title: Factors associated with pretreatment and treatment dropouts: comparisons between Aboriginal and non-Aboriginal clients admitted to medical withdrawal management.
abstract: BACKGROUND
  Addiction treatment faces high pretreatment and treatment dropout rates, especially among Aboriginals. In this study we examined characteristic differences between Aboriginal and non-Aboriginal clients accessing an inpatient medical withdrawal management program, and identified risk factors associated with the probabilities of pretreatment and treatment dropouts, respectively.
  
  
  METHODS
  2231 unique clients (Aboriginal = 451; 20%) referred to Vancouver Detox over a two-year period were assessed. For both Aboriginal and non-Aboriginal groups, multivariate logistic regression analyses were conducted with pretreatment dropout and treatment dropout as dependent variables, respectively.
  
  
  RESULTS
  Aboriginal clients had higher pretreatment and treatment dropout rates compared to non-Aboriginal clients (41.0% vs. 32.7% and 25.9% vs. 20.0%, respectively). For Aboriginal people, no fixed address (NFA) was the only predictor of pretreatment dropout. For treatment dropout, significant predictors were: being female, having HCV infection, and being discharged on welfare check issue days or weekends. For non-Aboriginal clients, being male, NFA, alcohol as a preferred substance, and being on methadone maintenance treatment (MMT) at referral were associated with pretreatment dropout. Significant risk factors for treatment dropout were: being younger, having a preferred substance other than alcohol, having opiates as a preferred substance, and being discharged on weekends.
  
  
  CONCLUSIONS
  Our results highlight the importance of social factors for the Aboriginal population compared to substance-specific factors for the non-Aboriginal population. These findings should help clinicians and decision-makers to recognize the importance of social supports especially housing and initiate appropriate services to improve treatment intake and subsequent retention, physical and mental health outcomes and the cost-effectiveness of treatment.
authors: Xin
authors: X
authors: Li
authors: Huiying
authors: H
authors: Sun
authors: David C
authors: DC
authors: Marsh
authors: Centre for Health Evaluation and Outcome Sciences, 588-1081 Burrard Street, Vancouver, B,C, V6Z 1Y6, Canada. aslam.anis@ubc.ca.
authors: Aslam H
authors: AH
authors: Anis
mesh_terms: D000328:Adult; D001955:British Columbia / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D007198:Indians, North American; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D012307:Risk Factors; D012944:Social Support; D012946:Social Welfare; D012959:Socioeconomic Factors; D016320:Substance Abuse Treatment Centers; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000534:rehabilitation; D013375:Substance Withdrawal Syndrome / Q000534:rehabilitation / Q000628:therapy; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D044465:White People