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Use of drugs by 1,340 alcoholic clients of 17 New York alcoholism rehabilitation units was assessed for pre-treatment and three and eight month post-treatment periods. Drug use was reported by 44% of the clients before treatment and about 30% after treatment. Clients who were drinking greater amounts of ethanol before treatment tended to be drug users after treatment. Only a slight substitution of drug use for alcohol use was found from before to after treatment. Alcoholic substance users were more likely to be behaviourally and physiologically impaired than were alcohol users. Greater impairment for alcoholic and substance users was found both before and after treatment. Special categories of pre-treatment drug use showed differential predictive relationship with alcohol use after treatment. Drug use by alcoholics was shown to be related to a number of dysfunctional behaviours indicating a need for improved assessment and treatment of substance users in alcoholism rehabilitation programmes.Foreword reprint requests to

Treatment programs across the State of New York were studied to determine the differential impact of treatment orientations upon various types of alcoholism clients. 1340 patients from 17 alcoholism treatment programs were treated and followed up 3 and 8 months after treatment. The majority of the clients were categorized as either Behaviorally Impaired Drinkers (n = 205) or Alcoholics (n = 814). Each of the treatment programs were classified according to either Peer Group, Rehabilitation Professional, or Medical Orientations. Three different outcome measures were examined: abstinence, amount of alcohol consumed at follow-up, and improvement (life and drinking) at follow-up. The generalizable conclusions were that females had significantly better outcome (78% abstinent) when treated according to a medical orientation. Male Behaviorally Impaired Drinkers had better outcomes when treated in Rehabilitation Professional Orientation (74% abstinent) and male alcoholics had the best outcome in Peer Group (60% abstinent), although male alcoholics achieved similar abstinence rates in Medical (59.5%) and Rehabilitation (55%) orientations.

Those clients who completed inpatient alcoholism treatment are shown to have a better outcome than those who dropped out or were terminated, even after correcting for poorer original prognosis. Financial status, time since last employment, social stability, and age prove to be significant predictors of reason for leaving treatment.

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