Substance Abuse Treatment Modalities and Outcomes in a Naturalistic Setting

Objectives: To measure follow-up abstinence rates at a private residential substance abuse treatment facility, and to examine correlations between treatment modalities, demographic characteristics, and abstinence outcomes.Methods:A retrospective case series study based on a chart review was conducted in a private residential substance abuse treatment facility.Results:During the 18-month time period of the study, 775 patients entered treatment and 677 completed treatment (87.4%). For those who completed treatment, follow-up data were collected by telephone calls. The abstinence rate at 1 year, including non-respondents to follow-up, was approximately 11%. Women were less likely to be abstinent than men, even though they were more likely to complete treatment. Those aged 65 years and older and 30 years and younger were more likely to be abstinent than those aged 31 to 64 years; yet an incremental increase by age category was found to be associated with treatment completion. Two intervention modalities, relapse prevention and spirituality, significantly differentiated patients by treatment completion in a univariate analysis. In a multiple imputation logistic regression analysis of abstinence, social support was the only interventive modality found to be positively related to abstinence, whereas substance abuse counseling was the only modality found to be negatively associated with abstinence.Conclusions:The results of this study suggest considering simplification of clinical interventions to those that have written manuals and specific protocols; limiting interventions to spirituality, cognitive behavioral therapy, relapse prevention, and social support; revising application of substance abuse counseling; and paying special attention to Baby Boomers, Generation Xers, and women. The limitations of the study are discussed.