A Novel Investigation of Substance Use Outcomes in Substance-Specific Outdoor Behavioral Healthcare Programs

Abstract

Substance Use Disorders (SUDs) are one of the greatest public health burdens to date. Available evidence suggests that despite the availability of evidence- based therapeutic interventions, successful recovery from alcohol and drug dependence is hard to achieve and much harder to maintain over time. Further, young adults present with unique risk factors and tend to have a less optimal response to treatment. Consequently, a novel treatment has been developed in an effort to improve outcomes for young adults with SUDs. Substance-specific outdoor behavioral healthcare (S-OBH; term developed by the author for clarity herein) may be more appealing to young adults who have resisted or responded poorly to inpatient drug and alcohol treatment, which is identified as the standard of care. The current study sought to investigate whether S-OBH interventions are equivalent to the standard of care, using a non-inferiority design. The sample was 256 young adults (Mage = 25.8) presenting for treatment at one of two experimental treatment sites or the active comparison site, residential treatment for SUDs. Primary study hypotheses were that S-OBH treatment would be associated with similar symptomatic improvements, relative to the comparison condition, particularly relevant to symptoms of SUDs and overall quality of life. Secondly, S-OBH would be associated with the maintenance of the hypothesized treatment gains during the 12-month follow up period. Findings were consistent with hypotheses, suggesting that participants evidenced significant symptomatic reductions and maintained these improvements over a 12-month follow-up period, regardless of treatment condition. Results are discussed in terms of better understanding factors associated with a positive response to SUD interventions. Keywords: substance use disorders, novel treatment, outdoor behavioral healthcare, non-inferiority design AUTHOR NOTE: The author would like to thank the study participants and several key research collaborators and personnel, including scientific consultants and graduate students at the Intervention Sciences Laboratory at the University of Arkansas, Dr. Sheneen Daniels, Alex Pena, Jack Kline, and Gil Hollows, without whom this study could not have been completed.