"I already stopped": abstinence prior to treatment

Aims. To determine pre-treatment abstinence rates among treatment seekers a nd identify factors associated with pre-treatment abstinence. To evaluate t he association between pre-treatment abstinence and subsequent outcome. Des ign. An observational study using data collected for a randomized, experime ntal design. Setting. Conducted with participants immediately after assessm ent for publicly funded substance abuse treatment at the King County Assess ment Center (KCAC) in Seattle. Participants. People referred for outpatient or inpatient treatment by KCAC who had illicit drug use in the previous 90 days (N = 565). Participants waited a median of 12 days (range = 0-108 day s) until either treatment entry or waiting-list dropout. Measurements. A mo dified Drug History Questionnaire quantified drug use at baseline, treatmen t entry or waiting-list dropout and 3 months later Other measurement method s: Stages of Change Readiness and Treatment Eagerness Scale, participant co nfidence ratings and KCAC chart review. Findings. Sample-wide, 45% of parti cipants reported abstinence from initial assessment to when they entered or failed to enter treatment. Higher rates of abstinence were associated with shorter waiting periods, less substance use prior to initial assessment an d higher scores on change readiness. Pre-treatment abstinence was nor assoc iated with either treatment entry or completion. There was a non-significan t trend towards less improvement in substance use with pre-treatment abstin ence, with the greatest effect observed for short waits. Conclusions. Parti cipants can become abstinent prior to treatment, but this is not a good pre dictor of treatment entry, completion or outcome. A decisional balance stra tegy may be a more productive use of client and treatment program energy.