Kl. Sloan et G. Rowe, SUBSTANCE-ABUSE AND PSYCHIATRIC-ILLNESS - TREATMENT EXPERIENCE, The American journal of drug and alcohol abuse, 24(4), 1998, pp. 589-601
The purpose of this paper is to describe an outpatient dual-diagnosis
treatment program and 1-year clinical outcome and hospital utilization
data. Subjects were 118 consecutive admissions to the Seattle Veteran
s Affairs (VA) Medical Center's Dual Disorders program over the period
from June 1, 1992, to August 31, 1994. Program eligibility requiremen
ts included having a current substance use disorder and an active non-
substance-related major Axis I disorder (typically major depression, p
ost-traumatic stress disorder [PTSD], bipolar disorder, or schizoaffec
tive disorder). The treatment frame involved group-based programming (
including support, medications management, and psychoeducation), routi
ne urine drug screening, and crisis interventions. Results showed that
subjects averaged 1.5 non-substance-related Axis I psychiatric disord
ers (54% involving psychotic symptoms) and 1.8 active substance use di
sorders. Patients stayed engaged in treatment for a median of 217 days
, with 60% of patients having no positive drug screens, and the overal
l sample having a 40% reduction in the number of inpatient bed days in
the year after intake. Conclusions were that, for a number of patient
s with comorbid disorders, psychiatric stabilization and cessation of
substance use can be ac complished within an outpatient treatment fram
e that averages two completed clinical contacts per week.