Rational Drop-Out from Substance Abuse Treatment as A Means to Minimize Personally Felt Risk?

Abstract

Drop-out from resident substance abuse treatment may be viewed as rational behaviour given the expectations of the abuser. A model is presented which calculates the total risk and expected return on equity of the abuser's social capital towards a set of values of life. The model was tested by questionnaire on 60 substance abusers who were residents in treatment and rehabilitation facilities, and on the half of the initial group who could be traced after completing a six months' stay. A high level of normal culture values of life correlated with length of stay, and a decrease in expected return on equity on their values of life correlated with early drop-out. Both the group staying and the group leaving the facilities seemed to follow a personally felt rational path, as indicated in their own estimates of social capital of values of life. This path indicated a desire to reduce personally felt risk and increase expected return'on equity on a set of values of life. Defection from treatment may therefore not necessarily be thought of as a failure of either abuser or counsellor. Understanding personal rationality is suggested as a way to better matching of client to institution.

Key Words:

• Rational addiction
• drop-out
• substance abuse
• treatment