An Australian survey of the procedures used for the treatment of opiate users.
Drug and alcohol agencies across Australia were asked to describe the services they offer to opiate users. Of the 284 agencies identified as providing treatment, 229 (81%) responded. A standard assessment procedure was used in 72% of agencies. Eighty (35%) agencies offered detoxification and had assisted 7883 clients with detoxification in the 12 months prior to March 1990. Methadone maintenance was offered in 20% of agencies with 5234 clients currently receiving this treatment. Daily doses of methadone in the range of 40-80 mg were described for most (51%) clients receiving methadone and concurrent counselling was provided in 45% of cases. Standard psychosocial interventions were provided by 60% of agencies. Out-patient or non-residential settings were most common (36%), with residential therapeutic communities being the setting for 21% of programmes. Supportive counselling was the most commonly used individual approach, and cognitive-behavioural or 12-step approaches were the most commonly used group approaches. Brief support or referral to Nar-Anon were the most popular family interventions. Procedures aimed at reducing the risk of HIV were in place at 85% of agencies. These findings are discussed in light of research evidence. Briefly, there is a diversity of treatment options available from different treatment agencies which is not reflected within the agencies, little aftercare is offered despite high rates of relapse, and doses of methadone are lower than has been found to be optimal.
Baillie
A J
AJ
National Drug and Alcohol Research Centre, University of New South Wales, PO Box 1, Kensington, NSW, 2033, Australia.
Webster
P
P
Mattick
R P
RP