Journal of Substance Abuse Treatment
Volume 14, Issue 6 , Pages 543-558, November 1997

Drug treatment careers A conceptual framework and existing research findings

  • Yih-Ing Hser, PhD

      Affiliations

    • Corresponding Author InformationRequests for reprints should be addressed to Yih-Ing Hser, PhD, UCLA Drug Abuse Research Center, 1100 Glendon Avenue, Suite 763, Los Angeles, CA 90024-3511.
    • Special thanks are due to Dr. Barry brown who provided valuable comments on an earlier version. The authors are appreciative to staff at the UCLA Drug Abuse Research Center for their supportive work.
  • ,
  • M.Douglas Anglin, PhD

      Affiliations

    • Special thanks are due to Dr. Barry brown who provided valuable comments on an earlier version. The authors are appreciative to staff at the UCLA Drug Abuse Research Center for their supportive work.
  • ,
  • Christine Grella, PhD

      Affiliations

    • Special thanks are due to Dr. Barry brown who provided valuable comments on an earlier version. The authors are appreciative to staff at the UCLA Drug Abuse Research Center for their supportive work.
  • ,
  • Douglas Longshore, PhD

      Affiliations

    • Special thanks are due to Dr. Barry brown who provided valuable comments on an earlier version. The authors are appreciative to staff at the UCLA Drug Abuse Research Center for their supportive work.
  • ,
  • Michael L. Prendergast, PhD

      Affiliations

    • Special thanks are due to Dr. Barry brown who provided valuable comments on an earlier version. The authors are appreciative to staff at the UCLA Drug Abuse Research Center for their supportive work.

Drug Abuse Research Center, Neuropsychiatric Institute, University of California, Los Angeles, CA, USA

Received 21 January 1997; accepted 4 April 1997.

Abstract 

While outcomes for any single intervention are important to determine, the long-term evaluation of multiple, sequential interventions is at least equally important. One strategy for examining this process is that of the treatment career. A treatment careers perspective applies a longitudinal dynamic approach to identify and understand key factors influencing the development of, and transitions in the course of, drug dependence and its treatment.

After presenting an overview of the treatment careers perspective, this paper reviews and discusses relevant research issues and findings on treatment seeking, utilization and resistance, entry and reentry, engagement and retention, client treatment matching, and outcomes. Key findings include high resistance to entering treatment by many drug users, late development of treatment careers relative to addiction and criminal careers, short durations of most treatment episodes, cumulative and facilitative effects of treatment experiences, and beneficial effects of matching clients to treatment. The treatment careers perspective provides a useful framework within which findings on drug treatment can be better integrated and critical issues can be identified for further research, leading to a better understanding of drug dependence and its treatment.

Keywords:  treatment careers, addiction careers, drug abuse treatment

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 Manuscript preparation was supported, in part, by the research grant P50DA07699 from the National Institute on Drug Abuse (NIDA). Drs. Hser and Anglin are also supported by the Research Scientist Development Award (K02DA00139, K02DA00146, respectively) from NIDA.

PII: S0740-5472(97)00016-0

Journal of Substance Abuse Treatment
Volume 14, Issue 6 , Pages 543-558, November 1997