Residential and outpatient treatment completion for substance use disorders in the US: Moderation analysis by demographics and drug of choice
Residential and outpatient treatment completion for substance use disorders in the US: Moderation analysis by demographics and drug of choice
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DOI：
10.1016/j.addbeh.2016.02.030
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发表时间：
2016-07-01
影响因子：
4.4
通讯作者：
DuCette, Joseph P.
中科院分区：
文献类型：
--
作者：
Stahler, Gerald J.;Mennis, Jeremy;DuCette, Joseph P.
背景：本研究使用美国公共资助的药物滥用项目的全国样本，调查住院治疗环境与门诊治疗环境对治疗完成的影响，以及这种影响如何因人口特征和选择的药物而变化。方法：这是一项回顾性分析，使用从 2011 年药物滥用和心理健康服务管理局 (SAMHSA) 治疗事件数据集 (TEDS-D) 中提取的数据。使用逻辑回归、固定效应逻辑回归和调节固定效应逻辑回归对总共 318,924 例病例进行了分析。结果：住院项目的完成率为 65%，而门诊项目的完成率为 52%。在控制其他混杂因素后，住院治疗的客户完成治疗的可能性几乎是门诊治疗的客户的三倍。住院治疗对治疗完成的影响并不受性别的显着影响，但受年龄、选择的药物和种族/民族的影响。与门诊治疗相比，老年客户、白人和阿片类药物滥用者分别与年轻客户、非白人、酒精和其他药物使用者相比，住院治疗在更大程度上增加了完成治疗的可能性。结论：我们推测，与其他药物滥用者相比，对于阿片类药物滥用者来说，住院治疗环境提供了更大的保护，使其免受可能导致复发和无法完成治疗的环境和社会触发因素的影响。特别是对于阿片类药物使用者，应探索更多地使用住院治疗。 (C) 2016 Elsevier Ltd. 保留所有权利。
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. (C) 2016 Elsevier Ltd. All rights reserved.