BACKGROUND:
This
study investigates the impact of residential versus outpatient treatment
setting on treatment completion, and how this impact might vary by demographic
characteristics and drug of choice, using a national sample of publicly funded
substance abuse programs in the United States.
METHODS:
This is a
retrospective analysis using data extracted from the 2011 Substance Abuse and
Mental Health Services Administration (SAMHSA) Treatment Episode Data Set
(TEDS-D). A total of 318,924 cases were analyzed using logistic regression,
fixed-effects logistic regression, and moderated fixed-effects logistic
regression.
RESULTS:
Residential
programs reported a 65% completion rate compared to 52% for outpatient
settings. After controlling for other confounding factors, clients in
residential treatment were nearly three times as likely as clients in
outpatient treatment to complete treatment. The effect of residential treatment
on treatment completion was not significantly moderated by gender, but it was
for age, drug of choice, and race/ethnicity. Residential compared to outpatient
treatment increased the likelihood of completion to a greater degree for older
clients, Whites, and opioid abusers, as compared to younger clients,
non-Whites, and alcohol and other substance users, respectively.
CONCLUSION:
We
speculate that for opioid abusers, as compared to abusers of other drugs,
residential treatment settings provide greater protection from environmental
and social triggers that may lead to relapse and non-completion of treatment.
Greater use of residential treatment should be explored for opioid users in
particular.
1Department
of Geography and Urban Studies, Temple University, Philadelphia, PA 19122,
United States. Electronic address: jstahler@temple.edu.
2Department
of Geography and Urban Studies, Temple University, Philadelphia, PA 19122,
United States. Electronic address: jmennis@temple.edu.
3Department
of Psychological Studies in Education, Temple University, Philadelphia, PA
19122, United States. Electronic address: jducette@temple.edu.
Addict Behav. 2016
Jul;58:129-35. doi: 10.1016/j.addbeh.2016.02.030. Epub 2016 Feb 17.
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