Drug Abuse Treatment
Outcome Studies
(Funded by NIDA)
Overview of
National Treatment
Outcome Studies
Charts Prepared & Released for Public Use by
Dwayne Simpson (TCU), Robert Hubbard (NDRI-NC),
Douglas Anglin (UCLA), & Bennett Fletcher (NIDA)
Slide 1 of 20
Drug Abuse Treatment Outcome Studies
Third National Evaluation of Treatment Effectiveness
Funded by the
National
Institute on
Drug Abuse
1991-93
11 Cities
96 Programs
~10,000 Patients
All treatment types
Follow-up: 1 & 5 Yrs
Over 60 Studies Published –
Psychology of Addictive Behaviors (Dec 97)
Drug and Alcohol Dependence (Dec 99)
Archives of General Psychiatry (June 99)
Slide 2 of 20
DATOS Research Centers
 Treatment Selection,
Access, and Utilization
Robert Hubbard, Ph.D.
NDRI, Inc.
Raleigh, North Carolina
 Addiction and
Treatment Careers
Douglas Anglin, Ph.D.
University of California
Los Angeles, California
 Treatment Engagement
and Retention
Dwayne Simpson, Ph.D.
Texas Christian University
Fort Worth, Texas
 Applications and Policy
Development
Bennett Fletcher, Ph.D.
NIDA
Rockville, Maryland
Slide 3 of 20
Reasons for Field-based
Treatment Outcome Studies
 Effectiveness in “real world settings”
 Funding decisions by policy-makers
 Public information & support
 Test impact of clinical advancements
 Changes occur over time in - Types or trends of patient drug use
 Treatment services & resources
Slide 4 of 20
Changes in Drug Use Patterns
alters Treatment Systems
% Using Opiates
% Using Cocaine
85
33
1970s (DARP)
82
39
1990s (DATOS)
Slide 5 of 20
CJ System Involvement and Referrals
to Community Programs (DATOS)
100
80
% Legally Involved
64
% Criminal Justice Referral
57
60
40
42
33
27
20
0
2
Long-Term
Residential
(n=2,774)
Outpatient
Drug-Free
(n=2,574)
Outpatient
Methadone
(n=1,540)
Slide 6 of 20
Craddock, Rounds-Bryant, Flynn, & Hubbard, 1997 (AJDAA)
DATOS: Overview of Sampling Plan
 Longitudinal Data Collection
 Intakes (1991-93)
 During treatment (1-3 mos)
 Year 1 posttreatment
 Year 5 posttreatment
New
York
Portland
Minneapolis
Chicago
San Jose
Newark
Pittsburgh
Phoenix
New Orleans
 Sampled from 11 Cities across the U.S.
Houston
Miami
 Includes 10,010 Admissions to 96 Programs




N=2,774 from 21 Long-Term Residential (LTR) programs
N=2,574 from 32 Outpatient Drug-Free (ODF) programs
N=3,122 from 14 Short-Term Inpatient (STI) programs
N=1,540 from 29 Outpatient Methadone Treatment (OMT)
Slide 7 of 20
Flynn, Craddock, Hubbard, Anderson, & Etheridge, 1997 (PAB)
Long-Term Residential (LTR)Treatment
Changes from Before to After Treatment
100
Pre
Post
88
77
80
66
60
41
40
40
22
20
24
19
17
16
13
6
0
Cocaine
(Weekly)*
Heroin
(Weekly)*
Heavy
Alcohol*
Illegal
Activity*
No FT
Work*
Suicidal
Ideation*
*p<.001
% of DATOS Sample (N=676)
Slide 8 of 20
Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997 (PAB)
Outpatient Drug-Free (ODF) Treatment
Changes from Before to After Treatment
100
Pre
Post
82
76
80
60
42
40
31
25
22
18
20
15
19
14
11
9
0
Cocaine
(Weekly)*
Marijuana
(Weekly)*
Heavy
Alcohol*
Illegal
Activity*
No FT
Work*
Suicidal
Ideation*
*p<.001
% of DATOS Sample (N=764)
Slide 9 of 20
Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997 (PAB)
Short-Term Inpatient (STI) Treatment
Changes from Before to After Treatment
100
80
Pre
Post
67
67
60
64
48
40
30
21
20
31
26
20
11
16
11
0
Cocaine
(Weekly)*
Marijuana
(Weekly)*
Heavy
Alcohol*
Illegal
Activity*
No FT
Work
Suicidal
Ideation*
*p<.001
% of DATOS Sample (N=799)
Slide 10 of 20
Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997 (PAB)
Outpatient Methadone Treatment (OMT)
Changes from Before to After Treatment
100
Pre
89
Post
85
82
80
60
42
40
29
28
22
15
20
16
17
14
13
0
Cocaine
(Weekly)*
Heroin
(Weekly)*
