Detoxification as a gateway to long-term treatment: assessing two interventions.
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.
Millery
Mari
M
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
Kleinman
Bhadra Paula
BP
Polissar
Nayak L
NL
Millman
Robert B
RB
Scimeca
Michael
M
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