Opioid-dependent individuals who want to kick the habit typically begin the road to recovery with detoxification. But detox is ineffective as a stand-alone treatment, with relapse rates ranging from 65% to 80% just one month after discharge. New research published online today in the journal Addiction reveals that individuals with substance use disorders may be as much as ten times more likely to stay abstinent when they have access to drug-free recovery housing and day-treatment programs following detox.
Opioid abuse, which includes the use of illegal substances such as heroin and the nonmedical use of prescription painkillers like OxyContin, Percocet, and Vicodin, has reached epidemic levels in the United States. According to a November 2011 press release from the Centers for Disease Control and Prevention (CDC), the death toll in the US from overdoses of prescription painkillers has more than tripled in the past decade, with more than 40 people dying each day. In 2010, 12 million people in the US reported using prescription painkillers for nonmedical use, according to the CDC's National Survey on Drug Use and Health.
To find out if opioid-dependent individuals achieve higher abstinence rates given access to recovery housing and day treatment, researchers from Johns Hopkins University School of Medicine followed 243 patients -- primarily heroin users -- after their release from detox. Eighty-three patients received 12 weeks of rent-free recovery housing and were required to remain drug-free during their residency. Eighty more patients received 12 weeks of recovery housing plus 26 weeks of outpatient treatment, including cognitive behavioral group therapy, recreational activities, vocational assistance, and individual counseling. The final eighty patients received referrals for aftercare treatment at other community programs. The researchers assessed all participants at one, three, and six months after detox to see how many had remained abstinent.
The overall abstinence rate for participants given no housing or treatment was a disappointing 13%, but patients who received housing showed a 37% abstinence rate, and among the group that received housing plus day treatment, 50% were abstinent. At each of the three assessment points, participants receiving housing plus treatment were twice as likely to remain abstinent than those receiving housing only, and ten times more likely to remain abstinent than those receiving no housing or treatment at all.
In general, the best outcomes came from participants who stayed in recovery housing the longest, and access to day treatment tended to promote longer residencies: an average of 49.5 days versus 32.2 days for housing residents who received no day treatment.
Says lead researcher Michelle Tuten: "It's no surprise that opioid-dependent individuals stay off drugs longer when they live in a structured, drug-free environment after finishing detox. Drug-dependent individuals frequently report housing as their most pressing need. If we want to help people stay off heroin and stop abusing prescription painkillers, we need to do more than help them initiate abstinence; we need to help them maintain abstinence and build a drug-free life style as well. Improved access to drug-free recovery housing and day-treatment programs would clearly move us closer to that goal."
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