? ? Substance use dependence with multiple co-occurring problems is increasingly recognized as a chronic, relapsing condition that may last for decades and require multiple episodes of care over many years before reaching a sustained state of remission. While most treatment research has focused on single episodes of care, the average person entering publicly-funded treatment has been in treatment before and is likely to return to treatment again. More work is needed to understand the decades-long course of addiction, treatment and recovery. ? ? The proposed study is designed to test specific hypotheses from a bio-psycho-social-spiritual model used for people with other chronic conditions in order to develop testable strategies for more effectively managing recovery over time. The study will expand from 5 to 10 years a longitudinal study of 1326 participants sequentially admitted to a treatment. The sample was stratified by level of care (outpatient, intensive outpatient, methadone maintenance, halfway houses, short-term residential, long-term residential) to ensure a range of substance use disorders and stage of addiction/treatment career. The participants are 59% female and 87% African American. Using a comprehensive assessment package, we conducted follow-up interviews at 6 months, 18 months, 2, 3, 4 and 5 (half) years achieving follow-up rates of 93% or more per wave.
The specific aims are to: 1) examine the association between multiple treatment episodes, relapse, and recovery patterns over the course of 10 years; 2) evaluate individual differences that may moderate one's ability to initiate and sustain recovery, such as, psychiatric co-morbidity, personality, and gender; 3) explore the extent to which treatment or other forces change mediators of recovery, such as changes in motivation, coping strategies, spirituality, social networks, and physical recovery environment; and 4) evaluate the extent to which sustained recovery and attenuated substance use reduce the long-term consequences associated with substance use, including illegal activity, physical or mental illness, expensive service utilization, and death.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA015523-04
Application #
6932468
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Jones, Dionne
Project Start
2002-08-20
Project End
2007-07-31
Budget Start
2005-08-01
Budget End
2006-07-31
Support Year
4
Fiscal Year
2005
Total Cost
$801,877
Indirect Cost
Name
Chestnut Health Systems, Inc.
Department
Type
DUNS #
125086173
City
Bloomington
State
IL
Country
United States
Zip Code
61701
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Grella, Christine E; Scott, Christy K; Foss, Mark A et al. (2008) Gender similarities and differences in the treatment, relapse, and recovery cycle. Eval Rev 32:113-37
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Dismuke, Clara E; French, Michael T; Salome, Helena J et al. (2004) Out of touch or on the money: Do the clinical objectives of addiction treatment coincide with economic evaluation results? J Subst Abuse Treat 27:253-63