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Type: Journal article
Title: Evaluating the impact of community-based treatment options on methamphetamine use: findings from the Methamphetamine Treatment Evaluation Study (MATES)
Author: McKetin, R.
Najman, J.
Baker, A.
Lubman, D.
Dawe, S.
Ali, R.
Lee, N.
Mattick, R.
Mamun, A.
Citation: Addiction, 2012; 107(11):1998-2008
Publisher: Blackwell Publishing Ltd
Issue Date: 2012
ISSN: 0965-2140
Statement of
Rebecca McKetin, Jake M. Najman, Amanda L. Baker, Dan I. Lubman, Sharon Dawe, Robert Ali, Nicole K. Lee, Richard P. Mattick and Abdullah Mamun
Abstract: AIMS: To evaluate the impact of community-based drug treatment on methamphetamine use using inverse probability of treatment-weighted (IPTW) estimators to derive treatment effects. DESIGN: A longitudinal prospective cohort study with follow-ups at 3 months, 1 year and 3 years. Treatment effects were derived by comparing groups at follow-up. IPTW estimators were used to adjust for pre-treatment differences between groups. SETTING: Sydney and Brisbane, Australia. PARTICIPANTS: Participants were methamphetamine users entering community-based detoxification (n = 112) or residential rehabilitation (n = 248) services and a quasi-control group of methamphetamine users (n = 101) recruited from the community. MEASUREMENTS: Frequency of methamphetamine use between interviews (no use, less than weekly, 1–2 days per week, 3+ days per week), continuous abstinence from methamphetamine use, past month methamphetamine use and methamphetamine dependence. FINDINGS: Detoxification did not reduce methamphetamine use at any follow-up relative to the quasi-control group. Relative to quasi-control and detoxification groups combined, residential rehabilitation produced large reductions in the frequency of methamphetamine use at 3 months [odds ratio (OR) = 0.23, 95% confidence interval (CI)0.15–0.36, P <0.001), with a marked attenuation of this effect at 1 year (OR 0.62, 95% CI 0.40–0.97, P = 0.038) and 3 years (OR = 0.71, 95% CI 0.42–1.19, P = 0.189). The greatest impact was for abstinence: for every 100 residential rehabilitation clients there was a gain of 33 being continuously abstinent at 3 months, with this falling to 14 at 1 year and 6 at 3 years. CONCLUSIONS: Community-based residential rehabilitation may produce a time-limited decrease in methamphetamine use, while detoxification alone does not appear to do so.
Keywords: Amphetamine
psychiatric comorbidity
substance abuse
HIV risk
Rights: © 2012 The Authors. Addiction © 2012 Society for the Study of Addiction
DOI: 10.1111/j.1360-0443.2012.03933.x
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