SUBSTANCE-ABUSE TREATMENT ENTRY, RETENTION AND EFFECTIVENESS - OUT-OF-TREATMENT OPIATE INJECTION-DRUG USERS

This study was designed to assess the effect of client characteristics and community interventions on treatment entry and retention, and to evaluate the relative effectiveness of treatment, compared to other in terventions; in reducing drug use and crime among out-of-treatment opi ate injectors. Subjects (N = 2973) from 15 cities were randomly assign ed to: standard intervention (SI)-HIV testing and counseling; or enhan ced intervention (EI)-SI plus additional educational sessions stressin g responsible drug use. EI in some cities included staff assistance wi th treatment admission (i.e. 'active' referral). All locations provide d intervention by community outreach workers. Factors positively assoc iated with treatment entry included: prior treatment, intervention by community workers, assignment to the EI, not injecting cocaine, inject ing opiates, and fewer program interventions received. Sites where the Fl included active referral achieved significantly higher treatment e ntry rates than sites where the EI did not. Findings supported the eff icacy of treatment over other interventions in reducing drug use and a rrests, the addition of staff assistance to facilitate clients' entry into treatment, and the involvement of community outreach workers in a chieving treatment entry.