Factors associated with 12 months continuous heroin abstinence: findings from the Australian Treatment Outcome Study (ATOS)

Darke, Shane; Ross, Joanne; Teesson, Maree; Ali, Robert; Cooke, Richard; Ritter, Allison; Lynskey, Michael

doi:10.1016/j.jsat.2005.01.006

« Previous Next »Journal of Substance Abuse Treatment
Volume 28, Issue 3 , Pages 255-263, April 2005

Factors associated with 12 months continuous heroin abstinence: findings from the Australian Treatment Outcome Study (ATOS)

Shane Darke, Ph.D.
- National Drug and Alcohol Research Centre, University of New South Wales, NSW, Australia
- Corresponding author. National Drug and Alcohol Research Centre, University of New South Wales, NSW, 2052, Australia. Tel.: +1 61 2 9385 0333.
Joanne Ross, Ph.D.
- National Drug and Alcohol Research Centre, University of New South Wales, NSW, Australia
Maree Teesson, Ph.D.
- National Drug and Alcohol Research Centre, University of New South Wales, NSW, Australia
Robert Ali, M.B.B.S.
- Drug and Alcohol Services Council, South Australia, Australia
Richard Cooke, B.A. Hons
- Drug and Alcohol Services Council, South Australia, Australia
Allison Ritter, Ph.D.
- Turning Point Drug and Alcohol Service, Victoria, Australia
Michael Lynskey, Ph.D.
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA

Received 19 July 2004; received in revised form 10 December 2004; accepted 11 January 2005.

Abstract

Aims: To determine the role of treatment and client characteristics associated with the achievement of continuous heroin abstinence. Design: Longitudinal cohort study. Setting: Sydney and Adelaide, Australia. Participants: 570 heroin users re-interviewed at 12 month follow-up for the Australian Treatment Outcome Study (ATOS). Findings: Continuous heroin abstinence was reported by 14% of participants. Continuous abstinence was associated with no previous treatment history, having entered treatment at baseline, and cumulative treatment exposure over the follow-up period. Longer retention times in index maintenance and residential rehabilitation treatments, but not detoxifications, were most associated with abstinence. At baseline, abstinent participants were more likely to have been classified as treatment ready, or to have used heroin less frequently; and less likely to have been daily injectors, using cocaine or criminally involved. Conclusions: Approximately 14% of ATOS participants achieved continuous heroin abstinence over 12 months. Such an achievement was strongly associated with a longer “dose” of treatment, and with more treatment stability over the follow-up period.

Keywords: Heroin, Treatment, Abstinence, Longitudinal