More from AHSR – Addiction research to increase treatment success

Okay, there was almost too much to cover in a single post today. Actually, hold the almost. I want to cover a few of the basic things we talked about today, but many of the rest will have to be incorporated into future posts.

Yesterday, I wrote about talks having to do with new ideas about necessary steps to improve treatment. Today, the main speaker hit on one of the factors discussed yesterday:

How can we improve the length of time that patients stay in drug treatment?

We know from research that one of the best predictors of success in treatment is longer retention. Some of today’s ideas were revolutionary and some not, but here’s a partial list –

  • Plan treatment lengths that are longer – This is especially true for outpatient treatment. If patients think of longer treatment from the outset, even if they don’t hit the intended mark, they’re likely to stay longer than if no end goal was set (this is called anchoring in psychology).
  • Send out appointment reminders and make phone calls – it works for dentists and doctors!
  • Start treating to patient strengths instead of just trying to fix their weaknesses – If you’ve never heard of motivational interviewing, you should read up, it’s all there.
  • Allow patient choice in treatment – The notion that patients shouldn’t have any say in their own treatment should be seriously questioned.
  • Provide small incentives (one way this is done is known as contingency management).
  • Create contracts and provide social reinforcement (like plaques and certificates).

That’s probably a good enough list for now. If we could put all these things to use, we’d already see a significant increase in client retention AND satisfaction.

I had a great day, more tomorrow!!!

Addiction services conference – Addiction research to addiction treatment success

I’m currently attending UCSF‘s Addiction Health Services Research Conference. The 3 day event aims to improve addiction treatment by bringing together researchers, treatment providers, and state and federal policy players. I’m going to write from here after every day filling you all in on the latest and greatest.

Today’s addiction research summary

Today’s main topics focused once again on the shift in addiction treatment conceptualization from a short term, black box sort of model to a more chronic one. I’ve already talked about comparing addiction to other chronic diseases, like diabetes or hypertension, in another post on here (see here). Nevertheless, today’s talks provided some additional insight.

Today’s speakers, members of UCLA‘s Integrated Substance Abuse Program (In the interest of full disclosure, I myself work at ISAP), talked about the notion that in order to provide the best treatment, we need to start looking at some more measures of treatment success. As it stand right now, those who assess treatment success mostly look at abstinence following discharge from treatment. While reductions in drug use are certainly important, they don’t tell the whole story.

Other measures of addiction treatment success

I won’t go into these in too much details (the presentation lasted 3 hours), but here are some of the suggested measures the speakers mentioned:

  1. Good treatment initiation rates.
  2. Client retention rates at or above 90 days.
  3. Percent (%) of clients successfully transferred to next level of care – This is especially important for the chronic care model of addiction.
  4. Treatment completion – A little dicey because providers set their own standards of completion.

Those were the major ones discussed today. Given my experience in research, I thought of some additional ones, including:

  1. Improvement in employment status for clients.
  2. Reductions in client drug use – I think testing should be a standard, and ongoing, aspect of all drug treatment programs. Drug users need to stay clean in early treatment and the only way to tell for sure is by testing them.
  3. Use of research-supported methods to increase treatment retention – There are quite a few tools (like CM, use of medications like suboxone, and more) that are often underused but have shown great promise in helping keep clients in treatment for longer.

That’s it for today. More tomorrow!!!