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Type of hospital setting and treatment outcome with heroin addicts

Results from a randomised trial

Published online by Cambridge University Press:  03 January 2018

John Strang ,
Isaac Marks ,
Sharon Dawe ,
Jane Powell ,
Michael Gossop ,
David Richards  and
Jeffrey Gray
John Strang*
Affiliation:
National Addiction Centre, Institute of Psychiatry/The Maudsley
Isaac Marks
Affiliation:
Department of Psychiatry, Institute of Psychiatry/The Maudsley
Sharon Dawe
Affiliation:
Department of Psychology, Institute of Psychiatry
Jane Powell
Affiliation:
Department of Psychology, Institute of Psychiatry and Drug Unit, National Addiction Centre
Michael Gossop
Affiliation:
National Addiction Centre, Institute of Psychiatry/The Maudsley
David Richards
Affiliation:
Department of Psychology, Institute of Psychiatry
Jeffrey Gray
Affiliation:
Department of Psychology, Institute of Psychiatry
*
Professor John Strang, Addiction Sciences Building, 4 Windsor Walk, Denmark Hill, London SE5 8AF
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Abstract

Background

General psychiatrists have recently been encouraged to provide treatment to heroin addicts, including in-patient detoxification. No comparison has previously been made of specialist versus general psychiatric in-patient care.

Method

During a randomised study of cue exposure, 186 opiate addicts were also randomised to either specialist in-patient (DDU; n=115) or general psychiatric (GEN; n=71) wards in the same hospital.

Results

From pre-treatment (post-randomisation) onwards, patient outcomes differed across the two in-patient settings. Of the original randomised sample, significantly more DDU than GEN subjects accepted their randomisation (100 v. 77%), were subsequently admitted (60 v. 42%), and completed in-patient detoxification (45 v. 18%). Of patients admitted, more DDU than GEN patients completed detoxification (75 v. 43%). During seven-month follow-up, of those 43 patients who reached the end of treatment, significantly more ex-DDU than ex-GEN subjects were opiate-free.

Conclusions

From pre-treatment onwards, significant differences in process and outcome were found after allocation to treatment on either DDU or GEN. Further randomised studies are required to replicate and explain these findings.

Type
Papers
Information
The British Journal of Psychiatry , Volume 171 , Issue 4 , October 1997 , pp. 335 - 339
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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