Predicting outpatient treatment entry following detoxification for injection drug use: The impact of patient and program factors.

This article examines variables that predicted outpatient treatment entry within six months of residential detoxification. Patient data were collected from 632 injection drug users enrolled in a randomized trial conducted at eight detoxification programs within the National Drug Abuse Treatment Clinical Trials Network (CTN) with follow-up assessments conducted at 2, 8, 16, and 24 weeks (protocol CTN-0017, “HIV and HCV Intervention in Drug Treatment Settings”). Detoxification program characteristics were collected during this study and from a survey of CTN treatment organizations. Survival analysis found that estimated proportions of reported outpatient treatment entry varied across sites from .06 to .72. A model-building approach determined variables significantly associated with outpatient treatment entry. The best predictive model contained five program-level variables: accreditation, fewer beds, longer stays, shorter distance between detoxification and outpatient unit, and the larger city population.

This study suggests that smaller detoxification units with longer lengths of stay and treatment services nearby may boost rates of continuing treatment beyond detoxification for injecting drug users. In addition, innovative research should combine what are typically separate areas of inquiry, for example, matching patients to program variations and examining multilevel interventions that target both patient-level change and programmatic quality improvement.

Related protocols: CTN-0017