National Drug Abuse Treatment Outcome Studies
The National Drug Abuse Treatment Outcome Studies (DATOS) was a 5-year collaborative research project, funded by the National Institute on Drug Abuse (NIDA) and based on essentially the same national treatment evaluation strategy developed by the IBR 25 years earlier as part of the DARP Project. It brought together four teams of scientists to explore separate but complementary research themes. As part of this initiative, the IBR team focused on issues of client retention and engagement in treatment, including the significance of selected client and program variables on retention, treatment process, and program compliance. Attention was given to problem severity and its interactions with treatment variables. Also, factors associated with client motivation for treatment and client perceptions of treatment were examined to better understand their impact on program retention.
The National Development and Research Institutes of North Carolina (NDRI-NC) team, with Dr. Robert L. Hubbard as Principal Investigator, examined issues involving the selection of treatment by drug users, including client needs, access to services, and support and impediments to treatment selections. In addition, NDRI-NC considered factors related to service delivery and client subtypes. UCLA’s Drug Abuse Research Center (Dr. M. Douglas Anglin, Principal Investigator) explored factors in the addiction and treatment careers of drug abusers that influence response to treatment, including the relationship of background variables and drug use histories on decisions to enter treatment. The UCLA team also tested models of the process of addiction (initiation, progression, cessation, and relapse) among treatment clients. The Services Research Branch at NIDA, with Dr. Bennett Fletcher serving as Principal Investigator, focused on issues significant to policy development including cost-benefit analyses, the changing nature of drug abuse treatment clients and the implications for treatment programming and services, and the relations of client economic conditions to treatment performance.
Within their identified research themes, DATOS investigators examined treatment process, retention, and outcome in relation to four variable domains identified as having particular significance for contemporary drug abuse treatment. These included HIV risk behaviors, cocaine use, psychiatric comorbidity, and criminal justice status and activity. Sequential waves of studies were undertaken to look deeper into these research themes and variable domains.
Core data for the DATOS project included client information from 10,010 admissions to 96 treatment programs between 1991 and 1993, representing outpatient methadone, outpatient drug free, long-term residential, and short-term inpatient services. One-year and 5-year posttreatment follow-ups with DATOS clients were reported in special journal issues (1 year, Drug and Alcohol Dependence and Psychology of Addictive Behaviors; 5-year, Journal of Substance Abuse Treatment). Additional research addressed during-treatment and 1-year posttreatment outcomes of adolescent DATOS clients, and has been reported in a special issue of Journal of Adolescent Research. Altogether, 88 papers were published from this third national treatment evaluation funded by NIDA.
Selected Publications
Boles, S. M., Joshi, V., Grella, C. E., & Wellisch, J. (2005). Childhood sexual abuse patterns, psychosocial correlates, and treatment outcomes among adults in drug abuse treatment. Journal of Child Sexual Abuse, 14(1), 39-55.
Handelsman, L., Stein, J. A., & Grella, C. E. (2005). Contrasting predictors of readiness for substance abuse treatment in adults and adolescents: A latent variable analysis of DATOS and DATOS-A participants. Drug and Alcohol Dependence, 80, 63-81.
Flynn, P. M., Joe, G. W., Broome, K. M., Simpson, D. D., & Brown, B. S. (2003). Looking back on cocaine dependence: Reasons for recovery. The American Journal on Addictions, 12(5), 398-411. [Abstract]
Flynn, P. M., Joe, G. W., Broome, K. M., Simpson, D. D., & Brown, B. S. (2003). Recovery from opioid addiction in DATOS. Journal of Substance Abuse Treatment, 25(3), 177-186. [Abstract]
Flynn, P. M., Porto, J. V., Rounds-Bryant, J. L., & Kristiansen, P. L. (2003). Costs and benefits of methadone treatment in DATOS – Part 1: Discharged versus continuing patients. Journal of Maintenance in the Addictions, 2(1/2), 129-149. [Abstract]
Flynn, P. M., Porto, J. V., Rounds-Bryant, J. L., & Kristiansen, P. L. (2003). Costs and benefits of methadone treatment in DATOS – Part 2: Gender differences for discharged and continuing patients. Journal of Maintenance in the Addictions, 2(1/2), 151-169. [Abstract]
Simpson, D. D. (Ed.). (2003). Special issue: 5-year follow-up treatment outcome studies in DATOS. Journal of Substance Abuse Treatment, 25(3).
