Substance use outcomes following treatment: Findings from the Australian Patient Pathways Study

Journal article


Manning, Victoria, Garfield, Joshua BB, Best, David, Berends, Lynda, Room, Robin, Mugavin, Janette, Larner, Andrew, Lam, Tina, Buykx, Penny, Allsop, Steve and Lubman, Dan I 2016. Substance use outcomes following treatment: Findings from the Australian Patient Pathways Study. Australian & New Zealand Journal of Psychiatry. 51 (2), pp. 177-189. https://doi.org/10.1177/0004867415625815
AuthorsManning, Victoria, Garfield, Joshua BB, Best, David, Berends, Lynda, Room, Robin, Mugavin, Janette, Larner, Andrew, Lam, Tina, Buykx, Penny, Allsop, Steve and Lubman, Dan I
Abstract

Our understanding of patient pathways through specialist Alcohol and Other Drug treatment and broader health/welfare systems in Australia remains limited. This study examines how treatment outcomes are influenced by continuity in specialist Alcohol and Other Drug treatment, engagement with community services and mutual aid, and explores differences between clients who present with a primary alcohol problem relative to those presenting with a primary drug issue. In a prospective, multi-site treatment outcome study, 796 clients from 21 Alcohol and Other Drug services in Victoria and Western Australia completed a baseline interview between January 2012 and January 2013. A total of 555 (70%) completed a follow-up assessment of subsequent service use and Alcohol and Other Drug use outcomes 12-months later. Just over half of the participants (52.0%) showed reliable reductions in use of, or abstinence from, their primary drug of concern. This was highest among clients with meth/amphetamine (66%) as their primary drug of concern and lowest among clients with alcohol as their primary drug of concern (47%), with 31% achieving abstinence from all drugs of concern. Continuity of specialist Alcohol and Other Drug care was associated with higher rates of abstinence than fragmented Alcohol and Other Drug care. Different predictors of treatment success emerged for clients with a primary drug problem as compared to those with a primary alcohol problem; mutual aid attendance (odds ratio = 2.5) and community service engagement (odds ratio = 2.0) for clients with alcohol as the primary drug of concern, and completion of the index treatment (odds ratio = 2.8) and continuity in Alcohol and Other Drug care (odds ratio = 1.8) when drugs were the primary drugs of concern. This is the first multi-site Australian study to include treatment outcomes for alcohol and cannabis users, who represent 70% of treatment seekers in Alcohol and Other Drug services. Results suggest a substantial proportion of clients respond positively to treatment, but that clients with alcohol as their primary drug problem may require different treatment pathways, compared to those with illicit drug issues, to maximise outcomes.

KeywordsAlcohol, drug, treatment outcomes, substance dependence, mutual aid, continuity of care
Year2016
JournalAustralian & New Zealand Journal of Psychiatry
Journal citation51 (2), pp. 177-189
PublisherSAGE Publications
ISSN1440-1614
Digital Object Identifier (DOI)https://doi.org/10.1177/0004867415625815
Web address (URL)http://hdl.handle.net/10545/625362
http://journals.sagepub.com/page/policies/text-and-data-mining-license
hdl:10545/625362
Publication dates14 Jan 2016
Publication process dates
Deposited06 Nov 2020, 17:42
Accepted2016
ContributorsEastern Health, Fitzroy, VIC, Australia, Monash University, Melbourne, VIC, Australia, Sheffield Hallam University, Australian Catholic University, Melbourne, VIC, Australia, La Trobe University, Melbourne, VIC, Australia, Stockholm University, Curtin University, Perth, WA, Australia and University of Sheffield
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