The effects of planned duration of residential drug abuse treatment on recovery and HIV risk behavior.
OBJECTIVE
This study assessed the effects of planned duration of residential drug abuse treatment on recovery from drug use and on human immunodeficiency virus (HIV) risk behaviors.


METHODS
Two concurrent randomized controlled trials of programs differing in planned duration were conducted: 6-month vs 12-month versions of a traditional therapeutic community program, and 3-month vs 6-month versions of a modified therapeutic community incorporating a relapse prevention and health education program. Outcomes, measured at least 16.5 months after admission, included time from admission to first drug use; severity of drug, alcohol, legal, and employment problems; and risky drug injection and sexual behaviors.


RESULTS
Among 539 clients (86% of those enrolled), there were no significant effects of planned duration of treatment upon Addiction Severity Index scores or HIV risk behavior. In the relapse prevention program, clients randomized to the 6-month program had a longer time to first drug use than those in the 3-month program (hazard ratio = 0.74; 95% confidence interval = 0.58, 0.93). Employment problems at follow-up were significantly less severe among clients treated in the therapeutic community than among those in the relapse prevention program.


CONCLUSIONS
No overall benefit of extending treatment beyond 6 months was found.
McCusker
J
J
School of Public Health, University of Massachusetts, Amherst, USA.
Bigelow
C
C
Frost
R
R
Garfield
F
F
Hindin
R
R
Vickers-Lahti
M
M
Lewis
B
B
D000328:Adult; D004651:Employment; D005260:Female; D015658:HIV Infections / Q000209:etiology*; D006801:Humans; D007902:Length of Stay; D008297:Male; D012309:Risk-Taking; D012720:Severity of Illness Index; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000523:psychology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome