Drug abuse treatment success among needle exchange participants

Objective. Although lowering incidence rates of human immunodeficiency viru s (HIV) transmission is the primary goal of needle exchange programs (NEPs) , other desirable outcomes are possible. Referring exchange participants to more comprehensive drug abuse treatment programs has the potential to redu ce or eliminate the use of drugs. This possibility was evaluated by compari ng the treatment responses of new admissions with an outpatient opioid agon ist treatment program in Baltimore, Maryland. Methods. New admissions (1994-1997) to an opioid agonist treatment program were first grouped by referral source (needle exchange, n = 82 vs, standard referrals, n = 243) and then compared on admission demographic and clinica l variables and response to treatment during the first three months. Outcom e measures included retention rates, self-reported drug use and injecting f requencies, self-reported illegal activities for profit, and results from w eekly urinalysis testing for opioids and cocaine. Results. Patients from the NEP were significantly older and more likely to be male, African American, and unemployed than standard referral patients. Needle exchange patients also had a greater baseline severity of drug use t han patients in the standard referral group. Despite these baseline differe nces, both groups achieved comparably good short-term treatment outcomes (i ncluding reduced drug use and criminal activity for profit); treatment rete ntion was also good, although slightly better in the standard referral grou p (88% vs. 76%). Conclusion. These data demonstrate the feasibility and merits of creating s trong linkages between NEPs and more comprehensive drug abuse treatment cli nics.