Utilizing an expanded concept of level of burden, the impact of multip
le problems experienced by women in a residential drug abuse treatment
program on treatment retention and outcomes is investigated. Level of
burden is defined in this study as the number and severity of problem
s, including psychological problems, cognitive impairment, chronic hea
lth problems, HIV/AIDS status, as well as substance abuse. In the firs
t study of 260 women, the ability to retain women in treatment as a fu
nction of their level of burden is examined using the technique of sur
vival analysis. Results indicate that early in the course of treatment
, high-burden clients tend to be the highest risks for early terminati
on. In addition, there is a significant interaction between time in th
e program and level of burden. In the second study of 68 women, partia
l correlations between level of burden and ratings of outcomes by prog
ram staff at time of discharge are examined. Results show that many of
the treatment outcomes are significantly negatively correlated with t
he initial levels of burden. Implications for treatment providers and
directives for future studies are discussed.