Outpatient treatment engagement and abstinence rates following inpatient opioid detoxification.
Many patients with chronic opioid dependence are referred to drug-free outpatient treatment following inpatient detoxification even though successful outpatient treatment engagement and abstinence from opioids occur only in a minority of cases. This retrospective cohort analysis of medical records documents the post-discharge outcome in a treatment setting that maximizes the support during transition to abstinence-oriented outpatient care, with comprehensive social, medical and mental health services, including the availability of naltrexone. Participants were male veterans (N = 112) admitted at an urban VA medical center. Most patients (78%) successfully completed acute detoxification, 49% initiated naltrexone, and 76% accepted a VA aftercare plan. At 90-day follow-up, only 22% remained in aftercare, and < 3% had toxicology-verified abstinence from opioids. At one-year follow-up, 1 out of 5 had been readmitted for detoxification and 4.5% had died. Most patients successfully detoxified from opioids, but very few remained engaged and stabilized in abstinence-oriented outpatient treatment.
Davison
John W
JW
Va Puget Sound Health Care System, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seatte, WA 98195, USA. John.Davison@va.gov
Sweeney
Marie L
ML
Bush
Kristen R
KR
Davis Correale
Tania M
TM
Calsyn
Donald A
DA
Reoux
Joseph P
JP
Sloan
Kevin L
KL
Kivlahan
Daniel R
DR
D000359:Aftercare / Q000706:statistics & numerical data; D000553:Ambulatory Care / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008658:Inactivation, Metabolic; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011615:Psychotherapy, Group; D013997:Time Factors; D016896:Treatment Outcome; D014728:Veterans
D009292:Narcotic Antagonists; D009271:Naltrexone