Subject(s)
Mental Disorders/therapy , Mental Health Services/economics , Veterans/psychology , Aged , Alzheimer Disease/economics , Alzheimer Disease/psychology , Alzheimer Disease/therapy , Budgets , Continuity of Patient Care/economics , Cost Allocation , Dementia/economics , Dementia/psychology , Dementia/therapy , Female , Health Services for the Aged/economics , Humans , Male , Mental Disorders/economics , Mental Disorders/psychologyABSTRACT
The efficacy of three different residential therapeutic communities for male veterans addicted to heroin was studied, comparing 181 subjects who were randomly assigned to one of the communities with 166 subjects briefly hospitalized only for the treatment of withdrawal symptoms. At two-year follow-up, subjects from both a professionally staffed community and a peer confrontation community were found significantly more likely than the withdrawal-only group to be working or attending school and less likely to have been convicted of a crime. An eclectic program employing both professionals and paraprofessionals was not found to exceed the withdrawal-only group on any of the major outcome variables. The two relatively successful communities, although different in structure and style, were both perceived by their residents to have greater program clarity, order, staff control, and orientation to personal problems than the unsuccessful program.
Subject(s)
Heroin Dependence/therapy , Therapeutic Community , Adult , Attitude to Health , Clinical Trials as Topic , Follow-Up Studies , Heroin Dependence/psychology , Heroin Dependence/rehabilitation , Hospitalization , Humans , Male , Outcome and Process Assessment, Health Care , Prospective Studies , Residential Facilities , Sensitivity Training Groups , Substance Withdrawal Syndrome/prevention & controlABSTRACT
During a 2-year follow-up interview, 272 male veteran heroin addicts reported their recent heroin use and provided a urine sample. Eighty-four percent of those reporting no heroin use in the 3 months preceding the interview, and 78% of those declaring no use in the previous week had urines found negative for opiates. The subjective impressions of the interviewers were useful in predicting the veracity of the self-reports. Subjects who had been in longer-term treatment, especially therapeutic communities, were more likely to report heroin use truthfully.
Subject(s)
Heroin Dependence/psychology , Truth Disclosure , Adult , Follow-Up Studies , Heroin/urine , Heroin Dependence/therapy , Humans , Interview, Psychological , Male , Self Disclosure , Therapeutic Community , Veterans/psychologyABSTRACT
This study compares the efficacy of three residential therapeutic communities and an outpatient methadone maintenance program for 585 male veterans addicted to heroin. Subjects were randomly assigned to the treatment modalities. More than 93% of the subjects completed both six- and 12-month questionnaires. In this report, the treatment settings, characteristics of the sample, assignment protocol, and pattern of treatment entry and first-year follow-up results are outlined. The various clinical demands that affected the research protocol, the degree to which the randomization was compromised, and the implications for the analysis of outcome are discussed. One year after admission to the study, subjects who had been in a therapeutic community for longer than seven weeks or in methadone treatment were more likely to be employed or attending school, and less likely to be in jail, using heroin, or to have been convicted of a serious crime, than subjects who received no treatment at all beyond a short detoxification period. Those who spent less than seven weeks in a therapeutic community were doing no better than subjects in the no treatment group.
