Pathways to abstinence: Two-year follow-up data on 60 abstinent former opiate addicts who had been turned away from treatment

Structural changes in the organization of drug treatment services in the no rthwest of England during the early 80s provided a unique opportunity to st udy a group of opiate addicts who were turned away from treatment. This pap er reports on 60 opiate addicts who were abstinent at follow-up (2-3 years after their original referral). For the majority of subjects, any treatment received in the intervening period had been from a range of local, non-spe cialist treatment providers, including: general practices (n = 24) and loca l hospitals (n = 32). The subjects had also received assistance from non-st atutory agencies (n = 35). Informal sources of support were drawn upon in t he form of friends, family, and voluntary agencies. Social acceptance, lega l problems, financial difficulties, and imprisonment were frequently cited as motivational factors that led to abstinence. At follow-up, improvements were reported in personal relationships and family circumstances, although there was less progress in relation to employment, finances, and housing. I ncreased involvement with the criminal justice system was significantly ass ociated with a greater use of treatment services at follow-up. This paper p resents the treatment and non-treat ment pathways that led to abstinence am ongst this group of opiate addicts. It also points to the importance of inc luding non-treatment samples in evaluations of treatment interventions. Cop yright (C) 2000 S. Karger AG, Basel.