Abstract
Background: Few studies have explored changes in quality of life during the first three months of admission to a therapeutic community for addictions. The objective of this study was to determine the relationship between these changes and treatment outcomes at discharge. Methods: We undertook a prospective longitudinal study of 142 cocaine-dependent patients treated at a therapeutics community. All of these patients reached the 3-month evaluation and were subsequently followed until discharge. All participants completed the following measures: Health-Related Quality of Life for Drug Abusers Test; Beck Depression Inventory; State–Trait Anxiety Inventory; Opiate Treatment Index; Dual Diagnosis and Discharge Checklist. Results: At the 3-month assessment, scores on the Health-Related Quality of Life for Drug Abusers Test had increased significantly (Cohen’s d: 0.92), while scores on the Opiate Treatment Index (Cohen’s d: 0.86) and Beck Depression Inventory (Cohen’s d: 0.20) scales both decreased significantly. A higher proportion of the patients considered to have achieved “clinically relevant” treatment outcomes at discharge versus those without clinically relevant outcomes were considered “recovered” according to the Reliable Change Index. Conclusions: An improvement in quality of life-related variables from baseline to the 3-month assessment was associated with better outcomes at discharge from the therapeutic community. The findings of this study may help us to optimise therapeutic interventions.
Highlights
Cocaine use is a major public health problem [1]
The findings of this study support our initial hypothesis that the quality of life of cocaine-dependent patients would improve after three months of treatment in a therapeutic community, and that this initial improvement would be associated with better treatment outcomes at discharge
We found that health-related QoL—evaluated with an instrument designed to assess this dimension in drug addicts—improved significantly during the 3-month treatment period with a large effect size, a finding that is consistent with a previous study carried out by our group in opiate-dependent patients treated with buprenorphine, who showed improvement even before the 3-month assessment [22,23]
Summary
Cocaine use is a major public health problem [1]. Worldwide, there are an estimated19 million cocaine users, corresponding to 0.4% of the world’s population between the ages of 15 and 64. Few studies have explored changes in quality of life during the first three months of admission to a therapeutic community for addictions. Methods: We undertook a prospective longitudinal study of 142 cocaine-dependent patients treated at a therapeutics community. All of these patients reached the 3-month evaluation and were subsequently followed until discharge. Results: At the 3-month assessment, scores on the Health-Related Quality of Life for Drug Abusers Test had increased significantly (Cohen’s d: 0.92), while scores on the Opiate Treatment Index (Cohen’s d: 0.86) and Beck Depression Inventory (Cohen’s d: 0.20) scales both decreased significantly. Conclusions: An improvement in quality of life-related variables from baseline to the 3-month assessment was associated with better outcomes at discharge from the therapeutic community. The findings of this study may help us to optimise therapeutic interventions
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