Does a History of Violence Influence Treatment, Self-Help, and 1-Year Outcomes in Substance Use Disorder Patients?

ABSTRACT

Rates of violence perpetration are high among patients with substance use disorder, but the impact of violence on substance use disorder treatment outcomes has received little attention. Patients with (n = 155) or without (n = 190) a history of difficulty controlling violent behavior were interviewed at entry to substance use disorder treatment and 1 year later. Substance use disorder severity, amount of treatment, and extent of participation in 12-step self-help groups were assessed to examine potential differences in treatment outcomes between violent and non-violent patients. After adjusting for baseline differences, no differences in substance use disorder severity were found at 1 year. However, over the year, violent patients received more treatment and participated more in 12-step groups compared to non-violent patients. In addition, violent patients benefited more from 12-step group participation than non-violent patients did. Referral to 12-step self-help groups may enhance the likelihood of recovery from a substance use disorder for patients with a history of violence.

KEYWORDS:

• Self-help
• substance use disorder treatment
• 12-step programs
• violence

Acknowledgments

This article is not subject to U.S. copyright law.

The authors thank Rudolf Moos, PhD, for help with this manuscript.

Dr. Schneider was supported by the VA Office of Academic Affiliations (TPP 62-500), and Dr. Timko by VA Health Services Research and Development Service (RCS 00-001). The views expressed here are the authors' and do not necessarily represent the views of the Department of Veterans Affairs.

Notes

^a Analyses of substance use outcomes control for baseline value of the outcome.