Treatment Compliance after Detoxification among Highly Disadvantaged Alcoholics

Abstract

An outcome study was carried out on a series of 109 highly disadvantaged alcoholics discharged from the detoxification unit of a large municipal hospital in New York City. We examined the impact of a variety of clinical and demographic factors on retention in the initial phases of outpatient and inpatient treatment following discharge. Both high school completion and a history of at least 6 months of employment in the two years preceding admission correlated with frequency of registration for continued aftercare. Measurements of cognitive flexibility correlated with frequency of aftercare completion. An association strongly approaching significance was also found between length of hospital stay and aftercare completion. Some suggestions are made as to the assessment and aftercare planning for highly disadvantaged alcoholics.

Higher Executive Control and Visual Memory Performance Predict Treatment Completion in Borderline Personality Disorder

“…Supporting these assertions, the present finding is in line with several prospective studies of alcoholism and other substance use disorders in which Trails B was predictive of participation in aftercare sessions and length of hospital stay during inpatient treatment [36,37]. Our negative finding on the WCST is consistent with a study which found that WCST scores did not differ between treatment completers and dropouts in the treatment of cocaine dependence [18].…”

Shelter-based managed alcohol administration to chronicallyhomeless people addicted to alcohol

“…6,[21][22][23][24][25] Obstacles to sobriety include psychiatric illness, poor social support, lack of stable housing, duration of addiction and refusal of treatment.…”

“…It has been reported to affect 53%-73% of homeless adults, [1][2][3] with a high frequency of heavy alcoholism (i.e., > 20 drinks/day). [4][5][6] Because of its availability and low cost, nonbeverage alcohol (e.g., mouthwash) is commonly used. 7,8 People with chronic alcoholism are frequent users of crisis health services such as the emergency department (ED);…”

Alcoholism—still an inferior disease?

“…Although simple medical detoxification without subsequent rehabilitation leads to no long term improvement except in very few patients (5% in the study of Wieser & Kunad 1965), even highly disadvantaged alcoholics can be convinced to follow the necessary aftercare when adequate motivational treatment is applied. This was recently shown by Castaneda et al (1992). Their study of 109 highly disadvantaged patients merits special attention.…”