Predictors of deterioration among patients with substance-use disorders

The purpose of this study was to identify patients with substance-use disorders who deteriorate during treatment, and to examine baseline predictors of deterioration. Three groups of 872 patients each, matched on number of problems at baseline, were selected from a larger sample based on their treatment outcome (improved, nonresponsive, deteriorated). Deterioration was predicted by younger age and African-American race; four aspects of patients' history (psychiatric symptoms, arrests, prior drug treatment, and recent inpatient or residential care); and having no close friends. Patients who had both an alcohol and a drug diagnosis, a personality-disorder diagnosis, and those who had a shorter episode of care and fewer outpatient-mental-health visits, also were more likely to deteriorate.