OBJECTIVE: Addiction treatment studies examining the influence of patients' partners suggest that partner behaviors affect patients' substance-use outcomes. We examine the influence of having a partner at treatment entry as well as the influence of the general quality of support and substance-using status of the partner, on outcomes following treatment for substance-use disorder. We also examine the influence of relationship stability on treatment outcomes and examine baseline partner behaviors that may predict relationship stability.
METHOD: A prospective, intact-group design was utilized with data analyzed using logistic regression. Participants (N = 3,014) from 15 intensive substanceuse disorder treatment programs were assessed at treatment entry and 1-year postdischarge.
RESULTS: Although patients with partners possessed a more favorable clinical profile, their outcomes were no better than those of their single counterparts. However, patients whose relationships lasted through the first year posttreatment had better outcomes than patients whose relationships ended. Relationships with more positive partner behaviors and fewer negative partner behaviors at intake were more likely to remain intact over the course of the first year posttreatment. Positive partner behaviors did not enhance patients' outcomes directly, but partner interpersonal stressors and patients' belief that their partner had a substance-use problem had a significant, deleterious impact on patients' substance-use outcomes.
CONCLUSIONS: Clinicians should routinely assess the quality of patients' relationships with partners. If deleterious partner behaviors exist, empirically supported interventions (e.g., behavioral couples therapy) could be utilized to reduce these behaviors and ultimately reduce relapse risk.
Youth substance use disorder treatment programs frequently advocate integration into 12-Step fellowships to help prevent relapse. However, the effects of the predominantly adult composition of 12-step groups on adolescent involvement and substance use outcome remain unstudied. Greater knowledge could enhance the specificity of treatment recommendations for youth. To this end, adolescents (N = 74; M age = 15.9, 62% female) were recruited during inpatient treatment and followed up 3 and 6 months later. Greater age similarity was found to positively influence attendance rates and the perceived importance of attendance, and was marginally related to increased step-work and less substance use. These preliminary findings suggest locating and directing youth to meetings where other youth are present may improve 12-step attendance, involvement, and substance use outcomes.
A substantial number of patients with substance use disorders (SUDs) are mandated to treatment by the justice system. However, little is known about their characteristics and how they fare during treatment and in the longer term compared with nonmandated, justice-system-involved patients and patients not involved in the justice system. This prospective study (n=2,095) examined differences in pretreatment characteristics, treatment perceptions and satisfaction, during-treatment changes, and 1- and 5-year outcomes among these three types of patients and tested whether differences in pretreatment characteristics or during-treatment changes could help explain posttreatment outcome similarities or differences. Mandated patients had a less severe clinical profile at treatment intake, yet this did not account for their observed similar/better outcomes, which appeared because of the similar therapeutic gains made during treatment. Treatment perceptions and satisfaction were also comparable across groups. These findings appear to support the idea that judicial mandates can provide an opportunity for offenders with SUDs to access and benefit from needed treatment.