Processes and Outcomes of Substance Abuse Treatment Between Two Programs for Clients Insured Under Managed Care

Published in: American Journal of Drug and Alcohol Abuse, v. 33, no. 3, May 2007, p. 439-446

Posted on RAND.org on January 01, 2007

by Donna McNeese-Smith, Adeline Nyamathi, Douglas L Longshore, Mary Wickman, Scott Robertson, Jeanne Obert, Michael McCann, Kenneth B. Wells, Suzanne L. Wenzel

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The purpose of this research (N = 160) was to describe and compare substance abuse treatment in two programs under managed care: one residential (RT) and one outpatient (OP). Clients in both settings improved significantly from before to after treatment in relation to substance use and quality of life. However, intensity of treatment (hours of care/week) was much greater in RT and days of sobriety were significantly higher after treatment in RT than in OP (p = .04). Intensity was negatively related to incidents of substance use during treatment (SUdT), which predicted substance use after treatment; SUdT averaged .2 for RT, and 1.6 for OP (p = .0001). Importantly, treatment was completed by 74 patients (over 90%) from RT, with 8 dropping out, and 53 (almost 70%) of those in OP completed treatment while 25 dropped out. Intensity, as seen in the RT program, rather than duration, was more effective in substance use reduction and treatment completion.

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