Heavy
Alcohol
Illegal
Activity*
No FT
Work
Suicidal
Ideation
*p<.001
% of DATOS Sample (N=727)
Slide 11 of 20
Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997 (PAB)
Drug Abuse Treatment Core Components
and Comprehensive Services
Medical
Financial
Housing &
Transportation
Core
Treatment
Intake
Assessment
Child
Care
Treatment
Plans
Group/Individual
Counseling
Abstinence
Based
Pharmacotherapy
Mental
Health
Urine
Monitoring
Vocational
Case
Management
Continuing
Care
Educational
Self-Help
(AA/NA)
Family
AIDS /
HIV Risks
Legal
Slide 12 of 20
Etheridge, Hubbard, Anderson, Craddock, & Flynn, 1997 (PAB)
Changes in LTR Core Treatment:
1990s (DATOS ) vs. 1980s (TOPS)
1990s
1980s
83
74
69
41
33
20
Patient Saw
Trt Plan
Group
Counseling
In 12-Step
Aftercare (FU)
% of Long-Term Residential (LTR) Sample
Slide 13 of 20
Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997 (PAB)
Changes in ODF Core Treatment:
1990s (DATOS ) vs. 1980s (TOPS)
1990s
1980s
66
41
31
22
13
Patient Saw
Trt Plan
Group
Counseling
11
In 12-Step
Aftercare (FU)
% of Outpatient Drug-Free (ODF) Sample
Slide 14 of 20
Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997 (PAB)
Changes in OMT Core Treatment:
1990s (DATOS ) vs. 1980s (TOPS)
1990s
1980s
48
42
25
22
6
1
Patient Saw
Trt Plan
Group
Counseling
In 12-Step
Aftercare (FU)
% of Outpatient Methadone Treatment (OMT) Sample
Slide 15 of 20
Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997 (PAB)
Changes in “Wrap-Around” Services:
1990s (DATOS ) vs. 1980s (TOPS)
1990s
77
1980s
60
50
20
15
5
LTR
ODF
OMT
% of Sample Receiving 2 or More Services
Slide 16 of 20
Etheridge, Craddock, Dunteman, & Hubbard, 1995 (J Sub Abuse)
Changes in LTR Comprehensive Services:
1990s (DATOS ) vs. 1980s (TOPS)
1990s
78
1980s
59
55
42
33
13
Medical
Services
Psychol
Services
28
20
Family
Services
Educational
Services
% of Long-Term Residential (LTR) Sample
Slide 17 of 20
Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997 (PAB)
Changes in ODF Comprehensive Services:
1990s (DATOS ) vs. 1980s (TOPS)
1990s
1980s
68
43
23
26
21
10
Medical
Services
Psychol
Services
10
Family
Services
10
Educational
Services
% of Outpatient Drug-Free (ODF) Sample
Slide 18 of 20
Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997 (PAB)
Changes in OMT Comprehensive Services:
1990s (DATOS ) vs. 1980s (TOPS)
1990s
27
1980s
33
10
Medical
Services
16
Psychol
Services
10
10
Family
Services
10
10
Educational
Services
% of Outpatient Methadone Treatment (OMT) Sample
Slide 19 of 20
Hubbard, Craddock, Flynn, Anderson, & Etheridge, 1997 (PAB)
Home Page
About DATOS
News and Features
Background
Highlights
Special Topics
Publications
Web Posters
Latest DATOS studies have
been published in Drug and
Alcohol Dependence
What’s New
Cocaine Treatment Outcome
Study is Released
CONTENT
Treatment process (engagement and participation),
retention, and outcomes are the focus of this series of
studies, and our first cost-benefit analysis addresses
cocaine treatment. The latest DATOS publications and "in
press" are listed on the Publications page.
(in June 1999 issue of Archives of General Psychiatry)
Findings emphasize the need for "adequate treatment stays,"
especially when problem severity is moderate-to-high. At
least 90 days in intensive residential (TC) programs was
indicated for high-severity cases. More information is
provided in a new section of Highlights page, "Outcomes for
Treatment of Cocaine Dependence.”
www.datos.org
Selected
Studies
1-Year
Outcomes
Treatment
Services
& Process
Cocaine
Treatment
Selected
Web Posters
Adolescent
Studies
Cost Benefits of
MM Treatment
Readiness
for Treatment
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