SUPPLEMENTAL SOCIAL-SERVICES IMPROVE OUTCOMES IN PUBLIC ADDICTION TREATMENT

Aims. To evaluate the effectiveness and value of social services added to standard addiction rehabilitation. Design. A controlled, quasi-exp erimental, field study with repeated measures. Setting. Conducted in t wo groups of publicly supported outpatient addiction treatment program s. Control programs provided standard, twice-weekly, outpatient group counseling. ''Enhanced'' programs provided standard counseling but als o case managers to coordinate and expedite use of pre-contracted medic al screenings, housing assistance, parenting classes and employment se rvices. Measurements. The Addiction Severity Index was used to record the nature and severity of patient problems in seven areas at treatmen t admission and at 6-month follow-up. Services provided during treatme nt were measured with the Treatment Services Review. Measures were tak en on consecutive samples of patients admitted to all programs-before enhancements (wave I, N = 431)-and at 12 months (wave 2, N = 710); and 26 months following enhancements (wave 3, N = 187). Findings. There w ere no significant differences in patient characteristics, treatment s ervices or 6-month outcomes of the two sets of programs in wave 1. Wav e 2 and especially wave 3 enhanced programs provided significantly mor e social and medical services than control programs. Patients treated in enhanced programs showed significantly less substance use, fewer ph ysical and mental health problems and better social function at 6-mont hs than Controls. Conclusions. Adding social services to public sector programs substantially improved the outcomes of addiction treatment. Changes in ''real world'' systems require time to implement; early eva luations may fail to capture the full impact of those changes,