Simpson, D. D., Joe, G. W., & Broome, K. M. (2002). A national 5-year follow-up of treatment outcomes for cocaine dependence. Archives of General Psychiatry, 59, 538-544. [Abstract]
Knight, K., Hiller, M. L., Broome, K. M., & Simpson, D. D. (2000). Legal pressure, treatment readiness, and engagement in long-term residential programs. Journal of Offender Rehabilitation, 31(1/2), 101-115. [Abstract]
Rowan-Szal, G. A., Joe, G. W., & Simpson, D. D. (2000). Treatment retention of crack and cocaine users in a national sample of long term residential clients. Addiction Research, 8(1), 51-64. [Abstract]
Broome, K. M., Flynn, P. M., & Simpson, D. D. (1999). Psychiatric comorbidity measures as predictors of retention in drug abuse treatment programs. Health Services Research, 34(3), 791-806. [Abstract]
Broome, K. M., Joe, G. W., & Simpson, D. D. (1999). HIV risk reduction in outpatient drug abuse treatment: Individual and geographic differences. AIDS Education and Prevention, 11(4), 293-306. [Abstract]
Simpson, D. D., Joe, G. W., Fletcher, B. W., Hubbard, R. L., & Anglin, M. D. (1999). A national evaluation of treatment outcomes for cocaine dependence. Archives of General Psychiatry, 56(6), 507-514. [Abstract]
Hiller, M. L., Knight, K., Broome, K. M., & Simpson, D. D. (1998). Legal pressure and treatment retention in a national sample of long-term residential programs. Criminal Justice and Behavior, 25(4), 463-481. [Abstract]
Joe, G. W., Simpson, D. D., & Broome, K. M. (1998). Effects of readiness for drug abuse treatment on client retention and assessment of process. Addiction, 93(8), 1177-1190. [Abstract]
Articles in Special Issue of Psychology of Addictive Behavior (1997, Vol. 11, No. 4),
D. Dwayne Simpson & Susan J. Curry (Issue Editors)
The Drug Abuse Treatment Outcome Study (DATOS): Treatment evaluation research in the United States. (Fletcher, B. W., Tims, F. M., & Brown, B. S.)
Methodological overview and research design for DATOS. (Flynn, P. M., Craddock, S. G., Hubbard, R. L., Anderson, J., & Etheridge, R. M.)
Treatment structure and program services in DATOS. (Etheridge, R. M., Hubbard, R. L., Anderson, J., Craddock, S. G., & Flynn, P. M.)
Overview of 1-year follow-up outcomes in DATOS. (Hubbard, R. L., Craddock, S. G., Flynn, P. M., Anderson, J., & Etheridge, R. M.)
Program diversity and treatment evaluation retention rates in DATOS. (Simpson, D. D., Joe, G. W., Broome, K. M., Hiller, M. L., Knight, K., & Rowan-Szal, G. A.) [Abstract]
Treatment retention and follow-up outcomes in DATOS. (Simpson, D. D., Joe, G. W., & Brown, B. S.) [Abstract]
Drug addiction and treatment careers among clients in DATOS. (Anglin, M. D., Hser, Y., & Grella, C. E.)
The National Treatment Outcome Research Study (NTORS) in the United Kingdom: 6-month follow-up outcomes. (Gossop, M., Marsden, J., Stewart, D., Edwards, C., Wilson, A., Segar, G., & Lehmann, P.)