Type of hospital setting and treatment outcome with heroin addicts. Results from a randomised trial.
BACKGROUND
General psychiatrists have recently been encouraged to provide treatment to heroin addicts, including in-patient detoxification. No comparison has previously been made of specialist versus general psychiatric in-patient care.


METHODS
During a randomised study of cue exposure, 186 opiate addicts were also randomised to either specialist in-patient (DDU; n = 115) or general psychiatric (GEN; n = 71) wards in the same hospital.


RESULTS
From pre-treatment (post-randomisation) onwards, patient outcomes differed across the two in-patient settings. Of the original randomised sample, significantly more DDU than GEN subjects accepted their randomisation (100 v. 77%), were subsequently admitted (60 v. 42%), and completed in-patient detoxification (45 v. 18%). Of patients admitted, more DDU than GEN patients completed detoxification (75 v. 43%). During seven-month follow-up, of those 43 patients who reached the end of treatment, significantly more ex-DDU than ex-GEN subjects were opiate-free.


CONCLUSIONS
From pre-treatment onwards, significant differences in process and outcome were found after allocation to treatment on either DDU or GEN. Further randomised studies are required to replicate and explain these findings.
Strang
J
J
National Addiction Centre, Institute of Psychiatry/The Maudsley, London.
Marks
I
I
Dawe
S
S
Powell
J
J
Gossop
M
M
Richards
D
D
Gray
J
J
D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006556:Heroin Dependence / Q000534:rehabilitation*; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D008658:Inactivation, Metabolic; D007902:Length of Stay; D008297:Male; D010352:Patient Dropouts; D016896:Treatment Outcome; D006113:United Kingdom