Readiness for change and drug use outcomes after treatment.
OBJECTIVE
The present study represents the first large-scale test of the capacity to predict illicit drug treatment outcomes of an instrument [Stages of Change and Treatment Eagerness Scale (SOCRATES)] purporting to measure processes underlying stages of change. The main hypothesis was that 'taking steps' should be predictive of less frequent use of illicit opiates (heroin and non-prescribed methadone) at follow-up.


METHODS
The sample comprised 1075 people seeking treatment for drug abuse problems in 54 treatment agencies in England. The study uses a longitudinal, prospective cohort design. Structured interviews were conducted at treatment intake and at 1-year follow-up. Data were collected about illicit drug use (frequency of use of heroin, non-prescribed methadone, cocaine and amphetamines, and non-prescribed benzodiazepines) and other problems.


RESULTS
Results failed to support the hypothesis that taking steps should be associated with less frequent use of illicit opiates at follow-up. No statistically significant associations of any kind were found between readiness for change measures and use of opiates or stimulants at follow-up. A negative association was found between taking steps and benzodiazepine misuse. Readiness for change measures were correlated with heroin use and psychiatric symptom scores at treatment intake.


CONCLUSIONS
Readiness for change measures were not associated with illicit drug use outcomes. Of the 12 hypothesized relationships between readiness for change measures and outcomes, our results show only one 'hit' and 11 'misses'.
Gossop
Michael
M
National Addiction Centre, Maudsley Hospital, Institute of Psychiatry, King's College London, London, UK. m.gossop@iop.kcl.ac.uk
Stewart
Duncan
D
Marsden
John
J
D000293:Adolescent; D000328:Adult; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use*; D015813:Substance Abuse Detection / Q000379:methods*; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000534:rehabilitation*
D009294:Narcotics; D008691:Methadone