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Substance Abuse and Addiction Health Center

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Intensive Substance-Abuse Treatment Fails to Deliver Better Results: Study

But researcher isn't ready to give up on the multi-pronged approach


One expert thinks motivation is the key to any program to treat addiction. People who are motivated are most likely to start and stick with a program or join a clinical trial, said Dr. James Garbutt, a professor of psychiatry at the University of North Carolina at Chapel Hill.

"That's an important point because that's saying they already wanted to make some changes," Garbutt said. "That's a huge step in substance-abuse treatment."

This likely explains why people in both groups seemed to benefit, he said.

Chronic care management has been shown to be effective for chronic medical and mental-health conditions, including depression and tobacco dependence, Saitz said. This led him to believe it might work with drug and alcohol dependence.

To test that theory, the researchers recruited nearly 600 people suffering from drug or alcohol addiction and randomly assigned them to chronic care management or primary care and referral.

Those in the chronic care management group received a variety of on-site services coordinated with their primary medical care. These included motivational therapy, relapse-prevention counseling, addiction and psychiatric treatment, social work assistance, and referrals to drug- or alcohol-abuse programs. Addiction drugs also were prescribed if appropriate.

Patients received reminders, and care providers worked in collaboration with one another.

Those in the other group received a medical care visit, a list of addiction-treatment resources and a phone number for accessing motivational therapy sessions.

Although there was no difference in results between the groups, patients with alcohol dependence in the chronic care management group had fewer alcohol problems, the researchers said.

There were, however, no differences in the severity of addiction, health-related quality of life or drug problems between the groups, they said.

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