The effect of a change in drug markets on drug-free treatment admissions, retention and program completion, 2003 to 2008

Objectives: To ascertain whether changes in the heroin and methamphetamine markets were associated with changes in the profile of admissions and completion rates of a drug-free residential rehabilitation admission. Methods: Admission and treatment completion data for 2519 clients admitted to a therapeutic community between 2003 and 2008 were analyzed. Results: There was a significant decrease in heroin as the principal drug of concern (33% to 19%) and a corresponding increase in the proportion of clients nominating methamphetamine as a primary drug problem (21% to 34%). Despite these changes, treatment completions remained stable, and length of stay increased. Methamphetamine dependence was not associated with either treatment completion or length of stay. There was a significant increase in the proportion of repeat admissions (13% to 24%), again unrelated to methamphetamine use. Conclusions: A major change in the case mix was observed, reflecting the broader methamphetamine epidemic. Despite this, treatment completion and retention were not adversely affected. Although community drug trends are dynamic, fundamental alterations in case mixes does not necessarily translate into major disruptions in treatment efficacy.