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Substance abuse treatment works to stem illicit drug use and crime. That message was brought home by results of a new national study released by the Substance Abuse and Mental Health Services Administration (SAMHSA) last month at the National Press Club in Washington, D.C. Moreover, the findings were similar to results of previous studies.
Five years after treatment discharge, the overall use of any illicit drug among patients had declined by 21 percent, alcohol use by 14 percent, marijuana use by 28 percent, cocaine use by 45 percent, crack use by 17 percent, and heroin use by 14 percent, according to the SAMHSA Services Research Outcomes Study. The results were weighted to reflect an estimated national drug abuse population discharged from treatment in 1990 (976,012 individuals).
Most criminal activity, including income-producing crimes such as breaking and entering, drug sales, and prostitution, and violent and disorderly offenses such as driving under the influence of alcohol or drugs and weapons use, declined between 23 and 38 percent following treatment, according to the study (see chart).
SAMHSA Administrator Nelba Chavez, Ph.D., told reporters, "The study adds more evidence and provides a new perspective to what we have been saying for years. Alcohol and drug treatment programs produce results. An investment in treatment is really a long-term economic investment in our nation's families and communities."
She also said, "The study found that not only did drug use decline following treatment, but these individuals are enjoying better physical and mental health, have more reliable housing, and are retaining and regaining child custody."
There were also decreases in loss of child custody (30 percent), time spent on the street (40 percent), being assaulted (20 percent), and suicide attempts (43 percent), according to the study.
Barry McCaffrey, director of the White House Office of National Drug Control Policy, told reporters, "The study makes the case that treatment deserves the full support of Congress."
The Clinton Administration has requested a $200 million budget increase for Fiscal 1999 for the Health and Human Services Substance Abuse Block Grant to expand the nation's treatment capacity, according to McCaffrey. Congress is also being asked to approve the administration's request of $85 million to support the Department of Justice Drug Intervention Program that seeks to break the cycle between drugs and crime, McCaffrey noted.
The study results were based on extensive interviews with 1,799 people five years after their discharge from 99 treatment facilities nationwide. The facilities were randomly surveyed and represented a national sample of treatment programs, including hospital inpatient, residential, outpatient methadone, and outpatient nonmethadone programs, and were located in rural, suburban, and urban locations.
The researchers compared the respondents' self-reported status (validated by urine tests) during the five years before treatment and five years after treatment to determine an individual's change in drug use, health status, and social functioning.
The investigators also found that the longer respondents stayed in the treatment facility, the less likely they were to abuse substances five years following discharge. Approximately 75 percent of respondents in outpatient nonmethadone and methadone facilities stayed at least one month. Those who stayed six months or longer in treatment and those who completed treatment regardless of length of stay had the most significant reduction in substance abuse five years later.
Alcohol was the main drug reported by patients at intake in inpatient, residential, and outpatient nonmethadone facilities. Heroin was the main drug reported at intake by patients at the outpatient methadone facility.
Sheldon Miller, M.D., chair of APA's Council on Addiction Psychiatry, told Psychiatric News, "The results show the importance and effectiveness of treatment to individuals in the war against drugs. Treatment works and reduces the demand for drugs, selling drugs, and criminal activity."