Abstinence at Successful Discharge in Publicly Funded Addiction Health Services

Abstract

Abstinence at successful discharge in substance use disorder treatment is important to reducing relapse rates and increasing long-term recovery from substance use disorders. However, few studies have examined abstinence as an essential component of successful discharge. This study examined rates and correlates of reported abstinence (nonuse of drugs 30 days prior to successful discharge) among clients attending publicly funded treatment in Los Angeles County, California. Finding show that only 36% of clients who were successfully discharged reported abstinence. Black clients were less likely than non-Hispanic Whites to report abstinence at successful discharge. Clients in methadone treatment programs were less likely than outpatient clients to report abstinence, whereas clients referred to treatment through the legal system (Proposition 36) were more likely to report abstinence compared to self-referred clients. Findings underscore the importance of systematic assessment of abstinence in determining successful discharge and provide a basis for further examination of strategies to improve abstinence and reduce relapse.

Integrating Positive Psychology into Substance Use Treatments

“…However, some potential explanations include that ~95% of people do not want treatment [44] and clinician-patient goal misalignment is common [45]. Further, for those who enter treatments, abstinence rates (i.e., those who completely stop their use) remain low (e.g., estimates range from 36 to 56% at treatment completion and 16 to 53% at threeto six-month follow-ups) [46][47][48][49]. Moreover, harm reduction is a newer alternative to abstinence-based treatments that allow for more flexibility.…”

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“…The determination of whether a +UDS during treatment indicates noncompliance and warrants termination of services versus persistent symptomology and increasing treatment support depends on the philosophy of the treatment program and the opinion of the primary clinician (e.g., Gjersing, Waal, Caplehorn, Gossop, & Clausen, 2010). For example, in one study, only 35.91% of clients across 106 treatment programs representing 11,533 treatment episodes, reported abstinence at successful discharge (e.g., Frimpong, Guerrero, Kong, & Kim, 2016).…”

The Criminal Justice System and More Lenient Drug Policy: Three Case Studies on California's Changes to How Its Criminal Justice System Addresses Drug Use

“…As I will show below, this group has a higher rate of mental health diagnoses, more drug-related arrests, and is more likely to have had a prior treatment episode, all of which are associated with longer treatment careers Dennis et al, 2005). Finally, studies that have explored the length of treatment careers have defined as a desired stable state, abstinence from use for at least 30 days at treatment discharge (Dennis et al, 2005;Frimpong, Guerrero, Kong, & Kim, 2016). The analysis sample in this study is limited to those that had not yet fulfilled this goal, meaning their treatment career was ongoing.…”