Impact of a stimulant-focused enhanced program on the outcome of alcohol- and/or stimulant-dependent men

Background: The approaches to the treatment of most forms of substance depe ndence are similar. It is not clear whether specific treatment components n eed to be added to address specific substances. This study asks two questio ns: What is the impact of a more intense drug treatment program, and do dif ferent substance problems require different treatment interventions. Methods: The 383 veterans included in this study represent two groups of co nsecutive inpatient male admissions with current alcohol dependence and/or dependence on amphetamines or cocaine at the inpatient Alcohol and Drug Tre atment Program of the Veterans Affairs San Diego Healthcare System. All wer e interviewed at intake by trained interviewers using a standardized semist ructured assessment instrument, and a resource person interview also was co nducted with 85% of them. The first group of men received the Standard Trea tment Program (STP), whereas the second group received the Enhanced Treatme nt Program (ETP). The latter included an addition of 10 hr per week of inte nse treatment aimed at stimulants, including two newly developed manual-dri ven groups (Relapse Prevention and Interpersonal Counseling), each of which met twice a week. Results: The patient follow-up was 92% at 3 months and 83% at 12 months. Ab stinence from substances of abuse for ETP and STP were 63% vs. 49% at 3 mon ths and 43% vs. 24% at 12 months. Logistic regressions demonstrated that tr eatment type continued to predict outcome even in the context of other pote ntially predictive variables. Conclusions: Despite the ETP emphasis on stimulants, both alcohol- and stim ulant-dependent men appeared to benefit, suggesting a generic improvement i n substance use.