title: Detoxification as a gateway to long-term treatment: assessing two interventions.
abstract: Two interventions designed to increase the likelihood of entry into long-term treatment upon discharge from hospital detoxification are compared in a randomized controlled trial. The 279 study participants were treated for heroin and/or cocaine dependence on detoxification wards in two hospitals in a poor, predominantly Hispanic, neighborhood in New York City. One-third of the participants entered and remained in long-term treatment for the first 30 days after discharge from detoxification, 23% were in treatment for 1-29 days, and 43% received no treatment in the 30 days. Neither of the interventions--one, a brief motivational psychotherapy, the other, a series of treatment-related videos--is found to be significantly superior to treatment as usual in increasing the likelihood of utilization of long-term treatment. While weaknesses in the interventions themselves need to be examined, it is also concluded that conditions on the detoxification wards may hamper effective intervention.
authors.affiliation: Department of Sociomedical Sciences, Mailman School of Public Health of Columbia University, 722 West 168 Street, Room 11-14, New York, NY 10032, USA. mm994@columbia.edu
authors.forename: Mari
authors.initials: M
authors.lastname: Millery
authors.forename: Bhadra Paula
authors.initials: BP
authors.lastname: Kleinman
authors.forename: Nayak L
authors.initials: NL
authors.lastname: Polissar
authors.forename: Robert B
authors.initials: RB
authors.lastname: Millman
authors.forename: Michael
authors.initials: M
authors.lastname: Scimeca
mesh_terms: D000328:Adult; D019970:Cocaine-Related Disorders / Q000188:drug therapy / Q000534:rehabilitation*; D004637:Emergency Services, Psychiatric; D005260:Female; D006556:Heroin Dependence / Q000188:drug therapy / Q000534:rehabilitation*; D006801:Humans; D007902:Length of Stay; D008297:Male; D009042:Motivation; D009519:New York City; D010353:Patient Education as Topic; D011614:Psychotherapy, Brief; D012044:Regression Analysis; D014743:Videotape Recording