TY - JOUR
T1 - Evaluating the impact of community-based treatment options on methamphetamine use: Findings from the Methamphetamine Treatment Evaluation Study (MATES)
AU - McKetin, Rebecca
AU - Najman, Jake
AU - Baker, Amanda
AU - Lubman, Dan
AU - Dawe, Sharon
AU - Ali, Robert
AU - Lee, Nicole
AU - Mattick, Richard
AU - Mamun, Abdullah
PY - 2012/11
Y1 - 2012/11
N2 - 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: Sydney and Brisbane, Australia. 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.
AB - 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: Sydney and Brisbane, Australia. 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.
KW - Amphetamine
KW - Crime
KW - HIV risk
KW - Longitudinal
KW - Methamphetamine
KW - Outcomes
KW - Psychiatric comorbidity
KW - Substance abuse
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=84867219650&partnerID=8YFLogxK
U2 - 10.1111/j.1360-0443.2012.03933.x
DO - 10.1111/j.1360-0443.2012.03933.x
M3 - Article
SN - 0965-2140
VL - 107
SP - 1998
EP - 2008
JO - Addiction
JF - Addiction
IS - 11
ER -