Drug Alc Depend 2006 83;2:174-180
One year outcomes for heroin dependence: Findings from the Australian Treatment Outcome Study (ATOS). Teesson M et al.
Dear Colleagues,
Professor Teesson and co-workers have performed yet another observational report of large numbers of heroin addicts one year after starting various forms of treatment (or no treatment - ref 1). Like the British "NTORS", the Australian "ATOS" (Australian Treatment Outcome Study) documents the most fundamental expectations of dependency treatment. Unlike the British study, Teesson's group also looked at 80 drug users who were not in treatment (initially) as a comparison group.
Just like Dole and Nyswander's work of 40 years ago, Teesson and colleagues found that a majority of subjects (52-65%) were abstinent at 12 months. They also found substantially less crime, risk taking behaviours and psychopathology in the 80% who could be contacted 12 months after entering a variety of drug and non-drug treatments.
Teesson is also an author on another related paper in an upcoming issue of D&A Dependence (ref 2) which looks at possible drug substitution or 'swapping' in the face of reduced heroin use during treatment. They find none. In fact the frequency of use for other opioids, cocaine, amphetamine and benzodiazepines was also uniformly lower when heroin use was also reduced in treatment (as part of the same ATOS). A recent Canadian report found similar positive findings with improvements in general health for patients: 91% one-year treatment retention rates with mean dose 90mg daily (ref 3).
Repeated studies like this would be unnecessary in other fields, but drug treatments, including detoxification units and harm reduction services, are constantly under threat. Hence such reports can help to defend addiction treatment from critics. Such studies also remind us of the dramatic benefits of treatment and the disastrous consequences when it is limited, inflexible or almost non-existent such as in Russia, Korea and some American states.
So, partly due to the intransigence of the few remaining Australian members of the "temperance league" more public money is spent on (and researchers' time devoted to) finding the same outcomes from established treatments helping in drug addiction. It should be no surprise that dependent patients in fact behave just like those with other diagnoses (eg. depression, hypertension, diabetes, etc): good treatment leads to good outcomes.
Comments by Andrew Byrne ..
Citations:
- Teesson M, Ross J, Darke S, Lynskey M, Ali R, Ritter A, Cooke R. One year outcomes for heroin dependence: Findings from the Australian Treatment Outcome Study (ATOS). Drug and Alcohol Dependence 2006 83;2:174-180
- Darke S, Williamson A, Ross J, Teesson M. Reductions in heroin use are not associated with increases in other drug use: 2-year findings from the Australian Treatment Outcome Study. Drug and Alcohol Dependence 2006 Article in Press accessed 4/6/06
- Villeneuve P, Challacombe L, Strike C, Myers T, Fischer B, Shore R, Hopkins S, Millson P. Change in health-related quality of life of opiate users in low-threshold methadone programs. Journal of Substance Use 2006 11;2:137-149
