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.
Garner, Bryan R; Scott, Christy K; Dennis, Michael L et al. (2014) The relationship between recovery and health-related quality of life. J Subst Abuse Treat 47:293-8 |
Scott, Christy K; Dennis, Michael L; Laudet, Alexandre et al. (2011) Surviving drug addiction: the effect of treatment and abstinence on mortality. Am J Public Health 101:737-44 |
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 |
Dennis, Michael; Scott, Christy K (2007) Managing addiction as a chronic condition. Addict Sci Clin Pract 4:45-55 |
Scott, Christy K; Sonis, Jeffrey; Creamer, Mark et al. (2006) Maximizing follow-up in longitudinal studies of traumatized populations. J Trauma Stress 19:757-69 |
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 |