4.4 Article

Risky decision-making predicts short-term outcome of community but not residential treatment for opiate addiction. Implications for case management

期刊

DRUG AND ALCOHOL DEPENDENCE
卷 118, 期 1, 页码 12-18

出版社

ELSEVIER IRELAND LTD
DOI: 10.1016/j.drugalcdep.2011.02.015

关键词

Decision-making; Opiate; Outcome; Placement; Treatment; Predictors

资金

  1. NoCLoR (North Central London Research consortium)
  2. University College, London
  3. St. George's, University of London

向作者/读者索取更多资源

Background: Opiate addiction is associated with decision-making deficits and we previously showed that the extent of these impairments predicts aspects of treatment outcome. Here we aimed to establish whether measures of decision-making performance might be used to inform placement matching. Methods: Two groups of opiate dependent individuals, one receiving treatment in a community setting (n = 48) and one in a residential setting (n = 32) were administered computerised tests of decision-making, impulsivity and planning shortly after the beginning of treatment, to be followed up three months into each programme. Results: In the community sample, performance on the decision-making tasks at initial assessment predicted abstinence from illicit drugs at follow-up. In contrast, in the residential sample there was no relationship between decision-making and clinical outcome. Conclusions: Intact decision-making processes appear to be necessary for upholding a resolve to avoid taking drugs in a community setting, but the importance of these mechanisms may be attenuated in a residential treatment setting. The results support the placement matching hypothesis, suggesting that individuals with more prominent decision-making deficits may particularly benefit from treatment in a residential setting and from the inclusion of aspects of cognitive rehabilitation in their treatment programme. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

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