One year outcomes for heroin dependence: findings from the Australian Treatment Outcome Study (ATOS).
OBJECTIVE
To determine 1 year outcomes for drug use, criminality, psychopathology and injection-related health problems in those entering treatment for heroin dependence in Australia.


METHODS
Longitudinal prospective cohort study.


METHODS
Seven hundred and forty five individuals entering treatment (methadone/buprenorphine maintenance therapy; detoxification; residential rehabilitation) and 80 heroin users not seeking treatment.


METHODS
Sydney, Melbourne and Adelaide, Australia.


RESULTS
A total of 657 individuals were re-interviewed at 1 year, 80% of the original sample. There were substantial reductions in heroin and other drug use across all three treatment modalities. The majority of those who had entered treatment were heroin abstinent at 1 year (maintenance therapy 65%, detoxification 52%, residential rehabilitation 63%) compared to 25% of the non-treatment sample. The reduction in heroin use among the treatment samples was paralleled by reductions in poly drug use. There were also substantial reductions in risk-taking, crime and injection-related health problems across all treatment groups, and less marked reductions among the non-treatment group. Psychopathology was dramatically reduced among the treatment modalities, while remaining stable among the non-treatment group. Positive outcomes at 1 year were associated with a greater number of cumulative treatment days experienced over the 1 year follow-up period ('treatment dose') and fewer treatment episodes undertaken in that time ('treatment stability').


CONCLUSIONS
At 1 year, there were impressive reductions in drug use, criminality, psychopathology and injection-related health problems following treatment exposure. The positive findings were associated with a greater "dose" of treatment, and with more treatment stability over the follow-up period.
Teesson
Maree
M
National Drug and Alcohol Research Centre, University of New South Wales, NSW, Australia. m.teesson@unsw.edu.au
Ross
Joanne
J
Darke
Shane
S
Lynskey
Michael
M
Ali
Robert
R
Ritter
Alison
A
Cooke
Richard
R
D000293:Adolescent; D000328:Adult; D001315:Australia; D002047:Buprenorphine / Q000627:therapeutic use*; D003415:Crime / Q000706:statistics & numerical data*; D005260:Female; D006556:Heroin Dependence / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation*; D006801:Humans; D008658:Inactivation, Metabolic; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use*; D015995:Prevalence; D011446:Prospective Studies; D012309:Risk-Taking; D013997:Time Factors; D016896:Treatment Outcome
D009294:Narcotics; D002047:Buprenorphine