PREDICTION OF ATTRITION FROM DAY HOSPITAL TREATMENT IN LOWER SOCIOECONOMIC COCAINE-DEPENDENT MEN

This study attempted to identify predictors of completion of a 27 h/we ek 4-week day hospital program for cocaine dependence. The research su bjects were 95 lower socioeconomic, primarily African American male ve terans. Of a wide range of predictor variables available at baseline, including sociodemographic and historical information, Addiction Sever ity Index data, psychiatric diagnoses, SCL-90 measures, and measures o f craving and familial alcoholism, only the cocaine urine toxicology r esult and self report of days of cocaine use in the past 30 days (log transformed) were significant predictors. The urine toxicology result was the more powerful predictor with 73% with a negative urine complet ing treatment, as contrasted with 36% with a positive urine. Three add itional measures obtained at the end of treatment week 1 further incre ased ability to predict treatment completion/attrition. Two of these m easures were based on counsellor ratings and one was based on the pati ent's report of psychiatric treatment services received during the fir st treatment week. Thus, patients at high risk for dropout can be iden tified fairly early. Whether treatments can be adapted to retain such patients is an important question for the field.