title: [Social integration after 4 years of heroin-assisted treatment].
abstract: BACKGROUND
  Studies from several countries have by now shown the effectiveness of heroin-assisted treatment in comparison to methadone treatment. However, only few long-term results exist, and in particular data with a focus on social integration of the patients are scarce.
  
  
  OBJECTIVE
  The study analyzes the course of long-term social integration among the patients of the German diamorphine study.
  
  
  METHODS
  Individual changes in health, drug use and social integration among patients who had participated in a 4-year diamorphine treatment (n=156) were described and statistically tested by means of repeated measures analyses. The criteria used are based on the instruments OTI-HSS and SCL-90-R, on medical findings, urinalyses, and on variables as well as composite scores from the European Addiction Severity Index.
  
  
  RESULTS
  In all domains significant improvements were found after long-term treatment. The percentage of patients employed or currently working had increased 3-fold up to 40% after 4 years. Moreover, the living situation and leisure behaviour improved, and criminal activities declined markedly. The main influencing factor for successful social integration after 4 years of treatment is the ability to work.
  
  
  CONCLUSIONS
  Heroin-assisted treatment is a long-term effective treatment for severely dependent opiate addicts with respect to stabilization of health, reduction of illegal drug use and improvement of social integration. Furthermore, the results show that processes of social (re-)integration of drug users take time.
authors.affiliation: Zentrum für Interdisziplinäre Suchtforschung der Universität Hamburg.
authors.forename: U
authors.initials: U
authors.lastname: Verthein
authors.forename: I
authors.initials: I
authors.lastname: Schäfer
authors.forename: P
authors.initials: P
authors.lastname: Degkwitz
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D003415:Crime; D057915:Drug Substitution; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D003932:Heroin / Q000627:therapeutic use*; D006556:Heroin Dependence / Q000188:drug therapy / Q000453:epidemiology* / Q000534:rehabilitation*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D020127:Recovery of Function; D012307:Risk Factors; D012959:Socioeconomic Factors; D016896:Treatment Outcome
chemical_list: D003932:Heroin