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Research Summary

Improving Entry into Post-detoxification Treatment

Although inpatient detoxification for substance use disorders improves outcomes in the short term, long-term outcomes are poor. A substantial minority of patients don’t complete detoxification, and those that do rarely enroll in post-detoxification treatment. This study describes outcomes for the Intensive Treatment Unit (ITU), a brief inpatient detoxification program that includes linking patients with treatment. Staffed by an attending psychiatrist and a team of nurses, length of stay ranges from 3–4 days and includes pharmacotherapy and group therapy run by the nursing staff. Most patients are admitted for heroin, cocaine, or alcohol detoxification. Strategies to increase attendance in aftercare programs include involving the patients in their own discharge planning, escort to post-detoxification programs for the initial visit, and provision of transportation. Follow-up of 134 ITU patients was conducted at 1 month. Seventy-eight percent of patients were male, 73% were African American, 95% were unemployed, and 61% were homeless.

 

  • Of the 123 patients discharged with a post-detoxification treatment plan, 83% entered treatment. Successful entry was more likely with long-term residential facilities (99%) and recovery houses (96%) compared with outpatient programs (55%).

Comments:

The brief inpatient detoxification program described in this study demonstrated a high rate of aftercare enrollment. Interpretation of these results is limited by the study’s descriptive nature and lack of a comparison group. Also, the findings may apply uniquely to a low socioeconomic status group in an inpatient unit. Despite these limitations, the study suggests that linkage to treatment can be achieved after detoxification, even in a challenging population. Jeanette M. Tetrault, MD

Reference:

Carroll CP, Triplett PT, Mondimore FM. The Intensive Treatment Unit: A brief inpatient detoxification facility demonstrating good postdetoxification treatment entry. J Subst Abuse Treat. 2009;37(2):111–119.

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