Impact of a stimulant-focused enhanced program on the outcome of alcohol- and/or stimulant-dependent men.
BACKGROUND
The approaches to the treatment of most forms of substance dependence are similar. It is not clear whether specific treatment components need to be added to address specific substances. This study asks two questions: What is the impact of a more intense drug treatment program, and do different substance problems require different treatment interventions?


METHODS
The 383 veterans included in this study represent two groups of consecutive inpatient male admissions with current alcohol dependence and/or dependence on amphetamines or cocaine at the inpatient Alcohol and Drug Treatment Program of the Veterans Affairs San Diego Healthcare System. All were interviewed at intake by trained interviewers using a standardized semistructured assessment instrument, and a resource person interview also was conducted with 85% of them. The first group of men received the Standard Treatment Program (STP), whereas the second group received the Enhanced Treatment Program (ETP). The latter included an addition of 10 hr per week of intense treatment aimed at stimulants, including two newly developed manual-driven groups (Relapse Prevention and Interpersonal Counseling), each of which met twice a week.


RESULTS
The patient follow-up was 92% at 3 months and 83% at 12 months. Abstinence from substances of abuse for ETP and STP were 63% vs. 49% at 3 months and 43% vs. 24% at 12 months. Logistic regressions demonstrated that treatment type continued to predict outcome even in the context of other potentially predictive variables.


CONCLUSIONS
Despite the ETP emphasis on stimulants, both alcohol- and stimulant-dependent men appeared to benefit, suggesting a generic improvement in substance use.
Smith
T L
TL
Department of Psychiatry, University of California, San Diego 92161, USA.
Volpe
F R
FR
Hashima
J N
JN
Schuckit
M A
MA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000628:therapy*; D019969:Amphetamine-Related Disorders / Q000628:therapy*; D019970:Cocaine-Related Disorders / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D016320:Substance Abuse Treatment Centers / Q000379:methods*