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Evaluating the impact of community‐based treatment options on methamphetamine use: findings from the M ethamphetamine T reatment E valuation S tudy ( MATES )
Author(s) -
McKetin Rebecca,
Najman Jake M.,
Baker Amanda L.,
Lubman Dan I.,
Dawe Sharon,
Ali Robert,
Lee Nicole K.,
Mattick Richard P.,
Mamun Abdullah
Publication year - 2012
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/j.1360-0443.2012.03933.x
Subject(s) - methamphetamine , abstinence , confidence interval , medicine , odds ratio , treatment and control groups , naltrexone , generalized estimating equation , cohort , psychology , demography , psychiatry , antagonist , statistics , receptor , mathematics , sociology
Aims To evaluate the impact of community‐based drug treatment on methamphetamine use using inverse probability of treatment‐weighted ( IPTW ) estimators to derive treatment effects. Design A longitudinal prospective cohort study with follow‐ups at 3 months, 1 year and 3 years. Treatment effects were derived by comparing groups at follow‐up. IPTW estimators were used to adjust for pre‐treatment differences between groups. Setting S ydney and B risbane, A ustralia. Participants Participants were methamphetamine users entering community‐based detoxification ( n = 112) or residential rehabilitation ( n = 248) services and a quasi‐control group of methamphetamine users ( n = 101) recruited from the community. Measurements Frequency of methamphetamine use between interviews (no use, less than weekly, 1–2 days per week, 3+ days per week), continuous abstinence from methamphetamine use, past month methamphetamine use and methamphetamine dependence. Findings Detoxification did not reduce methamphetamine use at any follow‐up relative to the quasi‐control group. Relative to quasi‐control and detoxification groups combined, residential rehabilitation produced large reductions in the frequency of methamphetamine use at 3 months [odds ratio ( OR ) = 0.23, 95% confidence interval ( CI ) 0.15–0.36, P < 0.001), with a marked attenuation of this effect at 1 year ( OR 0.62, 95% CI 0.40–0.97, P = 0.038) and 3 years ( OR = 0.71, 95% CI 0.42–1.19, P = 0.189). The greatest impact was for abstinence: for every 100 residential rehabilitation clients there was a gain of 33 being continuously abstinent at 3 months, with this falling to 14 at 1 year and 6 at 3 years. Conclusions Community‐based residential rehabilitation may produce a time‐limited decrease in methamphetamine use, while detoxification alone does not appear to do so.