

RESUMEN

Resultados longitudinales para el uso tratado de opiáceos y el uso de los servicios auxiliares sociales y médicos

Con el empleo de una adaptación del perfil de la adicción de Maudsley, se entrevistó a 404 consumidores de opiáceos bajo tratamiento en Irlanda que lo consumían y que lo habían hecho entre 1 y 3 años, entre 2003 y 2006.

A los tres años, los clientes eran bien abstinentes de el tratamiento o bien sufrieron una recaída. El análisis de los servicios de tratamiento del uso en la vida reveló que gran parte de aquellos participantes que no consumieron drogas durante tres años, habían acudido a servicios de gabinetes de orientación psicológica. La regresión múltiple reveló que el número de episodios de tratamiento anteriores tuvieron un efecto positivo en los resultados obtenidos. Estos resultados son significativos en esta época de restricciones financieras, en las que las entidades que prestan estos servicios se encuentran bajo el apremio de los recortes presupuestarios que afectan a prestaciones esenciales.

Palabras clave: Tratamiento; uso de opiáceos; servicios de acceso; orientación psicopedagógica counselling, evaluación; resultados longitudinales; política.

Keywords :

• opiate use
• treatment
• services
• counselling
• evaluation
• longitudinal
• policy
• outcomes, dose

THE AUTHORS

Prof. Comiskey holds the B.A.(Mod) degree in Mathematics and Philosophy from Trinity College, Dublin University, Ireland, and the M.Sc. and Ph.D. degrees in Biomathematics with Statistics and Epidemiology from Dublin City University, Ireland. In 2007, she was appointed by Minister of Education and Science to serve on the board of The Irish Research Council for Science, Engineering and Technology, (IRCSET). Prof. Comiskey has over 20 years of research experience in Statistics and Mathematics applied to Health Care. As Director of Research and Associate Professor of Healthcare Statistics at the School of Nursing and Midwifery she is responsible for developing and implementing the School's strategic plan for research and advising and directing and promoting research. Her personal research interest is in longitudinal modelling of treatment and intervention outcomes with a special interest in substance misuse, infectious diseases, and prevalence. She is married to Architect Peter Carroll, and they have four children ranging in age from 7 to 16.

Robert Stapleton, Ph.D., is currently employed by An Garda Siochana. He has previously held positions as a postdoctoral researcher on the Research Outcome Study in Ireland Evaluating Drug User Treatment Effectiveness (ROSIE), NUI, Maynooth; a statistical officer at the National Drug and Alcohol Research Centre (NDARC), University of New South Wales; and a statistics lecturer at University College Dublin. His research interests include the design and analysis of experiments and the application of statistics in the design and analysis of treatment and intervention programs and the resulting provision of evidence in the development of decisions on policy delivery. In particular, he is interested in the application of statistics in determining those factors that influence outcomes in various medical, biological, and drug and alcohol abuse research studies. He has a PhD in Statistics from the University of Southampton, England.