The purpose of this demonstration project is to evaluate a program designed to enhance drug treatment retention and successful outcome. The project will test an enhanced treatment induction procedure and an intensive case management/advocacy (CM/A) program. The study will compare the relative treatment retention and outcome of four treatment groups admitted to standard outpatient or inpatient programs: (1) Veterans Administration Medical Center(VAMC) regular intake and referral, (2) VAMC regular intake and referral plus CM/A; (3) The Weekend Intervention Program (WIP), an enhanced treatment induction intake and referral; and (4) WIP intake and referral and CM/A. The project will also assess the prevalence of HIV infection and the degree of HIV risk behaviors among this population and examine the relationship between treatment attrition and outcome and changes in HIV risk behavior in all four groups. A sample of 600 qualified incoming Dayton Veterans Administration's (VA) patients will be randomly assigned to enhanced WIP induction (300) and conventional VA induction (300) before entering the VA's treatment resources. The entering sample of 600 will then be randomly assigned to regular treatment (300) or regular treatment augmented by intensive CM/A methodology. Follow-up will be conducted at 6, 12, and 18 month intervals. All patients will receive urine screens and HIV testing at intake and all follow-up intervals, as well as behavioral assessments of HIV risk and drug use and post-treatment assessments of attitude and behavioral changes. The proposed demonstration project will develop and test a costeffective, easily replicable method to address problems attendant to early attrition from substance abuse treatment programs and relapse.
